The Impact of HITECH on EHR Implementation

Software Advice, a trusted resource for buyers of software, recently published findings from a three-year study following the changing demand drivers among prospective buyers of eclectronic health record (EHR) software.

The study captured data over two sample periods: Q1 2010 (shortly after the HITECH Act was signed into law) and Q1 2013. In both sample periods, the reasons providers expressed interest in purchasing EHR software broadly fell into the following categories:

• Replacing paper records;
• Replacing existing EHR software;
• Opening a new practice;
• Replacing other software that wasn’t specifically designed for medical records; or
• Some combination of the above.

For both sample periods, replacing paper records was the most-mentioned reason for EHR purchases. However, the percentage of practices replacing paper records fell significantly from 2010 to 2013, while the percentage of respondents replacing existing software grew by almost 50 percent.

These findings seem to validate a hypothesis that the HITECH Act spurred some practices to adopt EHRs too hastily. For providers, this highlights the importance of having a rigorous selection process in place before making a purchase.

Digging deeper into the data allows us to determine why practices are replacing existing EHRs.

Mentions of being “unhappy with current EHR” grew by 11 percent from 2010 to 2013. Additionally, concerns with cost rose significantly, from only one mention in 2010 to being mentioned by one out of every eight participants in 2013. Customer service concerns grew by nearly 50 percent.

Replacing Paper
The percentage of buyers replacing paper charts decreased from 64.9 percent in 2010 to 50.9 percent in 2013.

In both 2010 and 2013, the top reasons practices mentioned for switching from paper to electronic records had to do with the general benefits of a paperless environment – decreasing paperwork, improving efficiency, and becoming more organized. These motivations suggest practices are interested in more than just stimulus dollars; they also seem to recognize the inherent value of electronic records.

Among potential EHR buyers, we observed a decline in the proportion of practices transitioning from paper to electronic records, contrasted with an increase in the proportion of practices replacing existing software. What our data points don’t show, by virtue of only including buyers in the market for an EHR, are the many providers who are not replacing their EHR solutions – those who have successfully implemented electronic records with great benefit to their practices.

With EHR replacements on the rise, we conclude by emphasizing the need for practices to perform due diligence before making a purchase decision. Careful research can be awarded with a system that contributes to improved patient outcomes as well as increased financial health for practices.


David Fried originally contributed this report to Software Advice, where he currently covers medical practice management, the EMR industry, and political and regulatory issues affecting doctors. View the full report, including methodology and limiting factors, here: Four Years Later: The Impact of the HITECH Act on EHR Implementations.

5010 Deadline Extended through June

The Centers for Medicare and Medicaid Services (CMS) announced an extension of enforcement discretion, through June 30, 2012, for any covered entity that is required to comply with the updated transactions standards adopted under the Health Insurance Portability and Accountability Act of 1996 (HIPAA): ASC X12 Version 5010 and NCPDP Versions D.0 and 3.0.

ASHA Offers Online Conference for Audiologists and Speech-Language Pathologists

September 9, 2011 · Posted in audiology, Speech Therapy · Comment 

Audiologists and speech-language pathologists will be able to earn up to 2.85 CEUs from the American Speech & Hearing Association (ASHA) by attending an online conference called “Audiology 2011″ from October 12–24, 2011.

Audiology 2011 will provide audiologists and speech-language pathologists with in-depth discussions on Audiologic Rehabilitation (AR) for Adults. The broad range of topics will include:

  • audiovisual speech perception and how this can impact speech reading in older adults
  • the social psychology of acquired hearing loss with implications for practice
  • the value of including communication partners in the AR process
  • rehabilitation for auditory processing difficulties among adults
  • accommodating the needs of adults with hearing loss in the workplace
  • auditory training
  • the importance and evidence behind effective counseling
  • evaluation of the evidence and cost-effectiveness supporting the inclusion of AR services
  • subjective and objective measures of hearing aid outcomes

For more information and system requirements, go to Audiology 2011.

Scottsdale Healthcare Outpatient Therapy Services Implements Chart Links Rehabilitation Software

Workflow management software enables more than 40 therapists in four locations to manage therapy documentation, scheduling, referrals, insurance authorizations, charges and more.

Electronic therapy documentation and scheduling software from Chart Links is now being used by more than 40 therapists in four locations at Scottsdale Healthcare, a community-based non-profit healthcare system in Scottsdale, Ariz.

