How Easy is it to Switch EMRs—Really?

If your current electronic medical record isn’t pulling its weight for your clinic, you may be wishing for a better one. However, switching EMRs isn’t nearly as easy as switching shops for your morning cup of coffee. You’ve invested time and money—in some cases, a lot of both—into your current system, so leaving could be more hassle than it’s worth. But it doesn’t have to be, because if you’re switching to the right EMR for your clinic, your new partner will do everything in its power to make your transition smooth, simple, and—dare we say—easy. Plus, once you’ve experienced the incredible benefits of a top-notch EMR, you’ll wonder why you didn’t make the leap sooner (even if it takes a little work to get there).

So, how easy is it to switch EMRs—really? Well, that depends on both your current EMR and your future one. Here are some things to think about:

The Contract

If you’re under contract with your existing EMR, it’s time to dust off the old paperwork and read the fine print. Before making any decisions, you should know what you’ve already committed to and what penalties you may face for terminating that contract early. When weighing the pros and cons of making a switch, consider this: whatever consequences you may face for leaving, you will most definitely make up in the benefits of finding a system that actually works for your clinic. There aren’t enough fees in the world that should keep you tethered to a software that’s making your life a living you-know-what.

Plus, the best EMRs don’t keep you under contract. They make their products so good that their customers want to keep using them. And if for some reason their system is not the best fit, they’d rather their customers have the freedom to find a partner who is.

The Data

Some EMRs on the market right now—we won’t name names—believe that in order to keep their customers loyal to them, they have to hold said customers’ data hostage. If your current EMR won’t give you back your data, you may have to devote some time to manually transferring your clinic’s information into a format you can upload into your new system. While that may seem somewhat daunting—and will be a bit time-consuming—the alternative is to stay beholden to a company that’s manipulating you. In this case, the data isn’t the only thing being held hostage.

Break free, and switch to a system that safely secures your data on your behalf with absolutely no absurd notions about who retains ownership rights: you do, obviously. That means you can take your data with you anytime you please.

The Learning Curve

When switching to a new EMR, there’s bound to be a learning curve as you and your staff get used to the new system. However, if you choose an easy-to-use and intuitive system, that curve will be anything but steep. You can make it even easier to get up and running on your new EMR if that new system offers in-depth, instructor-led training for your entire staff; an intuitive online training tool that you and your staff can consult whenever you need a refresher on a particular feature or function; and lifetime access to a super-knowledgeable, super-friendly Support team—all at no extra charge.

The Overwhelming Benefits of a Good EMR

Even if the road to your new EMR isn’t bump-free, you’ll be thrilled when you get there, because the best EMRs offer a ton of great benefits, including:

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As the saying goes, nothing worth doing is ever easy. And that certainly applies to changing EMRs. But, with a little planning and forethought, making the switch doesn’t have to be nearly as difficult as you might have thought—and the benefits far outweigh the cost. Switching sounds pretty good right about now, doesn’t it?


Why You Need an EMR for PQRS

Every November, Medicare releases its Final Rule. And nestled among the many regulatory updates—like warm buns in a basket—are the PQRS requirements for the coming year. The 2016 Final Rule reveals that not much is changing for rehab therapy providers on January 1. But, even so, satisfying PQRS requirements is rarely a piece of cake—er, bite of bun? Anyway, as I was saying: The rules can seem convoluted, and adhering to them requires precise documentation. Here’s how an EMR can help you remain compliant in the following areas:

Tracking Progress

In 2016, eight measures apply to physical therapy, ten to occupational therapy, and a whopping one measure applies to speech-language pathology. And the reporting requirements are pretty strict, as Brooke Andrus explains in this article: “Each eligible professional (EP) must report on nine measures across three NQS domains for at least 50% of Medicare Part B FFS patients.” That means PTs and SLPs are automatically subject to the MAV process, which allows Medicare to review their data to ensure they’ve reported on the maximum number of available measures for their specialties. With all of these complexities in mind, how do you track your progress? And how do you know that you are reporting on all of the measures available to you?

