Why EMR?

A Guide For Rehab Therapists
by Erica Cohen

Paper shredding, filing, shuffling, stacking. Basically, there's nothing appealing about paper documentation, especially if it's a quagmire of quarrelsome patient charts—handwritten, faded, and sharp as all get out—just waiting to wreak havoc on your soft, supple papercut-fearing fingers. And don't even get us started on ink stains.

As a rehab therapist, paper documentation was never on your "fun" list, but you did it—and happily so, as Mike Taylor, PT, points out—because you finally had the dream career you worked so hard for (and because there was no other option). But let's face it: rehab therapists have since tossed the "happily" aside and now despise paper charting and all the mess, pain, and time suck that goes along with it. Not to mention that now paper isn't your only option.

Yes, we're talking about electronic medical record (EMR) systems. Of course, there are reasons beyond paper cuts and chicken scratch for rehab therapists to switch from paper to EMR. In part one of this whitepaper series, we'll not only detail those reasons, but we'll also explain:

  • » the benefits of web-based EMR over server-based
  • » questions to ask your potential EMR vendor

Four Reasons Rehab Therapists Should Use EMR

1
Service

EMR systems—cloud-based ones to be specific— empower you to provide better customer service to your patients. Because cloud-based EMRs allow you to document anywhere, anytime from any mobile-enabled device, you can chart more efficiently, allowing you more time to devote to your patients. Plus, with an EMR, there is no misplacing of charts or brow furrowing over illegible marks. You can easily access and review data, so you spend more time treating than asking mind-refreshing questions.

In addition to helping you provide better service to your patients, EMRs—(more specifically, EMR providers)—actually give you—their customer—supreme service, too. In addition to having teams of tech wizards ready to assist you, many EMRs have alerts and measures in place to help you document defensibly, so you're never relying solely on your own paperwork. Furthermore, the créme de la créme of EMRs offer unlimited phone support and SOAP note customization options, so you can tailor your documentation to your clinic's needs. Stacks of paper, illegible handwriting, and wonky Word templates got nothing on all of that.

2
Organization

You may remember the towering stacks of paper we described in our introduction. If your office is in the throes of paper documentation—overflowing inboxes, messy desks, forever-multiplying file cabinets—it's probably beginning to impact your productivity (and your sanity). Cut the clutter and get your space—and your life!—back.

By transitioning all your documentation into a digital system, you can give your office some much needed feng shui. More importantly, with a complete EMR and practice management solution, you'll be able to find all the information you could ever need—about your clinic, your staff, your patients, your plans of care, your productivity— anytime, anywhere with the touch of a button; no binders or cabinets needed. Plus, with an EMR, there's no double data entry; you only have to enter your patient's information (name, diagnosis code, referrer info, etc.) once and the system carries it over appropriately.


3
Accountability

As mentioned above, most EMRs have a handful of alerts in place to make sure you document defensibly. Can paper do that? We didn't think so. In a perfect world, you wouldn't need alerts; you wouldn't need reminders; and you certainly wouldn't need sleep. But you're human. And last time we checked, therapists' caseloads weren't getting any smaller. So, mistakes happen and things are forgotten. With digital documentation, everything you could possibly need documentation-wise is right there, at your fingertips, replete with alerts and rubrics—not to dictate your documentation, but to help you stay compliant. And, with the increase in defensible documentation regulations, an EMR can help you keep up with the onslaught of changes so you can focus on treating your patients. Think of it like having a knowledgeable sidekick.

EMRs also increase accountability because they don't allow for the deletion of notes. That's a big no-no in the realm of documentation, and if you're ever audited, you'll be thankful your EMR empowered you to create an addendum, rather than crumple up the paper and pitch it.

4
Professionalism

Rehab therapy is a competitive profession, which is all the more reason why first impressions matter. This goes for your website, your business cards, your office, and your documentation. What image do you project to your patients when you're flipping through crumpled, barely legible patient charts or hunting around your desk for several minutes in an attempt to locate a working pen? Not only does an EMR allow you to enter, track, and find all your documentation in an incredibly organized and professional manner, but you can access it on any device—and we hear patients just love seeing their practitioner work off an iPad.

And, if most of your business is generated through physician referrals, then make every interaction count. EMRs not only allow you to electronically (and speedily!) interact with physicians (who are all mandated to use electronic medical records by 2014), but also enable you to brand your notes with your clinic's logo. Your notes will appear neat, clean, and legible, while also proudly displaying your brand for the world to see—a great way to stay top of mind.

Did you catch our clever (super subtle) acronym? Service, organization, accountability, and professionalism spell soap—as in soap notes, the backbone of your documentation and the main reason why you should make the switch to an emr. Because soap notes can and should be simpler, faster, cleaner, more legible, and overall, better.

Isn't it time you upped your clinic's game?

