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’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.


4 Reasons Why You’ll Need an EMR for ICD-10

With the switch to ICD-10 looming on the horizon, many healthcare providers are searching for a catch-all solution to ensure a smooth, snag-free transition. As this article points out, while there’s really no “magic bullet” for ICD-10, adopting an electronic medical record (EMR) will definitely help ease some of the pain associated with implementing this new diagnosis code set. In fact, the thought of tackling ICD-10 without an EMR is close to inconceivable. Here’s why:

1. It will be your life preserver in a sea of new codes. If you’re overwhelmed by the sheer number of codes included in ICD-10, you’re not alone. To give you an idea of the scope, there are more than 68,000 ICD-10 diagnosis codes and 72,000 procedural codes. For comparison, ICD-9 has 13,000 diagnosis codes and 4,000 procedural ones. Add to that a complete overhaul of the actual code structure—ICD-10 codes contain up to seven characters, whereas ICD-9 codes only contain up to five—and you’ve got a recipe for a serious panic attack. But if you have the right EMR, you can breathe easy—or at least easier. Good EMRs feature built-in intelligence to help you select diagnosis codes based on the information you’ve recorded in your documentation. That way, you don’t have to thumb through hundreds and hundreds of pages of diagnosis codes to find the one you’re looking for.

2. It will ensure you code as specifically as possible. In addition to helping you find the right code for each diagnosis, an EMR also will prompt you to code to the greatest possible level of specificity. For example, as explained in this blog post, some diagnosis codes require a related external cause code to indicate the origin of a patient’s injury or condition. These codes do not exist within ICD-9, so remembering to add them might prove difficult at first—unless you have an EMR that remembers for you. And with everything else you’ve got on your plate, that peace of mind could be huge—especially considering that payers will come to expect this information to be readily available on patient claims.

3. It’s a big piece of the interoperability puzzle. In their quest to increase the efficiency and quality of patient care in all specialties, healthcare leaders all over the world have pushed for a medical landscape with fast, seamless information exchange—a.k.a. interoperability—across all healthcare platforms. The global move toward ICD-10 represents a huge part of this initiative as it allows for uniform coding of complex information, thus making the resulting data easier to share. But true interoperability cannot exist without effective communication and adequate technology—and that’s where EMR comes into the picture. In this day and age, it would be nearly impossible to achieve constant interconnectivity and communication across all healthcare providers without across-the-board implementation of secure, portable, cloud-based EMR systems.

4. It will allow you to focus on what truly matters—your patients. The magnitude of the transition to ICD-10 could easily pull your attention away from your ultimate goal of providing exceptional care to each and every patient. But with an EMR, you’ll have a partner to tackle some of the tedious code selection stuff so you’ll have the bandwidth to handle bigger-ticket tasks—like helping your patients achieve amazing outcomes through therapy.

So, before you pull your hair out over this whole ICD-10 switch, be sure your practice has all of the tools necessary to make the transition as painless as possible—chief among them: an EMR.