Dishing on Big Data: Information Exchange and the Future of Health Care

When it comes to life in the modern world, data reigns supreme. Whether you care to admit it—or even think about it—the fact is, you cannot escape the influence of data. And in some cases, that’s a good thing. No, I’m not talking about the discount offer for your favorite restaurant that suddenly appears on your Facebook news feed just minutes after you’ve perused the menu online—though that’s definitely a data benefit, too. In this article, though, I want to focus on the benefits of big data with respect to health care—in terms of cost, quality, and efficiency.

If you’re a healthcare provider, there’s a good chance you’re already helping lay the foundation for a very bright—and data-driven—healthcare future. That’s because the government and other healthcare stakeholders already have implemented a variety of programs and systems—like PQRS and ICD-10—aimed at promoting quality data collection. But this is just the tip of the iceberg. As the US continues to make strides toward achieving the healthcare “triple aim”—that is, the nationwide push toward better access, lower cost, and improved accountability in health care—providers can expect data to step into an even bigger role in the delivery of, and payment for, their services.

Of course, you can’t have a conversation about data without mentioning technology. To return to the food theme, if data is the basket full of raw ingredients, then technology is the oven that turns those ingredients into something useful (and delicious). And that’s where EMR comes into the picture—er, kitchen. Because in today’s healthcare landscape, EMR isn’t just a tool for documentation; it’s a means of participating in—and benefitting from—the collective effort to amass meaningful information that has the potential to:

  • foster evidence-based practice;
  • improve patient outcomes; and
  • uncover trends—both globally and regionally—that influence the efficacy of care.

But, for those things to happen, providers cannot use their EMR systems in isolation. More importantly, EMRs cannot be designed solely for isolated use. To stay relevant in a value-driven healthcare system, EMRs must allow for interoperability—that is, the ability for different systems and organizations to exchange information, and thus, work together for an overarching purpose. In a healthcare context, this means successful, seamless data transmission across all healthcare platforms. This allows a patient’s entire care team to have access to up-to-date information about the patient and his or her treatment progress—making care delivery much more efficient and effective. It has the potential to take care quality to a whole new level—not to mention reinforce physical therapy’s place on the overall care continuum.

So, if interoperability isn’t on your EMR vendor’s roadmap—or even its radar—then it might be time to explore other options. That said, the US, as a country, still has a few significant hurdles to overcome in the road to total interoperability. As this article explains, the architecture that currently exists is laden with “trouble spots” that lead to “errors, omissions, and variability that are impeding data exchange.” Even more concerning, though, are the barriers created by current laws—or lack thereof—that prevent this type of information exchange from happening at all. While most of those laws are designed with privacy and security in mind, they—like technology—must evolve to align with changing care delivery models and payment structures.

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In a perfect world, all healthcare stakeholders would have access to all of the information relevant to their various functions—from plan of care development to payment for services rendered. Getting to that “heathcare utopia” will take time; after all, Rome—like interoperability—wasn’t built in a day. Still, it’s important that physical therapists—and all other types of providers—prepare themselves for a world in which data is the main ingredient in the recipe for creating a stronger, healthier society.


4 Reasons You Should Use an EMR for Practice Management

When you think about your EMR, documentation might be the first thing that comes to mind. And while defensible documentation is crucial—and should be the main component of your EMR—there are other perks your software vendor can offer you. One of the most efficient, cost-effective options available through your EMR is a practice management suite. Think you already have your processes on lock? Even if you do, you can further streamline your business when you take advantage of all of the benefits your software offers.

As this InformationWeek article explains, “Ideally, EHR and practice management systems work together so that patient registrations become patient health records, and the diagnosis recorded into the EHR turns into a properly coded insurance claim.” Sounds pretty slick, right? If you aren’t convinced yet, here are five mission-critical practice management functions made oh-so-simple with an EMR:

1. Capture Patient Demographics

When a patient enters your clinic, you’ve likely gathered all of his or her demographics before the appointment. You’ve got names, numbers, insurance information, and addresses. But, where do you store it all? Are you leaving PHI in paper files on your front desk or in a filing cabinet—thus putting your practice at risk for a HIPAA violation?

The best way to collect—and store—patient demographics is by entering this information into your secure EMR. Your EMR should provide a patient intake form option. That way, you can be sure you’ve collected all the relevant information, confirmed that it’s up to date, and stored all of it in a secure, cloud-based system. And if you ever need to access any patient info, it’s just a few clicks away. No more digging through stacks of paper—or shuffling through filing cabinets—to locate your patient data.

