An article summarizing how Chart Links Rehabilitation Software streamlined the clinical and financial operations of an outpatient rehab practice recently got published in the Jan/Feb 2011 Rehab Management magazine. Read the full article below or link to it here.
by Andrea Marchi, PT, MBA, CSCS
EMR streamlines rehab practice’s clinical and financial operations.
Many therapists are considering the implementation of electronic medical record (EMR) solutions, but hesitate on making the purchase because they aren’t sure exactly how the technology will help their practice.
Our practice had the same concern initially, so we thoroughly evaluated the areas where an EMR could improve our business. It was quickly apparent that paper-based processes had a stranglehold on our practice. We suffered from many of the challenges other practices experience, such as: misplaced patient records; incomplete, untimely documentation impacting the billing process or regulatory compliance; productivity and financial performance data that was several months old by the time it was compiledWith the industry steadily moving toward widespread adoption of EMRs, we wanted to get ahead of the curve. Our facility, HealthPoint Rehab, which is affiliated with Southeast Hospital, handles about 33,600 patient visits annually out of two outpatient rehabilitation centers located in Cape Girardeau and Jackson, Mo.
There are numerous EMRs designed for physician practice specialties, but few that address the specific needs of rehab centers. We found a system designed to accommodate our team of 25 therapists engaged in physical, occupational, speech, and specialty therapies. Our system automates workflow for cross-discipline scheduling, referrals, insurance authorizations, clinical documentation, charges, and more. It includes Health Level 7 (HL7) interfaces to our hospital information system for effortless exchange of data. Most importantly, it supports our efforts to comply with professional standards while running an efficient business.
After a comprehensive system selection process, we implemented a software system in January 2009. The following information details how the technology has helped our organization over the past 2 years.
The biggest benefit we immediately noticed was the timely documentation of patient treatments. We have desktop computers installed within private exam rooms and laptop carts in our open gym spaces. Most of our therapists complete the treatment notes during the patient visit, while others finish after the visit.
In contrast, it took us much longer to get our initial evaluation paperwork to the physicians’ offices when we relied on dictation, transcription, and snail mail. We used to employ a full-time transcriptionist, but we have since eliminated the position and use the system’s faxing software to electronically fax our documentation to the physicians.
The structure of our daily notes within the software system has allowed our therapists to document procedures in a very clean and concise format. Another benefit is that our software system can ensure compliance with insurance regulations and therapy standards. During the documentation process, the system alerts therapists if they do not complete sections of the note that are necessary to comply with requirements from Medicare and The Joint Commission.
Using the EMR has helped us improve our billing process. Since charts are electronic and always available to the billing specialists when they need them, we complete our billing in a much more timely manner. We no longer waste time searching for the paper chart.
Unlike most EMRs, our rehab-specific solution has therapy-based billing capabilities built right into it. Correct coding initiative (CCI) edits built into the system help prevent errors that can result in returned claims or rejections from payors. The latest CCI edit table is automatically downloaded into the charge table, so we are always working from the most current version. Our system automatically reviews charges as they are being entered and alerts users if charges are improperly grouped or are missing modifiers. Using the system gives us the confidence that we are doing our billing correctly the first time, so we don’t have to worry about rebilling later in order to fix errors.
Further assisting our billing efforts is an interface that connects the system to the Meditech hospital information system at Southeast Missouri Hospital. The interface allows the systems to exchange information for billing and results, as well as admission, discharge, and transfer data. The result is a reduction in duplicate data entry.
The tracking capabilities of the EMR also help with compliance, especially when it comes to ensuring that physicians sign plans of care following initial patient evaluations. The system’s reporting capabilities enable therapists and front-office workers to easily view all plans of care that have not been signed by physicians, which helps accelerate follow-ups. And in cases where physician signatures have not been obtained, it tracks the number of times the plan of care was faxed by the system to a physician for signature. This tracking capability helps rehab clinics demonstrate their due diligence in trying to obtain signatures, which is Medicare compliant.
Prescriptions for therapy are also tracked. Upon receiving a physician’s prescription for therapy, it is entered into the system along with the number of visits that are prescribed or allowed by insurance. It also reports patients who have prescriptions that are about to expire, so the front-office can ensure we continue to treat patients with a current prescription.
