Some people are pessimistic about the benefits of health care information technology.
Some people say health care IT might be dangerous.
Don't bet against it.
Some people estimate a $90 billion return on investment (ROI) in 10 years.
Don't bet on it.
I think the return will be positive, maybe not in dollars - but maybe in lives.
I just started investing in health care IT: $4,800 for new software and $5,000 for a new server and installation.
We've been at it for one month now.
We're not quite there yet.
Reinventing the physical therapy chart electronically means I have to undo years of 'training'.
The hardest part is time - time spent re-creating clinical templates, work flows and data collection.
Time spent away from patients is lost revenue - that's another 'investment
I might be tempted to get depressed or pessimistic about the process.
I might not see a big, positive return on my dollars.
But, I'm going to keep trying.
Some people think computers will improve our future.
Showing posts with label physical therapy chart. Show all posts
Showing posts with label physical therapy chart. Show all posts
Tuesday, January 27, 2009
Tuesday, December 16, 2008
How do physical therapists make decisions?
Physical therapists (PT) usually treat 11-15 patients per day in outpatient orthopedic clinics.
Most PTs in the United States still use a pen-and-paper approach to note writing.
We scribble all day long in between running to patient treatments.
Medicare only has these written notes to examine to determine if the physical therapy treatments are worth paying for.
What do most PT charts look like and what decisions do they reflect?
Get some perspective
Step back for a minute.
Stop writing your note.
Stop being a PT or PTA.
Look at your chart.
What does it look like?
Is it organized?
Neat?
Sequentially organized?
Are the most important documents on top?
Does it look like you chart is designed for fast, efficient treatment?
Or, does it look like your chart is designed for fast, efficient decisions?
What do skilled physical therapy decisions look like?
Your skilled physical therapist decisions are what Medicare is paying for.
Treatment is secondary to your decisions.
Make the chart work for you.
Set up your chart so that evidence of decision-making is foremost.
Put your goals at the front of the chart.
Make decisions about goals in the daily note. If you still use a SOAP note the Assessment portion should reflect progress towards goals.
Make your initial measurements accessible. Put your dictated Plan of Care where you can get to it easily (hint: not at the back of the chart).
Two types of measurement need to be accessible:
1. Impairment in body structure and function (ICF)
2. Activity and participation limitations (OPTIMAL)
Put these near the front of the chart.
Some therapists feel that the back of a double-sided, flip-type paper chart is just as accessible by grabbing the whole stack of paper and flipping it up.
Perhaps it is.
I think that putting your goals and measurements at the back of the chart however sends the subtle message that you see writing about goals as less important.
Goals are less apparent and less evident at the back.
The presentation of your chart should reflect your intent.
What is your intent?
Decisions or treatment?
Decisions are more defensible.
*****
To get an incredibly detailed, voluminous, technical and shelf-worthy resource on physical therapy do-it-yourself Medicare compliance go to the
To get a compliance program written by a physical therapist for physical therapists go to
Most PTs in the United States still use a pen-and-paper approach to note writing.
We scribble all day long in between running to patient treatments.
Medicare only has these written notes to examine to determine if the physical therapy treatments are worth paying for.
What do most PT charts look like and what decisions do they reflect?
Get some perspective
Step back for a minute.
Stop writing your note.
Stop being a PT or PTA.
Look at your chart.
What does it look like?
Is it organized?
Neat?
Sequentially organized?
Are the most important documents on top?
Does it look like you chart is designed for fast, efficient treatment?
Or, does it look like your chart is designed for fast, efficient decisions?
What do skilled physical therapy decisions look like?
Your skilled physical therapist decisions are what Medicare is paying for.
Treatment is secondary to your decisions.
Make the chart work for you.
Set up your chart so that evidence of decision-making is foremost.
Put your goals at the front of the chart.
Make decisions about goals in the daily note. If you still use a SOAP note the Assessment portion should reflect progress towards goals.
Make your initial measurements accessible. Put your dictated Plan of Care where you can get to it easily (hint: not at the back of the chart).
Two types of measurement need to be accessible:
1. Impairment in body structure and function (ICF)
2. Activity and participation limitations (OPTIMAL)
Put these near the front of the chart.
Some therapists feel that the back of a double-sided, flip-type paper chart is just as accessible by grabbing the whole stack of paper and flipping it up.
Perhaps it is.
I think that putting your goals and measurements at the back of the chart however sends the subtle message that you see writing about goals as less important.
Goals are less apparent and less evident at the back.
The presentation of your chart should reflect your intent.
What is your intent?
Decisions or treatment?
Decisions are more defensible.
*****
To get an incredibly detailed, voluminous, technical and shelf-worthy resource on physical therapy do-it-yourself Medicare compliance go to the
Compliance Program for Individual and Small Group Physician Practicesby the Office of the Inspector General.
To get a compliance program written by a physical therapist for physical therapists go to
BulletproofPT.comwritten by Tim Richardson, PT.
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American Physical Therapy Association
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.