2. Schedule Appointments

Just like those stacks of files, your appointment book shouldn’t be left to the whims the paper gods—and at risk for HIPAA violations, natural disasters, or misplacement. With the right EMR, you can easily schedule patients, color-code their appointments, manage multiple schedules, and even send automatic appointment reminders. You’ll save time and money when you let your EMR help you decrease no-shows through a seamless scheduling system.

3. Maintain Payer List

With an EMR, you can easily assign the appropriate payers to each of your patients, and it’s simple to keep a comprehensive list that’s available for updating at any moment. Plus, your EMR should offer documentation safeguards based on your payer list. For example, your Medicare patients should trigger certain documentation alerts. With the right EMR, you can control all of this within your payer settings.

4. Generate Reports

Your EMR contains a wealth of information, and when paired with your documentation, you can generate and analyze a number of metrics through easy-to-run reports. With a good EMR in place, you can track no-shows, provider productivity, completed documentation, and even PQRS progress. Running these reports regularly will give you true insight into your business.

5. Submit Clean Claims

The first step to submitting clean claims is creating clean documentation. Your EMR should already have that down pat. But, does your EMR automatically generate CPT codes that flow into your billing software or to your billing service? If not, it absolutely should. Dr. Heidi Jannenga explains in this article that using “a medical billing software or service that is integrated with your EMR means that demographic and billing data will be seamlessly transmitted from your documentation system to your billing company.” The more you can automate processes through your EMR, the more time—and effort—you can save doing routine tasks. And that, ultimately, allows you to spend more time doing what you love: helping patients.

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If you’re looking to improve your processes, look no further than your EMR’s practice management system. As this HealthIT.gov article simply states, “79% of providers report that with an EHR, their practice functions more efficiently.” Are you taking advantage of everything your EMR has to offer?


5 Reasons Why PTs Love Their Cloud-Based EMRs

Some physical therapy clinics seem to have it all together: documentation gets done in a flash, claims are processed—and reimbursed—with ease, and everyone’s up-to-speed on all the latest regulatory changes. Maybe they’re born with it—or maybe it’s their EMR. Great cloud-based EMRs are designed with PTs in mind; these systems help make running a clinic seem like a breeze. Here are the top five reasons why PTs love working with a cloud-based EMR:

1. Affordability

Thanks to the cloud, PTs no longer have to shell out big bucks upfront—or cover the recurring costs associated with manual updates and IT staff—to use server-based EMR systems. Plus, software-as-a-service (SaaS) EMR vendors typically offer month-to-month payment models, making a cloud-based EMR an even less risky investment—an especially crucial selling point for smaller practices. Plus, users of these systems can switch to another EMR at any time. Vendors know this, which means they’re dedicated to providing customers with the highest-quality products and support.

2. Support

Speaking of support, like your best friend (or a pint of ice cream), a good EMR vendor is there when you need it with top-notch customer service. Think you have to bust out a user manual or comb through compiled help files if you have issues during setup or implementation? Not with a cloud-based EMR that’s ready to assist you with how-to guides, extensive knowledge bases, and an expert support staff.

3. Ease-of-use

A great cloud-based EMR is simple, user-friendly, easily scalable, and flexible. PTs love that cloud-based EMR vendors provide constant software and compliance updates to improve the user experience. Some vendors even develop enhancements based on user suggestions. With cloud-based EMR systems, PTs never have to lift a finger to access the newest version of an application or waste time worrying about—or fixing—notes or claims that aren’t up to payers’ standards.

4. Security

When it comes to keeping your patient data safe and secure, never fear—cloud-based EMR is here. With bank-level security encryption, tough password guidelines, automatic data backups, audit trails, super-secure data centers, and specialized staff, cloud-based EMRs have your back (and your front, and your sides, and—you get the picture).

5. Accessibility

PTs enjoy the convenience of working with a truly cloud-based EMR, which can be accessed anytime, anywhere, from any browser, and on any Internet-enabled device (unlike those bulky server-based EMRs, which sit in your office like a bump on a log—and require downloads, installations, and manual upgrades).

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Cloud-based EMR vendors work hard behind the scenes to make documentation, billing, compliance, and practice management less of a hassle—and less of a hit to a clinic’s budget. But it’s not just about saving time and money (or wearing long-lasting makeup). A truly great EMR makes PTs feel all of the feels. Why? Because these features give PTs the freedom to get back to doing what they love most: helping patients.


