Why a Lack of Outcomes Tracking is an EMR Dealbreaker

If you’ve been searching for a while, you probably know that a cloud-based, therapy-specific EMR solution is the way to go. You also might appreciate the importance of added benefits like built-in compliance safeguards and ICD-10 coding capabilities, billing and RCM services, and comprehensive scheduling and business reporting functionality. But, there’s one more factor you should be considering—the rehab therapy software X-factor, so to speak: outcomes tracking.

Why is outcomes tracking such a big deal? Well, at the patient level, measuring progress has always been integral to providing the best possible care. Otherwise, it’s tough to know whether the treatment you’re providing is actually working. But, with the advent of technology, PTs and OTs now have the opportunity to leverage the information they record on a larger scale—one that’ll help move the entire profession forward and ensure rehab therapists survive and, more importantly, thrive in the face of a rapidly changing healthcare payment landscape.

Now, the word “data” often carries a negative connotation, especially in the rehab therapy world. That’s because historically, payers have been the owners of that data—which means they’ve used it to justify reduced payments for physical therapy services. But now that therapists have the power to compile their own data, they have a chance to tip the scale in their favor—if they track that data in the right way, that is.

Healthcare reform initiatives are pushing all providers—rehab therapists included—to deliver higher quality care at a lower cost, all while achieving higher levels of patient satisfaction. It’s the so-called triple aim, and it’s the driving force behind the industry-wide shift to value-based payment methodologies. Soon, the outcomes your patients achieve will have a direct impact on the amount of payment you receive. And you can help make that impact a positive one by:

  • Tracking your own outcomes data—rather than leaving yourself beholden to the data payers bring to the negotiation table.
  • Using an outcomes tracking platform that will help you compile and analyze that information in a way that’s digestible and meaningful.
  • Supporting your case for higher payment rates with results that are applicable across the entire healthcare spectrum (i.e., by using outcome measurement tools that are specialty-agnostic).

Now, the term “data” might conjure up not-so-rosy visions of complex formulas and spreadsheets. In reality, though, you’re probably already halfway to the data collection finish line—and you might not even know it. Because if you use outcome measurement tools to assess patient progress, then you are, in fact, collecting data. So, why not put that information to use beyond your clinic walls?

Here’s another tidbit you might not know: there are EMR solutions out there that allow you to complete—and track the results of—outcome measurement tools directly within your documentation. These platforms even generate easy-to-read reports that tell you how your clinic is performing at the individual therapist level, at the regional level, and even at the national level. This allows you to assess and fine-tune your own clinical processes and approaches to ensure you’re always providing the best possible care. More than that, though, it allows you to prove your value to payers, referring providers, and healthcare consumers using cold, hard facts.

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So, if you’re in the market for a new EMR—or if you’re simply evaluating your current one—integrated outcomes tracking capability certainly should be one of the boxes on your checklist. That way, you can be sure your EMR isn’t just your practice’s Mr./Ms. Right Now—but its forever soulmate.


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 Tips for Improving Patient Wait Times

Physical therapy treatment plans are designed to help people get back on their feet, yet your patients may find themselves doing a whole lot of the opposite when they’re at your clinic. Even the best physical therapy practices can experience long wait times now and then, but that can lead to patient dissatisfaction—and a lot of negative online reviews. Although your practice might not be the PT equivalent of the DMV, your patients will invariably spend at least a few minutes in your waiting room, so here are four tips to improve your wait times:

1. Collect patient feedback.

The first step toward improving your wait times is to understand exactly why your patients have to wait. Your gut may tell you to simply hire extra front office staff, but that might not be your most effective option for shortening patient wait time (and it’s certainly not the most cost-effective choice, either). So, talk to your patients, whether that’s through open and honest conversations or anonymous patient surveys. Once you know where your practice falls short, you can make improvements in those areas.

2. Rethink the space.

The above-mentioned patient surveys are a great way to discover what your patients dislike most about their wait (other than the wait itself, of course). That front office water feature you installed to help patients relax? Yeah, they may secretly want to throw it through a window to make the bubbling just stop already (and now that you mention it, where’s the bathroom?). So, consider how temperature, sound, lighting, color, and even the comfort of your chairs impact the environment in your waiting room. Think about it this way: if you’re in for a long flight, you’d be a lot more comfortable in first class than you would be in coach, right? Your patients feel the same way about sitting in stiff, armless chairs with no padding; trade up for something a little cushier.

