7 Ways to Increase Efficiency in Your Private Practice

You’ve surely heard the saying, “Time is money.” And as a physical therapist, you experience it first-hand when you bill for your timed services. But what about your non-billable hours? Are you using that time efficiently? In this Entrepreneur article, author Michael Moroney writes that “employees spend about 31 hours per month in meetings and spend less than 60% of [work] time actually working productively.” According to the infographic Maroney references in his article, the salary cost of unnecessary meetings for US businesses is $37 billion. Talk about inefficiency.

Even if your practice’s stats aren’t quite that shocking, there’s a good chance that you’re spending time on things that aren’t helping your patients, your staff members, or your bottom line. Luckily, you don’t need to overhaul your entire clinic to increase your efficiency—and you certainly don’t need to sacrifice patient care. Instead, try these seven small things to get the most out of every minute:

  1. Create and share processes. Whenever you identify a best practice—whether it be an efficient way to verify patient information or communicate instructions for a particular exercise—document it. Then, educate your staff and—when appropriate—your patients. Additionally, empower your staff members to become experts of their own domains by identifying, documenting, and sharing their own best practices—all in the name of efficiency.
  2. Keep things moving. While we definitely don’t recommend barking orders at your patients or your staff members drill sergeant-style, there may be opportunities to help everyone pick up the pace without rushing. Start paying attention to your patients’ experiences from the minute they walk into your clinic to the minute they leave. Are they spending a lot of time waiting on you or your front desk staff? If so, establish a process (see number one above) that helps speed things along at check-in. And consider prepping your therapy areas before patients arrive, so everything you need is easily accessible and ready to go. You also could enlist the help of an assistant or aide to start patients off with ultrasound, heat therapy, or warm-up exercises.
  3. See things through. As this article’s title points out, “Hand-offs are bad (but unavoidable).” Now, this doesn’t mean you shouldn’t delegate tasks when appropriate, but passing around to-dos without cause can lead to mistakes and a lot of wasted time. Unless you have good reason to involve multiple people in a particular task, designate a lead and let that person take the reigns and see it through.
  4. Hold morning standups. Start each day with a super brief team meeting—a standing meeting ensures it won’t drag on—to review the appointment schedule and discuss any questions or concerns. Some potential topics to cover might be patients who require extra time or assistance; cancellations or open appointment slots; or changes to staff schedules. By proactively addressing these items—and others that are pertinent to your clinic—you won’t have have to deal with them in the middle of a busy day when you have a waiting room full of patients.
  5. Build promptness into your culture. If you maintain a lax attitude about timeliness in your clinic, your staff members and patients will do the same—and that can lead to dawdling employees and lots of missed appointments. Instead, lead by example: show everyone you respect your time and theirs by doing your best to stick to the schedule.
  6. Work to your strengths. Everyone has a different working style, so experiment until you find one that enhances your productivity and efficiency—rather than diminishing it. Do you enjoy back-to-back appointments in the early morning; need a two-hour break midday to catch-up on notes; or perform your best work after the sun sets? Consider your personal preferences, and whenever possible, take advantage of the times when you’re in the zone.
  7. Make friends with technology. Using the right PT-specific EMR can drastically improve your clinic’s efficiency. (Choose one that offers integrated billing and outcomes tracking tools, and your clinic will be so efficient you may find yourself with extra time on your hands.) Speaking of extra, if you’ve got some extra money in your budget this year, you also may want to consider investing in an iPad or two so your staff can access patient charts and exercise flowsheets anytime, anywhere. You could even use the tablet to pull up one of these nifty iPad apps to help patients better understand their injuries.

What steps does your clinic take to improve efficiency? Tell us in the comment section below.


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.