6 Ways an EMR Keeps Your Data Safe from Hackers

Sadly, the Internet is full of folks looking to steal your personal information, and while most people probably are keenly aware of the need to protect their Social Security numbers (SSNs) and credit card accounts, many don’t realize that their medical identities also are vulnerable to hackers. According to NBC News, the Ponemon Institute estimates more than 2.3 million adult Americans have either been the victim of or know someone who has been a victim of medical identity theft during or before 2014. Even scarier? The institute’s fifth annual survey revealed that medical identity theft rose by 22% in 2014—and that rate shows no signs of slowing down. Forbes reports that in this year alone, three major health insurers—Anthem, Premera, and CareFirst—were hacked. These major data breaches exposed tens of millions of patient records, leaving those patients at risk for medical identity theft.

Using stolen patient information, criminals can fraudulently receive medical care—inherently altering victims’ medical records and racking up costly medical bills in those patients’ names. If you’re a medical provider, the responsibility of preventing data breaches—and the legal and financial consequences of failing to do so—is on you. But you aren’t in this fight alone. Here are several ways top-notch cloud-based EMR systems keep your patient data safe:

1. Bank-level security encryption

An industry standard, bank-level security encryption scrambles up your information (sort of like my breakfast this morning), so you can safely transmit it over the Internet using a cypher (i.e., an encryption algorithm)—like a 256-bit or better Secure Socket Layer (SSL)—and a cipher key. Furthermore, as this resource explains, “Data transmitted over an SSL connection cannot be tampered with or forged without the two parties becoming immediately aware of the tampering.”

2. Password guidelines

Password-protected access is a given for any technology company worth its salt, but your EMR also should have strict password guidelines to better protect your patient data. For extra security, look for the TRUSTe Certified Privacy badge on your EMR vendor’s website. To earn the privilege of displaying that badge, the EMR must:

  1. employ strict password guidelines that ensure complete login security, and
  2. feature unique password-protected access to ensure HIPAA compliance.

3. Automatic data backups

When was the last time you backed up your data? (Insert cricket noises.) Yeah, that’s what I thought. Not to worry: your EMR has your back. Armed with automatic data backups—with multiple replication processes to boot—your EMR will never lose your all-important patient data, even if you lose power or Internet connection.

4. An audit trail

This special feature helps discourage hackers—and fraud in general—by tracking user activity (criminals don’t want to get caught, after all). So long as providers keep it turned on, an audit trail maintains a chronological record of all attempts to access patient data. It records the data accessed, who accessed it, and when and from where it was accessed.

5. Specialized staff

Great customer service reps are hard to find, but when it comes to protecting your patients’ protected health information (PHI), the search is crucial. That’s why awesome EMR vendors take the time to hire and train staff who are well-versed in online security measures and at the ready to provide you with their expertise.

6. Data centers

To ensure HIPAA compliance, the best EMRs house all their—and thus, your—data at state-of-the-art data centers. These data centers must possess bank-level security and supreme encryption methods that render data unreadable—even if hackers somehow get to it. WebPT, for example, stores all of its data at IO Data Center, a Tier III-Certified facility that provides multiple layers of access control, including a defensible perimeter, video surveillance, biometric screening, and round-the­-clock security guards.

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Often, the victims of medical identity theft remain unaware of the crime for months—or even years. Upon discovery, victims usually have a difficult time determining how it happened, and they often struggle to undo the damage. Make sure your patients don’t fall victim to medical identity theft. Web-based physical therapy software vendors—specifically, those that built their systems from scratch with the Internet in mind—are your practice’s best defense against cyber attackers.


4 Reasons You’ll Need an EMR for Pay-for-Performance

There’s no stopping payment reform, and no matter how tightly you cling to the fee-for-service structures you know—and, um, love?—you can’t slow the nationwide transition to a pay-for-performance environment. And it should come as no surprise that the move toward innovative payment structures goes hand-in-hand with the push for widespread adoption of innovative healthcare technologies, including electronic medical records (EMRs). But while federal initiatives—like the meaningful use program—have ushered medical professionals in other specialties into the technological age, physical therapists have, by and large, been left to fend for themselves on the EMR front. And if you’re a PT who hasn’t yet jumped on the EMR bandwagon, the pay-for-performance movement might be exactly the nudge you need to take the leap. Here’s why:

1. Outcomes tracking is crucial to proving your value as a healthcare provider.

In a pay-for-performance world, getting paid for your services hinges on your ability to objectively prove the effectiveness of those services. And that means introducing—or ramping up—outcomes data-collection efforts within your practice. The easiest way to do that? Implement an EMR with built-in outcomes tracking functionality. That way, you can easily complete outcome measurement tools directly within the patient record. If your EMR system is really on top of its game, it also will offer functionality that allows you to analyze your data in a way that produces real, meaningful insight—the kind that will go a long way toward ensuring you get the payments you deserve.