Scottsdale Healthcare Outpatient Therapy Services is a leading provider of therapy related to orthopedics and sports medicine, balance and vestibular disorders, swallowing and voice disorders, pediatrics, geriatric disability, neurological disorders, work-related injuries and total joint replacement, as well as hand therapy, aquatic physical therapy and audiology evaluation. In 2010, approximately 5,300 evaluations and 42,000 visits were processed across four Scottsdale Healthcare locations.

“We chose Chart Links due to the flexibility of its clinical documentation design,” said Therapy Services Manager Melinda Richardson, PT, MA. “We see patients of all ages across a variety of rehabilitation disciplines, so we require a high level of specificity in our therapy documentation to individualize patient care. Our clinicians didn’t feel that the fixed templates offered by other products allowed for easy modifications based on patient need. With Chart Links, we got the flexible documentation we needed without sacrificing compliance with Medicare CCI edits, modifiers and time tracking.”

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.

“Electronic access to our patient records has made us much more efficient,” said Richardson. “Before Chart Links, we used transcription along with handwritten documentation and had a scheduling system that was separate from our billing system. We were constantly handling and hunting down paper charts, and were tracking and reporting information manually. The electronic integration of Chart Links into our existing systems makes for a more productive and seamless management of information from start to finish. We’ve eliminated our transcription costs and resources, and we document in less time. We’ve also cut out labor and paper intensive processes like chart management, faxing and manual charge entry.”

Chart Links is capable of interfacing in a Health Level 7 (HL7) format to inbound Admission/Discharge/ Transfer (ADT) for patient registration data and to outbound billing systems. Interfaces also exist for inbound scheduling, outbound scheduling, outbound results, and customized ADT or billing, among others.

“Moving forward, we are poised for sharing information electronically across care settings, for example, with home health systems or accountable care organizations,” Richardson said. “It’s that kind of connectivity that will enable healthcare as a whole to deliver a higher quality of care with less administrative cost.”

About Chart Links, LLC
For more than 16 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, visit

About Scottsdale Healthcare
Scottsdale Healthcare is the community-based, not-for-profit parent organization of the Scottsdale Healthcare Osborn Medical Center, Scottsdale Healthcare Shea Medical Center and Scottsdale Healthcare Thompson Peak Hospital, Virginia G. Piper Cancer Center at Scottsdale Healthcare, Scottsdale Healthcare Research Institute and Scottsdale Healthcare Foundation. Arizona’s first and only multihospital health system to earn Magnet recognition for its nursing care, Scottsdale Healthcare is a leader in medical innovation, talent and technology, founded in 1962 and based in Scottsdale, Ariz. For more information, visit For information on Scottsdale Healthcare Outpatient Therapy Services, visit

ASHA Announces 2011 President

January 18, 2011 · Posted in audiology, Speech Therapy · Comment 

Paul R. Rao, PhD, CCC-SLP, recently took office as the 2011 president of the American Speech-Language-Hearing Association (ASHA), the national professional, scientific, and credentialing association for audiologists, speech-language pathologists, and speech, language, and hearing scientists.

Rao, 64, is vice president of operations and compliance at the National Rehabilitation Hospital, Washington, DC, and a visiting professor at the University of Maryland. Rao succeeds Tommie L. Robinson Jr, PhD, CCC-SLP, who continues to serve on ASHA’s board of directors.

“My goal is to better position ASHA members to serve their clients and to improve reimbursement and access for all,” Rao said. “As part of that, as ASHA’s president I look forward to working with ASHA member-advocates to see that the Association continues to be a significant player in the new health care reform legislation in order to help bring the promise of more freedom to individuals with communication disabilities.”

Rao comes to ASHA’s top elected office with more than 25 years of volunteer experience with ASHA. He has served on a number of ASHA committees and boards, such as the Board of Ethics, the Committee on Honors, and the Special Interest Divisions Board of Division Coordinators. He has also served as president for both the Maryland Speech-Language-Hearing Association and the District of Columbia Association for Healthcare Quality. In 1991, he became an ASHA Fellow, one of the highest honors of the Association. For more information, go to

[Source: Rehab Management]

Analyze Physical, Occupational & Speech Therapy Data

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.