Things can get really complicated when there’s that much data to account for, but the right EMR system makes the process simple by providing you with user-friendly reports that accurately display your progress. That way, you can adjust your processes as the year goes on. Sure beats trying to manually track all of that data.

Satisfying Measures Requirements

One of the potential time-sucks of reporting PQRS data properly is the need to document your measures. It can be difficult to remember which measures to report—and at which intervals. A great EMR will prompt you to report any necessary PQRS data at the right time (e.g., some measures are only reported at initial evaluation, while others require reporting at every visit). That way, you take the guesswork out of satisfactorily reporting, and you can always count on your documentation to be compliant.

Something to be aware of: as always, your bottom line depends on your compliance. When it comes to PQRS, you’re looking at a hefty 2% negative payment adjustment in 2018 if you don’t satisfactorily report on the measures that apply to your specialty in 2016. But, if you use an EMR, you don’t have to leave anything to chance. You’ll know exactly how many patients you’ve seen, which data you’ve reported, and how far you’ve progressed toward meeting the minimum requirements for reporting.

Submitting Data

Okay, so now you know that an EMR can help you easily track your PQRS data, satisfy the reporting requirements for all your measures, and avoid the penalty. But, I’ve yet to cover one very important part of this whole shebang: actually submitting your PQRS data to Medicare. Here’s the cold, hard truth: not every EMR is equipped to handle your data. So, make sure you look for an EMR with a certified CMS PQRS registry, meaning the system automatically compiles and submits your data to CMS on your behalf. No hassle necessary.

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Attempting to report on PQRS without an EMR is a lot like preparing a hearty meal without hot buns: sad and pointless. All kidding aside, keeping track of all of the regulatory changes on your own is enough to make your head spin. But the right EMR can help you avoid penalties, stay compliant, and cleanly submit data to CMS like a hot knife through butta’.


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.


3 Reasons Why PT Programs Should Teach Digital Documentation

As a future doctor of physical therapy, you bear a large burden: you’re responsible for not only healing your patients, but appropriately documenting your diagnosis and treatment as well. However, your PT program likely only places emphasis on one of those responsibilities—and that’s putting you at a severe disadvantage when you graduate. Here’s why your DPT curriculum should include digital documentation:

1. Most clinics don’t use pen and paper.

When you get out of school, your chances of landing a job with a clinic that doesn’t use an EMR are slim-to-none—and you wouldn’t want to work for a practice that’s stuck in the pen-and-paper past, anyway (the dream of the ’90s might be alive in Portland, but it won’t survive in PT). EMR is where it’s at, because it offers:

  • streamlined billing;
  • organized, compliant, and secure documentation;
  • built-in reports and alerts; and
  • the ability to access your records anytime, anywhere, and from any web-enabled device (with web-based systems, anyway).

It’s no wonder that over the last few years, EMR has become an integral part of the PT profession—which is exactly why DPT students should be learning how to use this technology.

2. It gives you a competitive edge

If you’re reading this in class, look to your right. Now, look to your left. Think about all the other DPT students out there at other schools, all working to become skilled PT professionals. Those folks are your direct competition for jobs when you graduate, so you need your resume to stand out. Understanding how to document digitally can help set you apart from other candidates—and help you ramp up more quickly once you land your dream job. A big part of being a successful PT is understanding how to market yourself—to future patients, referring physicians, and employers alike—and that should begin in DPT school.

3. Payers demand it.

As the healthcare industry quickly advances toward pay-for-performance payment models, interoperability—which calls for greater coordination among healthcare providers—will become the rule, not the exception. It would be impossible to organize the standardized and seamless exchange of information without the appropriate means of communication and technology. Thus, pen and paper documentation is bound to go extinct. Plus, with the introduction of ICD-10, billing—and actually getting paid—will become more complicated. To make that process easier, you’ll want to know how to use EMR technology.

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To set you up for success as a physical therapy professional, your PT program should train you on all aspects of being a physical therapist—including using EMR to document digitally. If your school doesn’t offer any digital documentation education, take the time to advocate for yourself, your program, and the future of your profession.