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 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 Signs Your EMR Fails to Scale

If you’re ready to start expanding your practice, you’ve probably spent a great deal of time making sure your staff is on board and getting your financials in order. But have you considered the impact your EMR might have on the success or failure of your expansion venture? Here are three signs your EMR isn’t built to support a growing clinic:

1. It makes you pay per patient or per visit.

If your EMR vendor charges you per chart or per visit, it’s impeding the growth of your business—and your bottom line. Under this kind of payment structure, increasing the number of patients your clinic treats means increasing the amount you pay your software vendor each month. Instead of working with a vendor that takes a bite out of each piece of your financial pie, look for one with a payment structure that allows you to pay per user.

2. It limits your number of users, records, or patients.

This one should be pretty obvious. If your EMR caps the number of users, records, or patients you can have, it also caps your clinic’s potential for growth. To keep up with your growth, switch to an EMR that makes it possible—and easy—to add patients, users, records, and clinic locations. Better yet—choose an EMR that offers volume-based discounts to growing practices.

3. It doesn’t give you access to crucial data.

To grow your practice, you need to be able to dig into your business metrics and identify areas where you may be missing out on revenue. Your EMR should provide you with valuable metrics on both your patients and your practice. Look for a multitude of reporting options that allow you to analyze all areas of your business, including:

  • inactive patients
  • patient cancellations and no-shows
  • claim statuses
  • units billed
  • number of patients per therapist
  • types of documents created
  • missed notes
  • referral sources

Additionally, look for an EMR that gives you insight into how regulations like FLR, PQRS, and MPPR are impacting your bottom line.

Behind every great clinic is a great EMR; can you say as much about your system? Make sure your EMR gives you the data space, financial freedom, and business intelligence you need to grow. Don’t settle for an EMR that penalizes you for being successful—or one that doesn’t allow you to be successful, period.


One-Size-Fits-All Software Zaps Productivity

Have you ever worn one-size-fits-all clothing? If not, let me give you a word of advice: it’s not actually made to fit everyone. If you wear it, you’ll likely spend half your day tugging, twisting, and jerry-rigging your outfit so it works for your body. Sounds pretty annoying, right? Now imagine applying that same one-size-fits-all approach to EMR software. As a 2010 UC Davis study discovered, implementing that kind of technology could spell disaster for your practice.

This four-year study focused on roughly 100 physicians—specializing in either internal medicine, pediatrics, or family practice—from six primary care offices, all of which were part of a large primary care physician network affiliated with an academic medical center. These offices had implemented a multimillion-dollar information technology system that “digitized patient records and allowed for electronic prescriptions and messaging.” The three researchers collected data on work hours and output levels from before and after implementation to analyze the impact the EMR had on productivity.

The research findings suggest that the one-size-fits-all approach doesn’t work. After an initial—and expected—drop in productivity post-implementation, researchers found that the internal medicine physicians and their staff were able to adjust to the new technology. And once they did, they rebounded to a slightly higher level of productivity. However, the pediatric and family practices involved in the study never returned to their original productivity levels.

Why? According to Heman Bhargava, associate dean and professor of management and computer science at the UC Davis Graduate School of Management, this kind of software can’t accommodate the needs of every practitioner. In fact, there’s a “‘mismatch between technology design and the work-flow requirements and health administration expectations for individual care units.’” Bhargava affirms that “‘the ideal technology design should vary by physicians’ requirements and work-flow demands.’”

Would you settle for a shirt made to fit what an industry has deemed “average” in size and shape? Certainly not. (And who wants to be considered average, anyhow?) So why would you settle for an EMR that isn’t tailored to your physical therapy practice? A therapy-specific EMR is designed to mimic the workflow of your clinic, meaning the documentation, scheduling, practice management, billing, and compliance features are built for the way you work. And that allows you to document efficiently, maintain full HIPAA compliance, decrease patient no-shows, save time and hard-earned dollars, and grow your business.

One-size-fits-all software can’t offer the kind of specialization your industry requires, and spending precious time adjusting a non-therapy specific software to fit your clinic’s unique workflows and documentation needs isn’t simply a mild irritation; it’s a serious problem that affects your clinic’s overall productivity—and, ultimately, your bottom line. You chose to specialize in physical therapy; you deserve to work with a software company that chose to specialize in PT, too. Still not sure what the big deal is? See for yourself.