3. Acknowledge the wait.

Have you ever noticed that the drive to somewhere always seems longer than the drive back? Similarly, if your patients don’t know how long they have to wait—or why—then their wait will seem much longer than it really is. To avoid that, you’ll need to acknowledge the wait time in two ways. First, set expectations by informing patients of your average wait time when they schedule their appointments. Second, if the wait time is longer on the day of a patient’s appointment, you should apologize, explain what caused the delay, and keep the patient updated during the wait. Your time is valuable, but be sure your patients know their time is valuable, too.

4. Use an EMR.

Is your practice having trouble scheduling and managing patient appointments? Patients showing up late and throwing off your whole day’s schedule? That’s where an EMR can help. WebPT, for example, allows you to easily view and edit schedules for your patients, therapists, and treatment rooms. Plus, you can automatically send appointment reminders so patients show up on time.  

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Of course, the best tip for improving the patient wait time is to keep it as short as possible. In fact, it’s possible to eliminate the waiting—and the waiting room itself—almost completely, like this practice did. But for the days when emergencies, flat tires, and bad traffic make staying on schedule an impossible task, strive to keep your patients comfortable and informed. The road to recovery for your patients can be grueling, but their wait time at your clinic shouldn’t be.


5 PT Industry Predictions for 2015

I’m no fortune teller; I don’t have a crystal ball, and I can’t see into the future. But like a good sports analyst or meteorologist, I can make some educated hypotheses. And while I definitely couldn’t tell you who’s going to win the Super Bowl next month—or what the weather will be like at kick-off—I’m pretty confident about these five predictions of the topics and trends that will have the biggest impact on the physical therapy community in 2015:

1. Outcomes

The healthcare industry is changing, and in the never-ending quest to control costs while simultaneously elevating the quality of care patients receive, outcomes have emerged as a vital component of the pay-for-performance reimbursement models many payers are embracing.

For physical therapists, outcomes have traditionally provided a mechanism for staying ahead of the game—for gaining a competitive edge in insurance contract negotiations and referral marketing efforts. As we enter 2015, however, outcomes are fast becoming necessary to merely stay in the game. To truly capitalize on our strengths—and own our roles—as healthcare providers in the current medical landscape, PTs must be able to objectively demonstrate the effectiveness of their care.

You all know how amazing you are; you witness incredible outcomes in your clinics every day. But physicians and insurance companies can’t see those results firsthand; they can’t experience the human impact of what you do. What they can see, though, are the numbers representing those results, and in our increasingly data-driven society, that information holds a lot of weight. Additionally, outcomes tracking allows practices to assess clinical team performance through benchmarking. Practice owners and directors can then use that data to make informed business decisions, enabling them to better manage their therapists and their practices as a whole. After all, you can’t manage what you don’t measure.

2. Consolidation

The therapy industry has changed a lot in the last couple of decades. Back when I first started practicing—almost 20 years ago—it was all about the big dogs. Then the economy did a 180, and things started breaking up. At that point, independent private practice clinics stepped into the spotlight, which did wonders in the patient care department. But now, with ever-increasing regulations and declining reimbursements, consolidation is making a comeback. Faced with shrinking profit margins—but not wanting to close their doors for good—many clinic owners are considering joining forces with larger practices that have the business resources necessary to contend with the market forces working against them. And while, according to this report from Harris Williams & Co., smaller, independently-owned practices still account for about 45% of the physical therapy market, many of those businesses are having a tough time expanding “outside of their local footprint due to underdeveloped referral sources and infrastructure.”

So, while I think we’re probably going to see a swing back to a less-fragmented landscape—a return of the big dogs, if you will—I also believe that this time around, things will be a lot different. Why? Well, most importantly, the people at the helm of these large practices are PTs—rather than hired CEO guns. So unlike the private equity-owned, HMO-driven mega-corporations of the past, these owners don’t see patients as just dollar signs. In 2015, I foresee a lot of PT businesses partnering, consolidating, buying in, and taking on private equity funding. And all of that means that influential, business-minded PTs—specifically, some key heavy-hitters in our industry—will maintain the power.

In my book, change is inevitable, and we here at WebPT support industry changes —so long as PTs have the final say over what happens in our profession, and so long as those in this industry make decisions that increase our clout, respect, and autonomy within the healthcare community.