How an EMR Can Work Miracles for Your Billing Process

Physical therapy billing is a process that begins well before your patients even enter your clinic. If your process is efficient, your bottom line likely will grow as a result of your efforts. However, if your process isn’t streamlined, you might find yourself regularly dealing with claim denials and reimbursement delays. And when it comes to process efficiency, there are few factors more influential than your software. I’m talking about your physical therapy EMR. Because with the right EMR in place, your billing process can miraculously transform from a pain-in-your-rear-end into a revenue-boosting machine. Here’s how:

Decreased Errors

Human error is inevitable. Why? Because we’re only, well, human. In general, making a mistake affords you the opportunity to learn a lesson and grow from the experience. But when it comes to coding mistakes, the lessons you learn will cost you—big time—in the form of claim denials. However, there is something you can do. With the right EMR in place—one with top-notch functionality—you can minimize coding errors. According to this study, using an EMR can increase revenue with a “better capture of charges, and decreased billing errors.” The same study goes on to reveal that “computerizing the encounter form could decrease these [billing] errors by 78%.”

Knowing the ins and outs of coding is complicated—even with highly-skilled coders and billers on staff. And as a PT, it’s incredibly challenging to mentally retain all of the information required to accurately code—especially with regulatory requirements that are constantly shifting. Having a system in place with a comprehensive code database is crucial for coding accuracy (say goodbye to cheat sheets). Clinical judgement has always been a crucial part of the coding process, but with ICD-10 right around the corner, the ability to code to the highest level of specificity is even more important. After all, if you don’t select the most specific code possible, you risk claim denials. But with the help of an EMR, coding correctly shouldn’t be rocket science.

Increased Efficiency

Take a few moments to consider the number of hours your staff spends entering charges from super bills into a billing system. What if you could eliminate all of that extra manual data entry? You can. When you work with an EMR vendor that’s integrated with your ideal billing solution, you eliminate all double entry. Your data flows seamlessly from your EMR into your billing software. From here, you can electronically scrub claims and submit them without missing a beat. And that frees up your billing staff to work on resolving other billing issues instead of toiling away at unnecessary data entry. As HealthIT.Gov explains, an EMR reduces the “time and resources needed for manual charge entry resulting in more accurate billing and reduction in lost charges.” Who doesn’t love a reduction in lost charges?

Improved Cash-Flow

The right EMR will help you code efficiently and accurately with the help of comprehensive documentation profiles. The system should prompt you to comply with all compliance requirements as well as provide tools for more accurate coding (e.g., 8-minute rule guidance, modifier options, and a comprehensive ICD-10 tool). What does accuracy mean in terms of cash-flow? Everything. When your documentation supports accurate coding, you have the best chance of getting paid—fast.

An electronic system will help you quickly determine what code is appropriate and accurate for that treatment. What’s more? When you submit a clean claim with accurate codes—the first time—that claim is paid quickly, which means you don’t have to deal with the hassle of going back through attending documents and resubmitting corrected codes. This NCBI study further illustrates this point: “With an EHR system, many billing errors or inaccurate coding may be eliminated, which will potentially increase a provider’s cash flow and enhance revenue.”

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If your practice could use a helping hand with your billing process, it might be time to re-evaluate your EMR. With the right system in place, you can streamline your workflow, increase your revenue, and clean up your claims for better billing results. And it doesn’t take magic—just some help from an EMR system that has your back.


Is Your EMR Ready for ICD-10?

It’s only a matter of time before the leaves start changing and the pumpkin spice lattes start flowing—and that means the October 1 transition to ICD-10 is just around the corner. But rather than kicking their preparations into high gear, many providers are kicking back and relaxing—because their EMRs already have everything handled, right? Right? Anyone? Bueller?