2. The more data PTs can collectively amass, the more powerful that information becomes.

For the PT industry to assert the value of physical therapy services on a grander scale—thus ensuring consistently high payment rates across the board—individual providers must coordinate their data-collection efforts. That means:

  1. using a standardized set of tools that the entire medical community—regardless of specialty—can recognize and understand, and
  2. entering data into a national—or even international—registry or repository.

After all, the larger—and more geographically diverse—the data is, the more authoritative it appears to payers and policymakers.

3. The dream of creating a national PT data registry probably won’t come to fruition without EMR integration.

The APTA has been working on creating a national data registry for a while now, and although the association’s head is definitely in the right place, the question remains: “How will the data get from individual providers to the registry?” As it stands, the answer to that question is that providers will have to manually enter their data into the registry—and as we all know, data-entry takes time. Many PTs are already so bogged down by administrative burdens that the mere thought of having to add one more item to the list is enough to outweigh the perceived benefit of having access to such a powerful data set. That’s why it’ll probably take an integrated solution—one in which patient outcomes data flows seamlessly from the EMR to the larger repository—to make the industry’s vision for a national registry actually happen.

4. Interoperability is crucial to care coordination, and web-based EMRs are crucial to interoperability.

For PTs to thrive in the coming era of pay-for-performance, they’ll need to step up and own their roles as care coordinators. But when you take on the responsibility of serving as a patient’s first point of medical contact, you also become responsible for guiding that patient’s journey through the care continuum. That means collaborating with your peers in other specialties to ensure the patient receives the best—and most appropriate—care possible, thus ensuring the best possible treatment outcome. But that kind of collaboration can’t happen—at least not in an organized, efficient manner—without patient records systems that talk to each other. Because for teams of providers to truly function as teams, each “player” must be able to access the most updated version of a patient’s medical record in real time. So, as you explore your web-based EMR options, make sure you look for a system that has interoperability on its roadmap.

There’s no way to sugar-coat it: pay-for-performance is going to have a massive impact on how—and how much—physical therapists get paid for their services. But with the right EMR by your side, the transition to value-based payment could actually benefit your practice.


Four Web-Based EMR Myths Exposed

Spend enough time scrolling through Facebook, perusing magazine headlines in the grocery store checkout line, or catching snippets of daytime television in the waiting room, and you’re bound to get a healthy dose of gossip. Typically, we assume that the grapevine babble stops with Miley Cyrus just being Miley or politicians getting caught doing smarmy things. In reality, though, rumors swirl everywhere—even within the healthcare industry. Take web-based EMR for example. Do you know the myths from the truth?

Myth: The Internet’s not secure enough to keep my important data safe.

Truth: With so much at stake, data security should be one of your top priorities—but don’t write off the Internet just yet. As Power Your Practice points out, web-based EMR systems “store data in high-level storage centers with bank-level security and a minimum of 128-bit encryption methods, per HIPAA’s standards.” Consider WebPT: We store data at IO Data Center, a Tier III-Certified facility that provides multiple layers of access control, including a defensible perimeter, video surveillance, and round-the­-clock security guards.

Paper storage certainly doesn’t offer that, but what about server-based EMRs? Well, if it’s under your desk or in a room in your office, I bet not. And that means you—and your patients—could be at risk. Just think about what could happen in a natural disaster. If your data is stored offsite, in the cloud, with multiple failsafes and backups, it will remain safe and secure. You’ll be able to get back to work as soon as you’re ready—exactly where you left off. What about theft? Whereas IO has 24/7/forever guard protection, your clinic probably doesn’t. WebPT currently holds 27 million patient records in the the cloud, and we’ve never lost a single one.

I could prattle on for several more paragraphs about how any web-based EMR worth its salt is far more secure than the server-based systems of yesteryear. Instead, I’ll refer you to this super awesome blog post I wrote about the security and compliance of web-based vs. server-based software.

Myth: Cloud-based systems go down—a lot.