The benefits of Web-Based over Server-Based

Cloud computing is, quite simply, internet-based computing. Essentially, shared resources, software, and information are provided to computers and other devices (like your smartphone) on demand. Think about it like an electricity grid for information—you plug in (sign on) and immediately access the flow of information available to you without needing your own generating station (in this case, bulky servers to house all your data).

Have a Gmail or Facebook account? Then you've used cloud-based software, and judging by the popularity of these two services, you're in good company. The public has most certainly adopted cloud technology, but what about businesses? According to a blog post entitled "Predicting Cloud Computing Adoption Rates" on A Passion for Research, "CDW recently published their Cloud Computing Tracking Poll Report reporting 37% adoption in enterprises followed by higher education (34%), healthcare (30%), federal government (29%), state & local government (23%), and [small and medium-size businesses] (21%)."

When it comes to EMRs, a truly cloud-based solution would only require a web browser, like Internet Explorer, Mozilla FireFox, or Google Chrome, and an Internet connection. Talk about ultimate convenience. Server-based EMRs, on the other hand, require downloads, installations, and manual upgrades. But let's get down to brass tacks: how specifically is cloud-based EMR better than server-based software?


Security & Storage

Storing your data on a server in your closet is just about as secure as keeping your money under the mattress; there's no failsafe. In fact, according to recently released data from the US Department of Health & Human Services (HHS), the root causes of most data breaches are physical theft and physical loss. Here are the key findings from the HHS 2011 HIPAA security violation report:

  • » 6,800 paper records were supposedly mailed but never received.
  • » An impostor posing as a recycling-service employee stole over 1,300 individuals'records.
  • » A former employee stole a laptop containing personal health records of over 50,000 patients.

So what's the takeaway? Keep your data in the cloud and you benefit from a host of super cool security features:

  • » Unique password-protected access (unique logins ensure HIPAA compliance)
  • » Bank-level security encryption (256 bit Secure Socket Layer)
  • » Automatic data backups with multiple replication processes
  • » Data stored in a secure, defensible facility

Plus, there's no more data stored on servers within your clinic. Talk about putting your mind at ease—and freeing up some space.

Expertise & Support

In addition to security and data storage, you get know-how with the cloud. You receive all the benefits of access, storage, tools, and features without any of the hefty storage or upkeep responsibilities you might have if you were running it directly from your hard drive. No internal IT staffs required. Your cloud-based EMR takes care of all of it for you, and many provide phone, email, and online support so you can always call on them for a techy helping hand.

Whether you're using server or cloud-based software, you can expect downtime. The benefit that the cloud has over server-based, though, is its ability to integrate the latest and greatest technology for redundancy and failover measures, with no need for effort on your part. Most cloud companies conduct updates in the wee hours of the morning (or whenever user activity is lowest). You don't have to do any downloads or installs. It's all done behind the scenes—quick and painless.

Ultimately, with a cloud-based EMR you don't have to worry about upkeep, maintenance, or computer science. It is the expert's job, not yours, which means more time for you to devote to your patients.

Cost

While many server-based software systems require a hefty capital investment upfront, especially if it requires expensive hardware, cloud-based options are typically low month-to-month costs and many don't require a contract. Plus, with cloud-based services, you get all the benefits of security and expertise with none of the typical costs associated with hiring new employees, conducting training,


Compliance

Everything from documentation and billing to payroll and accounting has compliancy standards. With regular and automatic updates, cloud-based EMRs can easily integrate new compliance measures as they become available. This ensures automatic alerts and other tools keep you on your toes regarding compliance. Additionally, many cloud-based EMRs streamline processes, reducing double data-entry or human error that can result in non-compliant activities.

The best cloud-based EMRs are fairly simple and user-friendly.

Convenience & Usability

When you make a decision to go with a new product or tool, you most likely want to get started right away. However, with a server-based choice, you may be in for some long days (and nights) as you and your IT staff work to acquire the appropriate server hardware and then install the EMR software on every computer in your practice. If you choose a cloud-based application, however, you just flip the switch (i.e., sign up) to access your new EMR from anywhere, anytime.

Additionally, the best cloud-based EMRs are fairly simple and user-friendly. After you sign up, they require just a brief training session or webinar, and then you can easily navigate the tool. If you ever need a refresher or want to learn something more in-depth, you never have to bust out a user manual or comb through compiled help files. Many cloud-based EMRs offer how-to guides, extensive knowledge bases, and at-the-ready, expert support staffs.

Cloud-based applications are also easily scalable, flexible, and constantly updated, which amounts to less work for you and your staff. Less administrative work means more time to practice, and that's ultimately what every business tool should help you achieve.


Questions To Ask Your Potential EMR Vendor

How do I get started?

Your vendor should make the "getting started" process easy for you and your clinic. Make sure you and any decision makers are able to demo the product before considering signing up. With WebPT, for example, you get a free, short, and to the-point demo—no hassles, hoops, or obligations. From there, a WebPT Sales Rep explains the simple signup process.