Unfortunately, not all EMRs are created equally—and not all are equally prepared for the impending ICD-10 transition. So, how do you make sure your system is in fighting shape for ICD-10? For starters, nail down the answers to the following questions:

1. Does your EMR prompt you to document specific details of the patient’s injury or condition?

One of the biggest reasons the medical community is transitioning away from ICD-9 is that the old code set doesn’t allow providers to accurately—and specifically—represent patient diagnoses through the use of diagnosis codes. And to encourage—er, force—healthcare professionals to move away from the now-common practice of submitting generalized or unspecified diagnosis codes, payers will require a high level of coding specificity as a condition of payment. As this HIMSS page explains, “With the expansion of diagnosis codes comes a greater level of detail; therefore a greater level of detail will be required in the encounter documentation in order to assign an appropriate diagnosis code.”

Of course, detailed diagnosis coding goes hand-in-hand with detailed documentation—especially if the clinician (e.g., the physical therapist) isn’t the one submitting claims. How is a biller or coder supposed to select and/or verify a diagnosis code if the supporting documentation isn’t detailed enough to inform that choice? Unless your practice’s coder moonlights as a psychic, he or she won’t be able to pull that one off—at least not 100% of the time. So, if you want to receive 100% of your payments—and I’m no psychic, but I’m betting that you do—you better cross all your t’s and dot all your i’s within your documentation, and make sure your EMR allows you to do so, too.

2. Does your EMR’s code selector prompt you to choose more specific codes when greater specificity exists?

Maybe you’ve already called up your EMR vendor and asked whether the system has—or will have—an ICD-10 code selection tool. (If you haven’t, stop what you’re doing and pick up the phone. I’ll wait right here.)

Okay, let’s assume your vendor has assured you that the system absolutely, positively will have functionality that allows you to select and document ICD-10 codes. That’s fantastic—but your investigative work shouldn’t stop there. Sure, your EMR might have all the applicable codes loaded into its system—and you might even be able to search for the right code by diagnosis or anatomic site. But just because you can find codes doesn’t necessarily mean you’ll find the right ones, especially when specificity comes into play.

For example, let’s say you’re searching for a code to express the diagnosis of patellar tendinitis. The code M76.50 (Patellar tendinitis, unspecified knee) might appear at the top of your search results, but it doesn’t account for one very important diagnostic detail: laterality. However, if your EMR prompts you to code for laterality when that specificity exists, then you’ll land on either M76.51 (Patellar tendinitis, right knee) or M76.52 (Patellar tendinitis, left knee). And by using a more specific code, you’ll greatly decrease your chances of receiving a claim denial.

3. Did your EMR base its ICD-10 code library on GEMs?

Despite this acronym’s sparkly association, there’s nothing precious about GEMs—a.k.a. general equivalence mappings. As this blog post explains, “…GEMs were never intended to serve as single-code translation dictionaries. Because of the way they’re structured—in clusters of two to four related codes—GEMs may map one ICD-9 code to several ICD-10 codes and vice-versa.” While GEMs can be useful for converting large batches of data, they’re not reliable mechanisms of one-to-one code translation. So, if your EMR simply used GEMs to map each of its existing ICD-9 codes to an ICD-10 substitute, then you could be in for a rude awakening come October.

4. Does your EMR claim to have an automatic crosswalk from ICD-9?

Like an ill-prepared college student desperately searching for a cheat sheet the night before the big test, healthcare professionals who have put off their ICD-10 prep work until the eleventh hour are desperately searching for a magic bullet that’ll make all their ICD-10 worries fade into oblivion. Some EMR vendors have capitalized on that desperation by claiming to offer solutions that automate the ICD-10 code selection process or produce accurate ICD-10 matches for all of the ICD-9 codes you know and love. The problem is, no such tool exists—at least not one that actually works. Why? Because, as this blog post points out, “…when it comes to translating ICD-9 codes into the language of ICD-10, there’s no technology sophisticated enough to do the thinking for you.” Furthermore, “the new code set wouldn’t function the way it’s supposed to without the human decision-making factor.”