Truth: System-wide downtime in a web­-based EMR should be a very rare occurrence. WebPT, for example, boasts over 99% uptime. Downtime for site maintenance is scheduled ahead of time during low-use hours, and Members always receive plenty of advance notice. There’s a lot of chatter out there about the threat of downtime with web-based applications, but oftentimes such problems are actually the result of issues with individual Internet providers. In that case, you can easily prevent outages with the installation of a backup Internet solution, such as a mobile hotspot device. Lastly, Internet speeds today are more than fast enough for your web-based EMR needs. (And remember, server-based or web-enabled systems often require Internet connections, too.)

Myth: Learning a new system is just too hard.

Truth: Contrary to popular belief, you can teach old (or change-resistant) practitioners new tricks. As Healthcare IT News reports, “although there is an initial learning curve during the EMR adoption process, an easy-to-use EMR can significantly improve workflows once [it’s] fully implemented.” We here at WebPT, for example, we routinely get new clinics up and running (with training) in a matter of days. Most new Members learn our application in a virtual meeting environment; however, we do offer onsite training as well, which might be convenient if you have a lot of employees who all need to learn the new system at once. Ultimately, no practice-wide change comes without a period of workforce adjustment. In the long run, though, you’ll recover any losses you incur due to transitional hiccups (see the next myth). Furthermore, if you’re considering retiring, selling, or changing hands at your practice, switching to EMR sets your clinic up for future success and an easier transition, says Healthcare IT News.

Myth: Switching to web-based EMR is expensive.

Truth: Some EMRs are expensive—and that goes for both server- and cloud-based systems. However, the best web-based EMRs cost merely a fraction of what server-based systems charge. Why? Because web-based options typically charge low month-to-month costs and require neither a contract nor a hefty upfront investment. Server-based systems, on the other hand, typically require a lot of upfront costs, including hardware purchases or upgrades and software installation. There are also recurring costs to consider, such as hiring new employees, conducting training, and replacing, repairing, or adding to your hardware.

I know I mentioned that web-based EMRs can be expensive, too. The key is to look for truly web-based (not web-enabled) software. True web-based EMRs charge per user, whereas web-enabled either employ the pricing structures of their server-based forebearers (contracts, hefty upfront investments, maintenance fees, etc.) or employ cost-per-chart pricing. You’re probably focused on growing your business, but that’s tough to do in a per-chart pricing structure where you pay more money for every patient you add. In my book, your EMR should work for you and your business, not the other way around.

Now, you may be thinking that paper is more cost-effective than EMR. That’s another myth. (Just think how quickly the costs of copying, transporting, and storing paper records add up.) Check out these myth-busting stats from DSSI:

  • One four-drawer file cabinet holds 15K-20K of pages, costs $25,000 to fill, and costs $2,000 per year to maintain.
  • The US spends $25-35 billion annually on filing, storing, and retrieving paper.
  • It costs $20 to file a document and $120 to track down a misfiled document (if you can find it).

Still not convinced? According to this article, it costs about $8 per year to maintain a paper record, compared to $2 to maintain an electronic record. Multiply that by hundreds of patients, and the case for EMR becomes pretty clear. Plus, with no need to spend precious minutes digging around for patient files, you’ll save in labor costs and free up more time to see patients—a double dose of increased efficiency.


Now that we’ve busted these web-based EMR myths, we can return to guessing which celebrities are now dating. In all seriousness, though, it’s important that private practice PTs wade through the hearsay, so they can make educated decisions about the tools they use. After all, decreases in reimbursements, increases in regulatory changes, and intensifying competition definitely aren’t rumors, and neither is this: Web-based EMRs can sincerely help you not only be better in business, but also stay compliant and craft clean, detailed, and defensible documentation.


What Twitter Can Teach You About EMR

By now you probably know that Twitter is great for communicating with potential customers and creating a public voice for your practice, but did you know that you also can use this social media platform as a real-time news source and learning tool? You can search using hashtags or relevant keywords to pull up all sorts of wonderful information—everything from 140-character op-eds and inspirational stories to advice from the experts and links to the biggest news sources around the world. So what can Twitter teach you about electronic medical record (EMR) systems? Let’s find out.

Adoption statistics:

Benefits:

New news sources:

The future of EMR:

What patients want:

Advice for finding the right vendor:

EMR on an international scale:

Challenges with generalist solutions:

Wondering what else Twitter can teach you? Try using one of these eight top trending healthcare hashtags (according to Leading Reach):

  1. #mhealth (mobile health)
  2. #HITsm (health information technology social media)
  3. #HealthIT (health information technology)
  4. #hcsm (healthcare social media)
  5. #patientengagement
  6. #digitalhealth
  7. #EMR (electronic medical record)
  8. #EHR (electronic health record)