What is the cost?

Look for an EMR solution (hint: WebPT) that helps your clinic's cash flow by offering a cost-per-user payment structure, a low upfront setup cost, and no contracts, obligations, or hidden fees. And watch out for cost-per-visit or cost-per-chart structures. Typically, the minimum monthly payment for this type of structure far exceeds the price of a simpler cost-per-user (membership style) structure. After all, you want your visits to increase as you grow your business. You shouldn't have to pay more for your EMR as a result.

Additionally, on the topic of cost, cloud-based solutions far outshine server-based because most server-based EMR systems require a hefty capital investment upfront, especially if that EMR requires expensive hardware. Cloud-based services, on the other hand, usually offer everything noted above, plus you get all the benefits of security and expertise with none of the typical costs associated with hiring new employees, conducting training, and bulking up your hardware.

How do I implement the EMR?

Look for a solution that offers speedy implementation that fits around your schedule—not the other way around. There are some EMRs on the market with strict, inflexible implementation processes. No matter how tech-savvy or eager your clinic is to get started, these EMRs simply won't allow it—until you jump through every one of their hoops.

Instead, look for an EMR that will allow you to jump in without the hoops as soon as you're ready. With WebPT, for example, you and your staff complete a live, web-based two-hour training session. From there, you receive a username and password and can go live when you want—easy peasy. And easy is exactly the type of implementation you should want.

What is the company's focus?

You want an EMR tailored to your practice and profession. Thus, look for an EMR that is specific to the rehab community. If you have a specialty, be sure to ask which clinic modules—occupational, speech language, pediatric, pelvic health, hand therapy—they offer.

Does the EMR keep its customers?

No one wants to sign up with a vendor that is constantly losing customers. Thus, when researching, be sure to look for an EMR that keeps their customers happy. A few figures to consider: retention rate, user size, and growth rate. Your best bet is a company that has shown continued customer growth (year over year) while maintaining or improving their retention rate. Asking friends, family, and fellow therapists for recommendations and referrals is always a great route, too.

Is the EMR accessible?

As a therapist, you're busy, constantly on the move. Make sure your EMR can move with you. Look for a solution that you can access anywhere, anytime, and from any web-enabled device. And by any web-enabled device, we do mean any. Choose an EMR solution that's compatible on Macs, PCs, iPads, tablets, and smartphones.

Also, if the EMR is a cloud-based solution (as it should be), make sure it's browser neutral, meaning no matter what browser (Safari, Google Chrome, Mozilla Firefox, or Internet Explorer) or version of that browser (IE7 vs. IE9) you use to access the Internet, the application will work.

What type of data security does the EMR offer?

As stated in the beginning of this whitepaper, cloud-based EMRs typically offer these security benefits:

  • » Unique password-protected access (unique logins ensure HIPAA compliance)
  • » Bank-level security encryption (256 bit Secure Socket Layer)
  • » Automatic data backups with multiple replication processes
  • » Data stored in a secure, defensible facility
  • » No more data stored on servers within your clinic

Of course, not all cloud-based EMRs are the same, so you want to make sure they're storing your data in the most hi-tech and secure facility possible. For example, WebPT employs a Level 1 secure data center, which boasts a defensible perimeter, digital video surveillance, biometric screening, and 24x7xforever guard staff.

How is my data backed up?

Your clinic and patient data is invaluable, so of course you want to make sure that it's always safe, secure, and frequently backed up. Additionally, ask your cloud-based EMR how they'll provide redundancies to ensure your data is always accessible and protected. That way if anything ever goes wrong, like if Godzilla storms the city, it won't affect your data. It's always safe. You, on the other hand, if you see Godzilla, run. Well, maybe YouTube it and then run!


What measures do you use to ensure my data is secure?

Your cloud-based EMR should use the SSL encryption that is standard for all online banking applications. The federal government uses this same type of encryption for all of their data and communications. Look for a vendor that offers unique user IDs and passwords because this is an absolute must for anything online. Two more plusses: a vendor that has an audit trail (i.e., user activity tracking) as well as specialized staff wellversed in online security measures at the ready to provide you with their expertise.

How do I get my data if I decide to leave?

If you're unhappy with your EMR vendor, you certainly don't want to stay tied to it simply because your data is stuck. Be sure you ask up front what happens to your data if you decide to move to greener EMR pastures. Most cloud-based EMRs will return your data to you digitally on a preloaded storage device (e.g., a CD) or in a way you can download it to a storage device of your choice.

With the decrease in reimbursements, the increase of regulations, and the overall competitive nature of the profession, you need tools to help you be better in business while staying compliant and crafting clean, detailed, and goal-oriented SOAP notes. You can't achieve all that paper charting. Isn't it time you elevated your practice? Isn't it time you implemented an EMR to help you achieve greatness?

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