The Software Bamboozle No One in the PT Industry is Talking About

Nowadays, shopping for business software is a lot like shopping for a car. You do a lot of online research; you ask friends and coworkers for their recommendations; and you take some test drives. One thing—besides the price tag—that can ruin the whole experience? You pulling out of the lot with your shiny, new investment—and an uneasy inkling that maybe, just maybe, you got the wool pulled over your eyes.

Of course, when you buy a car and you get that feeling, you talk to folks about it. The same can’t be said for the PT industry, though. Certain software have been duping us for many years now—and yet, we remain silent. That stops today. There are three ways physical therapy software vendors have been bamboozling their prospective customers. Let’s take a closer look.

The Web-Enabled Smoke and Mirrors

True web-based EMR systems store data within secure data centers; nothing is downloaded, installed, or stored on any customers’ computers. Customers then access that data via web browsers (e.g., Google Chrome, Mozilla Firefox, or Internet Explorer) using any device connected to the Internet. Essentially, this is how you use a web-based EMR system:

  1. You visit the website of the EMR system.
  2. You log in.
  3. You conduct your business directly through your secure login on the website.
  4. When you’re finished, you log off.

Web-enabled EMRs, on the other hand, require you to download and install a software platform that then connects to the Internet. As this article explains, “…you still have to install software on your computer, and your computer still does all the processing. However, at certain intervals, the software will connect to the Internet to sync your account and data to the cloud.” This means that like server-based systems, web-enabled ones only allow users to access the program on the computer to which it’s installed. Furthermore, every time there’s an update or upgrade, you’ve got to download and install more stuff. You also must deal with all the security drawbacks of server-based systems (i.e., storing data on local servers and managing all the hardware yourself). Plus, as the above-cited article states, “…your EMR and its data does not update online in real time,” and that’s problematic if you have multiple clinics or different therapists accessing records simultaneously. Individuals could access or alter outdated information, or accidentally save over others’ work.

In addition to coming with all of these significant drawbacks, these EMRs also usually charge per chart or employ pricing structures similar to those of their server-based forebearers, which typically involve upfront expenses, maintenance fees, and the like.

In short, web-enabled systems don’t satisfy the demands of a growing business because they’re ineffective at scaling. Vendors of these systems know that, and that’s why they never just come right out and say they’re web-enabled. Instead, they either a.) don’t specify what type of platform they are, or b.) say they’re “cloud-based” and hope that you—the customer—are none the wiser. Don’t fall for the old smoke-and-mirrors trick. After all, if a company isn’t truthful about its platform functionality, what else are they hiding?

Ask your current EMR or—if you’re shopping around—any systems on your “yes” list the following questions:

  1. Do I need to download or install anything? (With a true web-based system, you shouldn’t have to.)
  2. Does the system need to sync with the Internet periodically to update my online data? (A true web-based EMR is always functioning—and saving your data—in real time.)
  3. Will I need to store any data locally? (With a true web-based EMR, you don’t need to store any data on your computer.)
  4. When it’s time to document, how do I open the EMR? (With web-enabled software, you’ll open the program on your computer, and it’ll connect to the web. With a truly web-based system, you’ll visit a website to log in.)

The “Free” EMR Gimmick

In the world of PT, clinics typically rely on two types of software: electronic medical record systems, which handle documentation and scheduling, and revenue cycle management (RCM), which handles accounts payable and receivable. As this blog post explains, “Sometimes, you’ll see vendors advertising an ‘all-in-one’ solution, which implies the EMR and RCM live within one system…Other vendors will tout an ‘integrated solution,’ which is basically a fancy term for an EMR or RCM system that integrates with other softwares.” For an in-depth discussion of each setup’s pros and cons, I recommend this article.