5. Will your EMR allow you to practice coding with ICD-10 prior to October 1?

As the old saying goes, practice makes perfect. Attempting to code in ICD-10 with zero practice would be like showing up to run a marathon with zero training mileage under your belt. And with payment at stake, this definitely isn’t the time to wing it. The same goes for your coding tools: If your first time using your EMR’s ICD-10 functionality is October 1, 2015, then you could be fighting an uphill battle fraught with frustration, claims backup, and workflow disruption. So, make sure your EMR will release its ICD-10 coding tool before the go-live date. That way, you and your staff can train in a relaxed, no-pressure environment. Plus, you’ll be able to run internal testing programs and participate in external testing opportunities.

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Technology will play a huge role in the transition to ICD-10, and if you arm yourself with the right tools, you can greatly ease the shock of the shift. But while Ferris Bueller seemingly can navigate any sticky situation relying on wit and charm alone, no amount of charisma can make up for an EMR with a sub-par ICD-10 solution. So, before you put your feet up and enjoy the last of the summer sunshine before the fall chill sets in, make sure your EMR is truly ready for October 1.


Help! I Got a New Job, and They Still Use Paper!

Unless it’s your one-year wedding anniversary, you probably don’t want anyone to give you paper. And if you’ve just started a new job in the rehab therapy industry, you really don’t want anyone to give you paper. When it comes to documentation, paper doesn’t just kill trees—it can kill your new employer’s bottom line. But I don’t have to tell you that, do I? In fact, I’m preaching to the choir, but if you’re reading this article, you likely aren’t the ultimate decision-maker. However, you do have a voice, and you can use it to be an EMR champion at your new clinic. Here’s how:

1. Ask why the clinic still uses paper.

Do they fear EMR? Are they worried about potential costs? Or have they already had a bad EMR experience that forced them to go back to their old ways? Knowing what you’re up against will help you come up with a successful sales strategy.

2. Determine your clinic’s pain points.

Your new clinic is great, but no practice is perfect. So, look for issues that EMR can help resolve. Is your boss spending too much time doing administrative tasks? Is your office overrun with filing cabinets? Are there kinks in your customer service? Is your billing team getting bogged down? Is your clinic struggling to keep up with competition, or to grow its referrals or customer base? Pinpoint the top three needs that aren’t being met or goals that aren’t being achieved.

3. Play EMR matchmaker.

Now that you’ve figured out your clinic’s needs and goals, you can look for the right EMR solution and tailor your pitch to those exact issues. There are many different EMRs on the market, and they aren’t one-size-fits-all. What to look for? A web-based solution that is built for the way you work, meaning it offers:

4. Find the right time to pitch your boss.

The last thing you want to do is interrupt your boss when he or she is in a bad mood, working a full day of back-to-back appointments or elbow-deep in a tough task. If you can, set up a sync on his or her calendar to make sure you get the time you need to present your argument.

5. Make your case.

You’ll want to emphasize the positives of switching to an EMR. Talk about how great this move will be for business, and use research to back up your points. It doesn’t hurt to find clinics in your area that have successfully switched to EMR and use their stories as pseudo case studies. However, don’t skirt around the potential negatives of ditching pen and paper—just be ready to provide a solution to those problems. Your boss needs to make an informed decision. Plus, you don’t want to be stuck with the blame if something doesn’t go according to plan.

6. Be prepared to hear the word “no.”

Switching from paper to EMR can be tough, time-consuming, and terrifying. Even if you work the room like Perry Mason, your boss might not cave easily. Don’t give up. Ask for specific reasons why your boss turned you down and what might change his or her mind in the future. That way, you can adjust your strategy for next time. Are your fellow staff members on board? Rally the troops! There’s strength in numbers, especially if your boss respects staff opinions.

7. If you do make the switch, be all in.

If you’re able to convince your boss to leave pen and paper in the dust, remain a champion throughout the transition process. You worked hard to make the change possible, so now you should work hard to make sure it’s successful.

 

Deep down, your boss probably knows that adopting EMR technology is worthwhile, but depending on his or her concerns, it might take some time and consistent effort for you to close the deal. Stay positive and stick with it, champ. Need more talking points? Check out the rest of our blog (or this one) for more research and resources to help you fight the good fight.