A simple-to-use ad hoc analysis tool enables us to analyze practice trends, develop universal metrics, measure long-term changes, and gather operational decision-support data. Using the EMR’s analytics package, we have been able to analyze cancellation rates by patient type, determine our top referral sources by physician or physician group practice, track the number and type of CPT code charges, as well as proactively monitor staff productivity.
For example, by using the analytics module, we discovered that pediatric speech patients had the highest number of visit cancellations. Each cancellation negatively impacts our revenue and therapist productivity, so we developed new cancellation policies—applied to all patient types—to help curb the problem. By making patients aware of the new policy, we have been able to decrease our cancellation rate from 18% to 13%.
We also use the analytics module to track therapist productivity based on hours worked and units billed. In the past, we had one of our secretaries compile data to measure therapist productivity, but the process was cumbersome, and results were not available for 2 to 3 months after the time frame measured. Now, productivity is calculated weekly, so therapists can proactively monitor their productivity, which has been a wonderful management tool.
Another area we monitor with the analytics module is tracking referral sources. We can see exactly which physicians and physician clinics refer the most patients to us, which guides us in building relationships and growing our business.
The productivity of our front-office has been greatly improved by using the new system’s electronic scheduling capabilities. Now, scheduling is easy; as information can be clicked, dragged, copied, and pasted rather than entered manually. Also, scheduling multiple visits can be done all at once instead of creating individual appointments.
Front-office productivity is further enhanced by the system’s automated paging capabilities. Upon patient check-in, the system automatically sends an alphanumeric page to the corresponding therapist to let them know that the patient has arrived. Previously, the receptionist manually dialed the therapist’s numeric pager and during busy periods, it would be several minutes following the patient’s arrival before the secretary was able to send the page. In a business that bills based on time and units, a 3- to 5-minute delay can be the difference of billing an additional unit of service. In that regard, something as simple as automated paging may eventually lead to increases in revenue for us.
The EMR we selected has complemented our workflows and helped our practice improve productivity and documentation.
The most vital component to our successful EMR usage is that we selected a solution designed to operate in our business environment. The system’s rehab-specific capabilities allow our practice to automate the processes that matter most to our business. After using the solution for nearly 2 years, we can’t imagine doing our jobs without it.
Andrea Marchi, PT, MBA, CSCS, is the rehab manager at Southeast Missouri Hospital, HealthPoint Rehab, Cape Girardeau, Mo.
Chart Links, a provider of rehabilitation workflow management software, announces the implementation of its electronic therapy documentation and scheduling by 15 therapists at Tuomey Healthcare System’s Outpatient Rehab Services.
Rehab Services is a leading provider of outpatient physical therapy, occupational therapy, sports medicine, cardiac rehabilitation, developmental pediatrics, audiology and speech therapy in South Carolina. Located in the Tuomey Medical Park, Rehab Services includes physical therapists, occupational therapists, physical therapy assistants, certified athletic trainers, therapy technicians and administrative staff. The facility treats 150-200 patients per day.
“We researched systems for about a year,” says Jerry Shadbolt, M.Ed., ATC and Outpatient Clinical Manager. “We found Chart Links to be the most user-friendly and modifiable to meet our needs. Our goal was to make our clinicians as efficient and productive as possible by ridding ourselves of the paper. Chart Links is a flexible program offering us a variety of documentation templates — from pediatrics to ortho to spine.”
Chart Links software streamlines all of the daily tasks associated with a patient’s physical therapy, occupational therapy, speech language pathology, or audiology visits. The software manages adult and pediatric therapy treatment by automating evaluations, flow sheets, progress notes, patient education, clinical correspondence, and plans of care. It also manages payer compliance, provider reimbursement, outcomes reporting, administrative functions, business intelligence and enterprise productivity.
“From a management perspective,” says Shadbolt, “Chart Links keeps our clinicians compliant and accountable. We now have fewer incomplete documents at the end of the day. And, when it comes to reporting, there will be less of a ‘beastly effort’ to gather data and measure productivity. Overall, I give the product a high grade.”
Affiliated with 301-bed hospital Tuomey Regional Medical Center, Rehab Services has also implemented an interface from MEDITECH, the hospital’s information system, to Chart Links. Components of the interface include registration and billing data.