3. ICD-10

Try as they might, ICD-10 resistors aren’t gaining any ground in their efforts to further delay the implementation of these diagnosis codes. And while we may see some additional efforts to put off the inevitable—particularly in conjunction with the SGR fix legislation that likely will come around (again) in March—I truly believe that the switch to ICD-10 will occur October 1, 2015. What does that mean for you and your practice? If you haven’t already started preparing for the transition, then now’s the time to get going. I recommend checking out the resources on ICD10forPT.com. There’s a good deal that goes into getting ICD-10-ready, from learning the new code structure and ensuring the readiness of your vendors to evaluating your staffing needs and preparing for reimbursement delays.

4. EMR Switches

According to Robocop, Back to the Future 2, and The 6th Day, the year 2015 was supposed to feature cyborg police officers, hoverboards, and successful human cloning. Disappointingly, many of us in the healthcare industry instead will start this year with a strong desire to turn our backs on technology—and throw our computers out the window. Why? Well, the majority of our industry has switched from paper charting to EMR documentation, and while we certainly aren’t living in a Robocop-esque dystopian society, many PTs’ EMRs make them feel like they are. That’s why I envision 2015 to be the year of EMR-switching. Ultimately, there’s no reason for any PT to stay stuck in time with his or her lemon of an EMR, because believe it or not, there actually are great EMR systems out there—and there’s nothing fictitious about that science. And in 2015, PTs will go out and find them.

5. The Rise of the Patient

Back in the old days, getting more patients meant you had to get more physician referrals. And while doctors are still an important source of new business for physical therapists, patients are increasingly taking their health into their own hands. Because in this day and age, researching symptoms and vetting treatment options is as easy as hitting your Enter key. With that kind of power, patients no longer have to consult with their primary care providers to learn how physical therapy can help them. And with direct access to therapy services rapidly shifting from being the exception to being the rule—thanks to legislation passed last year, some form of direct access to physical therapy now exists in all 50 states—I predict that in 2015, we will really start to see a deviation from the traditional patient path to PT.

As physical therapists, we’re all about progress—and based on my predictions for 2015, we’re going to see plenty of progress in our industry over the next 12 months. Of course, there will be plenty of challenges, too. But although we might have to break a few tackles, if we keep playing tough—if we can we continue to move the ball down the field—we’ll score some major points this year.


Give Yourself the Gift of EMR

The traditional gift-giving holidays are all behind us now—even Cupid has holstered his bow and arrow—but that doesn’t mean you can’t treat yourself to something really nice just because. Give yourself the gift of EMR this spring, and say goodbye to writing, filing, and lugging paper charts—a pain, whatever the season. And that’s not all. With the right EMR, you’ll get these other great gifts that just keep on giving, too:

Legible, Accessible, and Defensible Documentation

All physicians must transition to EMR by 2014, and there’s a reason for that: compared to paper charting, EMRs are better able to provide the medical community as a whole with legible, accessible, and defensible documentation. And that’s important for both patients and providers, especially as we continue to move further into this pay-for-performance, regulation-heavy healthcare environment. With an EMR, your documentation will better tell your and your patients’ stories. And you’ll never again have to sort through another towering stack of filing cabinets in search of a certain note, only to find that you can no longer read the chicken scratch that once passed for handwriting.

A Partner in Compliance

Each reporting regulation has its own unique—and often messy—set of requirements, but with the right EMR,  you’ve got a partner in compliance. Instead of stressing about all the hard-to-keep-straight details—like those for PQRS, functional limitation reporting, the 8-minute rule, and the therapy cap—you need only follow the built-in prompts and alerts to complete the requirements for the right patients, every time. Plus, your EMR can help you manage the transition to ICD-10.

Unmatched Safety and Security

Choose a cloud-based EMR, and your patient data will be safe and secure—always. You’ll have all the perks of the world’s leading data centers—like protection from natural disasters, digital video surveillance, biometric screening, and round-the-clock guards—and none of the cost or responsibility.

A Leg-Up on the Competition

For most physical therapists, referrals make up a large part of new business. With an EMR, you can maximize those referrals by tracking how many you receive and from whom. It’s a great way to identify those in your network who need a little more attention and those who deserve a big “thank you.” With an EMR, you can also display your clinic’s logo on all of your digital documents, so every note you send is a reminder to prospective referrers of your skills and professionalism. Talk about a big leg-up.

Now’s the perfect time to nix perilous paper—think of it as an extension of your annual spring cleaning—and make 2014 a year to remember with the best gift you, your clinic, and all the trees of the world could ask for: EMR.


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.