Any healthcare provider can attest that the landscape of healthcare practice and reimbursement is rapidly changing. Medicare guidelines have become more and more demanding with less financial reward, and other insurance companies are following suit. G codes, PQRS reporting, and busy patient caseloads compound our need as clinicians to be efficient with our time. Not a single one of us spent several years in physical therapy school so that we could spend our days in front of a computer screen or buried under a pile of paper charts. The good news: paper charts are going the way of the dinosaur. The interesting news: technological based charting is here to stay, and it can truly enhance our practice.
Enter the discussion of electronic health records (EHR). The decision to change our physical therapy documenting system to electronic medical records approaches each of us in unique ways. For some, it slowly creeps up, like an awkward annual holiday party, something we dread but know we must endure to remain in good social graces. For others, the decision is made angrily after reviewing quarterly fiscal reports and realizing how much money is lost due to incomplete or unconvincing documentation of services. For others still, the decision is an enthusiastic one, recognizing the time and financial resources gained from the efficiency of electronic documentation.
“For the times, they are a changin'” – Bob Dylan
One way or another, as physical therapists, we must choose to keep up with the changes in electronic records or risk being swept away with the current. Thus, we are well suited to research various EHR systems, in order to find a system that works well for our individual facility. Secondary to finding and hiring skilled physical therapy practitioners, finding the right EHR system may be the most important decision that we make for our practice. When analyzing the cost of a new system we want to feel confident that we are gaining an asset that will hold it’s value, and with time more than pay for itself in the way of improved reimbursement.
Did you know that “Burn due to waterskis on fire is ICD-10 code V9107XA? How about the fact that ICD-10 code V9542XA describes “Spacecraft crash injuring occupant,” and ICD-10 W2202XA is “Hurt walking into a lamppost”. As outlandish as these injuries all sound (though I have treated a few lamppost-esque patients in my day), these injuries have happened, and these patients have found their way into physical therapy clinics. The upcoming change from ICD-9 to ICD-10 will increase from 13,000 available codes to 68,000. This is a 5 fold increase, waiting just around the bend in 2015. These injuries will have to be properly coded and billed according to some highly specified causes of injury, and training staff in the minutia of these codes would take a great deal of time.
Better than the most well trained human administrative and billing specialist, bestPT is capable of keeping up with the ever changing payer rules and compliance regulations. The upcoming and seemingly monolithic change to ICD-10 code billing will be handled efficiently and swiftly. This program assists with coding, denial patterns, and other mundane tasks so that we can focus on our passion of helping patients. Other available services include billing tracking which reduces delay in payment, and protects the user from audits and fines. A crisis management team is available to assist with large scale billing problems.
While administrators may immediately recognize the benefits of implementing EHR, sometimes change as grand as this one can be met with grumbling from staff. At the root of these grumblings we often find fear of change to be the cause. Older staff members may have limited experience with computers, or may worry that they will not be able to keep up with their current patient load while they are being trained in how to use the new system. The idea of typing into a computer while they are trying to speak with, evaluate, and form a relationship with a patient may seem barbaric, or cold. For a long time physical therapists have been able to boast that we spend time more face to face time with our patients than other types of practitioners, develop rapport, and see our patients through their rehabilitation on a personal level. The barrier of a computer documenting system may initially seem counter productive to this practice.
Rest assured, the staff at bestPT take the time to carefully prepare staff for the process of “onboarding” or training and then implementing all staff members in the use of the new system. Topics such as clinical flow throughout training, troubleshooting, and error modification will be covered in great lengths. Scheduled meetings with technology training staff are helpful to administrators, and training modules within the system itself assist in the preparation of general staff.
As I began the process of on-boarding, I received login capability, and was able to teleconference with technology training staff during a shared screen session. Technical support staff guided me through the daily charting system while demonstrating control panels, patient charting, task procedures, patient scheduling, and staff communication procedures, all on my computer screen. When a challenge arose during the training procedures, they were handled quickly and efficiently by multiple levels of staff.
As physical therapists, we recognize the importance of customer service. We want our patients to feel listened to, and that they are an integral part of their plan of care planning. Likewise, we expect this of our business partners. We have limited time for additional meetings, and sacred few minutes to spare for errors and mistakes. bestPT recognized and respected my time. The system operates on multiple servers, ensuring that there are no lapses in my ability to access charts, patient information, or billing activity due to a down server. The technology training staff and management team made themselves available to me through email or the ticketing system within the bestPT system itself. The customer service that I value for my own clinic was provided to me, ensuring that I had made the right decision, not only to move to electronic health records, but specifically to use bestPT.
-Amanda Olson, DPT