“Management of authorizations is one area that has greatly improved,” says Renee Brown, Office Manager. “We used to depend on the manual tracking efforts of our therapists and staff. Now, authorizations are automatically tracked in the system.”
About Chart Links, LLC
For over 15 years, Chart Links has developed rehabilitation software that automates workflow for referrals, insurance authorizations, cross-discipline scheduling, documentation, charges, and more. Chart Links allows medical rehabilitation facilities to be more efficient and to provide a higher quality of care by delivering results in the areas of compliance, outcomes, analytics and revenue. For more information about Chart Links, visithttp://www.chartlinks.com
About Tuomey Healthcare System’s Rehab Services
Tuomey’s Rehab Services team works every day to deliver personalized rehabilitation plans to help patients optimize their potential for good health. With an on-site physician, complete range of rehab services, world-class equipment and a team of rehab specialists, the rehab program is recognized as the finest and most comprehensive in the region. Tuomey rehab programs include physical therapy, occupational therapy, sports medicine, cardiac rehabilitation, developmental pediatrics, audiology and speech therapy. For more information, go to http://www.tuomey.com/facilities/tuomeymedicalpark.aspx
Effective management of any physical therapy, occupational therapy or speech therapy facility requires making informed clinical, financial and administrative decisions everyday.
At Chart Links, we provide an easy-to-use business intelligence and decision support solution that is capable of rendering complex information into a simple-to-understand format.
Visit our website to learn more about analyzing outpatient rehabilitation data.
In their August issue, Physical Therapy Products interviewd physical therapists across the country about the business software they utilize. Chart Links’ user Andrea Marchi, PT, MBA, CSCS from Southeast Missouri Hospital’s HealthPoint Rehab in Cape Girardeau, MO participated in the interviews. Here is what Andrea, the Rehab Manager at this two-location, hospital-based outpatient facility had to say about Chart Links rehabilitation software:
What led you to choose software from this company? Ultimately, we chose ChartLinks for the customization opportunities to best suit our wide range of specialties and disciplines. ChartLinks was able to best fit our needs. [For more information, go to http://www.chartlinks.com/]
What improvements have you seen in daily practice as a result of implementing this software? We have heightened awareness of our trends and reporting for better practice management. Scheduling, especially multidiscipline appointments, is easier and more efficient. Our therapists’ documentation is timelier. [For more information, go to http://www.chartlinks.com/therapy-scheduling.html and/or http://www.chartlinks.com/therapy-documentation.html]
What advice do you have for PTs who are currently in the market for new business software?Choose a system that will be end-user friendly and provides excellent customer support after go-live. [For more information, go to http://www.chartlinks.com/services.html]
What is the best feature of this software? ChartLinks’ has improved our daily efficiency, compliance, and business management. ChartLinks’ Analytics system sets it apart from the competition. With Analytics, we can easily create customizable reports. [For more information, go to http://www.chartlinks.com/analyzedata.html]
What was the implementation process like for this software? Chartlinks’ staff coached us weekly for approximately 8 months. Prior to go-live, we spent two weekends transitioning our documentation/schedule to electronic records followed by transition time for our therapists before returning them to a more typical workload. [For more information, go to http://www.chartlinks.com/services.html]
Are you interested in “diving in” to a comprehensive workflow management system for outpatient therapy management? Contact Chart Links at http://www.chartlinks.com/contact.html
MMCH Rehabilitation Center chooses Chart Links for niche-specific solution and hospital information system interface capabilities
Margaret Mary Community Hospital (www.mmch.org) in Batesville, Indiana, runs an off-site Outpatient Rehabilitation Center that handles more than 15,000 patient visits annually. The rehab facility employs 21 therapists providing physical, occupational, and speech therapies. Other services include work conditioning, sports medicine, balance, lymphedema, low vision and pediatric therapies. Aquatic therapy is offered at the local YMCA.
The rehab center had been using the hospital’s information system for documentation and billing and a manual, paper-based system for scheduling. Although the hospital system allowed some modification to accommodate documentation of the center’s special services, rehab center managers began to look for an end-to-end, niche-specific software solution that would assure documentation accuracy, improve workflow, save time, streamline scheduling and generally make life easier for a totally rehab-focused facility.
“We reviewed several different software options before narrowing our search to three companies,” said Carmen Pride, physical therapy manager and project manager on the search team. “After conducting extensive web demos and then comprehensive on-site demos of the three product finalists, we chose Chart Links. They definitely stood out and we especially liked the way their application looked.”
