"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, March 7, 2012

Electronic Health Records May INCREASE Uitilization of Diagnostic Imaging

Contrary to the notion that Electronic Health Records (EHR) will lower spending a new study in the March Health Affairs found a 40% to 70% INCREASE in ordering of second x-ray or CAT scan. EHRs are supposed to lower health care spending by improving physician access to a patient's medical history and diagnostic test results.

Read the Health Affairs article here.

A "convenience effect" may be the mechanism by which EMRs lead to increased imaging.
Physicians have the ability to review results much more quickly and without having to track them down from an imaging facility.
"The effect may be to provide subtle encouragement to physicians to order more imaging studies".
Referring to better access to results with computerization, lead author Danny McCormick, MD says,
"As with many other things, if you make things easier to do, people will do them more often."
You can also read this summary article from Fierce Healthcare.

One implication for physical therapists might be an increased need for critical pathways like the Starbucks/Virginia Mason model from 2006 or the Intel/Cigna model from 2011 in order to contain the overutilization of diagnostic imaging.

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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 .

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Copyright 2007-2010 by Tim Richardson, PT.
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Consistent with the American Physical Therapy Association Vision Statement for Physical Therapy 2020, the American Physical Therapy Association supports exclusive physical therapist ownership and operation of physical therapy services.