"Physical therapy is not a subspecialty of the medical profession and physical therapists are not medical doctors; we are a separate profession that provides a unique service that physicians are unable and untrained to provide."

Letter to the AMA from the APTA, Dec 2009

Wednesday, January 19, 2011

Are Physical Therapists Waiting for Electronic Medical Records?


"It's not that we don't care, we just know that the fight ain't fair... so we keep on waiting - waiting on the world to change"
Get Where The Light Is: John Mayer Live In Los AngelesDVD.

Physical therapists aren't the only ones waiting... Physicians, too, have traditionally waited before purchasing an electronic medical record (EMR).

However, physical therapists can take heart that we are not too far behind the curve set by physicians in the United States.

Until recently, physician adoption of EMRs has been fairly slow. But, all that changed on February 17, 2009 when President Obama signed the The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, to promote the adoption and meaningful use of health information technology.
"Pursuant to the HiTECH Act, providers can be eligible of incentives of up to $44,000."
Provider, however, is ONLY defined as physicians - not physical therapists...
  • Doctor of Medicine
  • Doctor of Osteopathy
  • Doctor of Podiatric Medicine
  • Doctor of Optometry
  • Doctor of Oral Surgery
  • Doctor of Dental Medicine
For the Medicare reimbursement of up to $44,000, the term eligible professional refers only to physicians as defined by section 1861(r) of the Social Security Act.

Physicians across the nation have increased their adoption of Electronic Medical Records (EMR) according to the Electronic Medical Record Systems of Office-based Physicians: 2009 - 2010:
"Additional survey data from National Center for Health Statistics show that significantly increasing numbers of primary care physicians have already adopted a basic EHR, rising by 50 percent from 19.8 percent of primary care physicians in 2008 to 29.6 percent in 2010."
This data was published by the Centers for Disease Control and Prevention on December 8th, 2010.

Dr. John D. Halamka of Harvard Medical School, estimates that only 2% of physicians have a "full-featured" EMR (2010).


"Full-featured" EMRs have all the bells and whistles that define the Meaningful Use criteria (from Dr. Halanka's blog):
  1. Computerized Physician Order Entry (CPOE) - and different orders, such as physical therapy electronically.
  2. Drug-drug interaction checks
  3. Drug-allergy interaction checks
  4. e-Prescribing
  5. Report patient demographics
  6. Report PQRI quality measures electronically
  7. Maintain active problem lists
  8. Maintain active medication lists
  9. Maintain active allergy lists
  10. Check smoking status
  11. Check vital signs
  12. Clinical Decision Support systems (CDS) to improve quality and save time - right now, most physical therapist EMRs provide reminders and prompts for charge capture and revenue enhancement which, while perfectly rational, do little to enhance clinical quality.
  13. Formulary checks
  14. Advanced directives
  15. Incorporate lab results as structured data
  16. Generate patient lists
  17. Send patient reminders
  18. Electronic outpatient notes
  19. Electronic inpatient notes
  20. Electronic Medication Administration Records
  21. Provide an electronic copy of health information
  22. Provide a copy of discharge instructions
  23. Patient specific educational resources
  24. Web-based download of inpatient records
  25. Provide clinical summaries for each office visit
  26. Timely electronic access
  27. Measures for clinical summaries and timely electronic access
  28. Online Secure messaging
  29. Patient preference for communication medium
  30. Patient Engagement
  31. Perform test of HIE
  32. Perform Medication reconciliation
  33. Provide summary of care record
  34. List Care members
  35. Longitudinal care plan
  36. Submit immunization data
  37. Submit reportable lab data
  38. Submit syndromic surveillance data
  39. Ensure privacy
Many of these Meaningful Use mandates do not apply to physical therapy and physical therapists are not considered "eligible professionals" but many of us are still forging ahead with EMR and CDS purchases..

PhysicalTherapyProductsOnline poll of 19,000 rehab professionals

I'm not waiting on the world to define my future - I'm defining my future by investing in the tools of tomorrow.

In 2011, I'll spend several thousand dollars on software coding for a proprietary Clinical Decision Support system that is HITECH compliant using Treatment Based Classification to improve quality and get better outcomes.

How about the rest of us?

Will you spend money on Electronic Medical Records software in 2011?

6 comments:

  1. I have been far from satisfied with the options out there. None of the creators/vendors care what the printed report forms look like. All the data dumped into a report that is to be shared with physicians or attorneys or case managers - talk about overwhelming. It has no eye appeal... it isn't realistic... and can you tell, I hate 'em. Then, take into consideration there is a full lack of control of the purchaser's "brand." What the heck does a 5 page evaluation report do for those in which I communicate? My company has an "image" and if the electronic medical record can't help me to maintain my "image," that's a problem. No other businesses I know would ever agree to another company holding the control and creating "impressions" of them like we are allowing with electronic medical records in our industry.

    ~Selena

    ReplyDelete
  2. According to my knowledge, Physical Therapy Electronic Medical Records Software is a computer application that manages the clinical, financial and administrative functions of a healthcare organization.

    ReplyDelete
  3. Yah! EMR has a meaningful use and you don't need to keep the records manually. You can easily do it with the use of EMR. Anyway, thanks for sharing this post.

    -mel-

    ReplyDelete
  4. Tim, your post is nice to read.Nice presentation.
    Regards
    Physical therapy billing software

    ReplyDelete
  5. As much as three quarters of hospital staff are usually burdened with some sort of billing-related work in a traditional billing system. Opting for electronic medical billing solutions (ones that come with free EMR plans) that fit easily into the healthcare business' workflow are key to freeing up staff resources.
    Physician Billing Services
    Medical Billing Services

    ReplyDelete
  6. Thanks for this Therapy billing software information. it's really a new and valuable thing. by the help of these thing we can got our result in faster way.

    ReplyDelete

Free Tutorial

Get free stuff at BulletproofPT.com

Tim Richardson, PT owns a private practice at Medical Arts Rehabilitation, Inc in Palmetto, Florida. The clinic website is at MedicalArtsRehab.com.

Bulletproof Expert Systems: Clinical Decision Support for Physical Therapists in the Outpatient Setting is a manager's workbook with stories, checklists, charts, graphs, tables, and templates describing how you can use paper-based or computerized tools to improve your clinic's Medicare compliance, process adherence and patient outcomes.

Tim has implemented a computerized Clinical Decision Support (CDS) system in his clinic since 2006 that serves as a Reminder, Alerting, Prompting and Predicting CDS using evidence-based tests and measures.

Tim can be reached at
TimRichPT@BulletproofPT.com .

"Make Decisions like Doctors"


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