One major reason to avoid the all-in-one system, though, is its fee model. Often, the vendor will offer the EMR portion of its software for free in order to gain your business. Then, you simply pay for the RCM. But watch the pricing on this “deal”; sometimes, vendors will charge high percentages per reimbursement for billing, which means the more money you make, the greater your vendor’s cut. Your billing software should take the smallest percentage possible, and the money you’d save with a “free” EMR definitely doesn’t make up for an overcharging RCM.

Before committing to any software, make sure you ask about its pricing structure and how it adjusts for your business’s growth. Then, compare it with other systems’ pricing to gauge whether the giveaways really make for a better deal.

The Per-Patient Pricing Hustle

Software costs money. But every system charges its customers in a different way and at a different rate. It’s imperative that you understand your EMR vendor’s pricing structure, because some systems charge per patient visit or chart. And that’s detrimental to your practice’s cash flow. Here’s why: The more patients you generate, the more visits you’ll have or the more charts you’ll create. That means you pay more as your business grows. In other words, you’re punished for being more successful.

Your EMR should work for you and your business, not the other way around. So, instead, look for an EMR solution with a per-user pricing model. Also, investigate whether the company sets different rates for different user types. Finally, look for a system with a cancel-anytime subscription model. This ensures you know what you’re paying for from the get-go—no surprise fees or rate hikes. That’s the kind of EMR system that works for scale.

 

Now that I’ve essentially shown you the “EMRFAX,” you’re in the driver’s seat—and you shouldn’t have any uneasy feelings or buyer’s remorse as you drive your physical therapy software off the lot. Be well-informed when you shop for EMR, RCM, and practice management platforms; trust your gut; and ask not only a lot of questions, but the right questions. You might not be able to out-sell a salesperson, but you can certainly outsmart ’em.


5 Things Rehab Therapists Love About EMR

We could sing the praises of EMR until we go hoarse, but luckily, we don’t have to (which is a good thing, because we just weren’t cut out for vocal performance). Instead, we asked a few rehab therapy professionals to explain how their EMR helps them achieve greatness not only as a therapist, but also as a businessperson. Here’s what they had to say:

  1. It streamlines the billing process and cuts down on the time therapists spend filling out their charges.

    “We find that there is far less redundant data entry, and less time that our therapists have to spend filling out charge vouchers, and ensuring they match the notes precisely. This of course eliminates billing errors,” says Kerry Siman-Tov, MS, PT, MTC, of Archer Physical Therapy & Pilates Institute in Aventura, Florida.

  2. It keeps all patient information organized and secure.

    “The fact that data is encrypted and stored in multiple locations around the country to protect against loss and power outages pleased my computer-savvy technical advisor,” says Deborah Stack, PT, DPT, PCS, of Pediatric Therapy Center of Bucks County in Doylestown, Pennsylvania. She also loves that there are “no bulky charts to carry home, store, or get misplaced!”

  3. Built-in alerts give therapists—and clinic managers—peace of mind.

    “I don’t have to worry that a therapist has been treating a patient for eons and not reporting back to the doctor, because the system prompts them to report,” says Andrea Viel, the office manager at Mt. Eden Physical Therapy Center in Castro Valley, California. “I don’t have to worry about going over the number of authorized visits or past the authorization expiration date, because the system does the prompts. To sum up, I don’t have to nag everyone all the time anymore!”

  4. Branded documents and reports appear clean, readable, and professional.

    “Faxing to doctors is done with the push of a button and our records look a lot better and more professional,” says Lauren Hebert, PT, DPT, OCS, of SmartCare Physical Therapy in Dixfield, Maine.

  5. Web-based systems mean therapists can document anytime, anywhere, from any web-enabled device.

    “I’m very mobile. What I like best is that I have access to all my PTs’ phone numbers whenever I need them. I also like that I can email or fax documents with ease through the program,” says Laura Burger, OTR, CHT, of Maui Hand Therapy in Maui, Hawaii.

  6. There you have it—some EMR kudos straight from the people who know firsthand just how beneficial such a system can be in a rehab therapy practice. So, what are you waiting for? It’s time to ditch the pen and paper for good and take your clinic to the next level with EMR.