“We wanted to continue to use our primary EMR as the central point for our patients’ summary of care and billing records,” said Donna Nobbe, information systems director. “Therefore, our requirements for this project included a series of interfaces. Chart Links had experience doing this work with our hospital EMR vendor and provided valuable interface documentation.”
The MMCH Rehabilitation Center launched Chart Links in January 2009. “I totally expected the first day of ‘go live’ to be really crazy and haywire,” remarked Pride. “We sat in a room waiting to problem solve and expecting to help steer people through a hectic transition. But no problems came! That first day – and since – everything with the Chart Links system has been smooth and seamless. I’d recommend it to anyone.”
Chart Links solution exceeds rehab center’s expectations
MMCH has realized a full range of benefits, well beyond expectations:
Insurance reimbursement is significantly faster. Before, it took an average of 90 days until bills were sent out. Now, the timeframe is under 30 days. “This was made possible by the customized interface Chart Links created for us,” noted Pride. “Our billing is still distributed through Hospital’s primary EMR, but the Chart Links solution has streamlined and accelerated the process. We get our insurance monies in the door much more quickly now.”
Compliant documentation is more accurate and worry-free.
“We’re billing now with far less anxiety about errors because of Chart Links,” said Pride. “CCI edits, for example, have improved. Chart Links automatically notifies you of CCI edits so we don’t have to catch them on the backside or lose payments because we billed two procedures instead of one. Chart Links is our first line of defense, letting us know immediately if there’s a problem.”
Scheduling is more organized, streamlined and accurate.
Prior to Chart Links, the MMCH rehab facility scheduled manually with an appointment book (referred to as ‘the Bible’) which often resulted in confusion and error. “It was very unorganized,” said Pride. “There were too many therapists and not enough spaces to write in. Patients sometimes showed up when we didn’t expect them.”
The Chart Links solution has not only streamlined the scheduling process and cleaned up the errors but has also made the process completely user-friendly and intuitive. Unlike the other complicated-looking schedulers the rehab center management had considered, the Chart Links scheduler appears on the screen exactly like a book, a format the staff was very comfortable with. “The Chart Links scheduler was so easy to use and get used to that the staff abandoned ‘the Bible’ on day two of go-live rather than the six months they thought they would need to transition,” remarked Pride.
The workflow of the application makes sense, reflecting the way a therapist works and reports.
“Everything on the screen is organized and logical,” said Pride. “It’s Windows based operating system is a superior advantage. Print Preview, for example, depicts what the chart note will actually look like, a huge improvement over what we had. Even the range of motion measurements come out neater and, therefore, easier to read by the physician. Everything just looks better and flows better.”
The Chart Links Analytics option is a huge time-saver.
“With Analytics, you can look at specific programs and find out which ones are doing well or not,” noted Pride about the Chart Links ad-hoc reporting tool. “You can pull anything out of the system you want and analyze the data. Where month-end statistics would take an enormous amount of time to assemble with our old manual system, now we can run a report almost instantly.”
Customer service has been superb right from the start.
“Another major selling-point of Chart Links is their depth of rehab knowledge and their willingness and eagerness to share that expertise with us,” noted Pride. “We get very few vendors who have given us the customer service that Chart Links does,” said Trisha Prickel, manager of information system services. “They have responded to help desk questions at night and have been available to check the system after hours. I have been very impressed.”
To effectively manage an outpatient rehabilitation facility, you must make important clinical, financial and administrative decisions everyday. How can you make the most “informed” decisions about your department or practice? You can do it by culling and relating each important data element from your billing or therapy documentation software with a business intelligence solution.
While there are a variety of analytics or business intelligence solutions on the market that can work for outpatient rehab, it is advantageous to get one that does not require someone from IT To operate it. You need one that is easy-to-use and capable of rendering complex information into a simple-to-understand format. The solution should combine ad hoc analysis and reporting capabilities to allow for presentation services, graphing, and everything else needed to analyze practice trends, develop universal metrics, measure long-term changes, and gather operational decision-support data.
If you find that you’re asking questions but not getting answers for your outpatient rehab department, call Chart Links. We can introduce you to a business intelligence solution that can provide answers for your toughest outpatient rehab questions.