Margaret Mary Community Hospital Chooses Chart Links

MMCH Rehabilitation Center chooses Chart Links for niche-specific solution and hospital information system interface capabilities

Margaret Mary Community Hospital ( 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.”

Extension of Therapy Cap Exceptions Process

According to the Centers for Medicare & Medicaid Services (CMS), on March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act, which extends the exceptions process for outpatient therapy caps (see Section 3103).  Outpatient therapy service providers may continue to submit claims with the KX modifier, when an exception is appropriate, for services furnished on or after January 1, 2010, through December 31, 2010.  

The therapy caps are determined on a calendar year basis, so all patients began a new cap year on January 1, 2010.  For physical therapy and speech language pathology services combined, the limit on incurred expenses is $1,860.  For occupational therapy services, the limit is $1,860.  Deductible and coinsurance amounts applied to therapy services count toward the amount accrued before a cap is reached.

May is Better Hearing and Speech Month

March 23, 2010 · Posted in audiology, Industry News, Speech Therapy · Comment 

The American Speech-Language-Hearing Association (ASHA) is promoting “Better Hearing and Speech” in the month of May.  This annual event provides opportunities to raise awareness about communication disorders and to promote treatment that can improve the quality of life for those who experience problems with speaking, understanding, or hearing.

For resources to help your facility celebrate Better Hearing and Speech month, go to

Spartanburg Eliminates Transcription Costs, Improves Clinician Productivity and Documentation Consistency Using Chart Links

Spartanburg Regional Rehabilitation Services is a division of Spartanburg Regional Healthcare System, which is based in South Carolina and was named one of the nation’s “Most Wired” hospitals in 2007 by Hospital & Health Networks magazine. Spartanburg Regional Rehabilitation Services focuses on physical therapy, occupational therapy and speech-language pathology, and includes 68 clinicians and 10 support staff across eight locations.

At the time that Spartanburg Regional Rehabilitation Services began evaluating electronic charting solutions, the organization’s use of paperbased patient charts required advanced planning to ensure that the chart was available at the location where the patient was visiting. In addition, Spartanburg maintained the majority of its paper-based charts older than one year at an off-site storage location. As a result, the office often had to retrieve records from offsite storage before patient visits.

“One of the many disadvantages of using paper-based documentation was that the therapists had to complete a billing sheet with every patient encounter, which was time consuming, and on some occasions, was not completed in a timely manner,” said Kelly Sheppard-Fowler, Practice Manager at Spartanburg Regional Rehabilitation Services. ” Another challenge with our manual processes was the lack of electronic scheduling, which makes it all too easy to encounter scheduling errors when coordinating across different sites.”

“The other solutions evaluated didn’t have the rehabilitation-specific functionality that we needed, such as specialized reports and templates, as well as a way to link clinical documentation with scheduled appointments,” Sheppard-Fowler said. “Most importantly, the solutions didn’t track insurance authorizations for patient visits, or notify the therapists when additional visit authorization was needed for the patient. Chart Links had all of these capabilities, plus much more.”

Spartanburg went live on Chart Links electronic documentation in August 2006 following a six-month implementation that included the creation of an interface to the organization’s McKesson Star billing system. “The implementation of Chart Links was successful due to the extensive planning and knowledge of the Chart Links staff. It was very helpful that the implementation staff included a therapist from Chart Links that could relate with our clinical staff,” Sheppard-Fowler said.

Users quickly adopted the solution because it mirrored the organization’s workflow. “Illegibility problems were immediately eliminated and the accuracy and thoroughness of our documentation improved drastically,” Sheppard-Fowler said.

Using Chart Links, Spartanburg clinicians no longer have to fill out billing sheets for each patient, since the system automatically completes the task. Edits within the system check that charges are compliant with private insurance and Medicare requirements, and that any charging errors are routed into a queue for review. To further prevent errors, the interface with the McKesson Star system allows Chart Links to confirm that patient information is consistent between the two systems. Additionally, Chart Links alerts therapists if Medicare modifiers are missing, and the system tracks patient visits that count toward insurance authorizations, automatically notifying clinicians when additional visits will require reauthorization. Chart Links also allows the clinical staff to fax plans of care directly out of the system to referring physicians, and has a tracking system to ensure compliance.

Since using Chart Links, reimbursement has increased due to more accurate documentation and the ability to track insurance authorizations that help avoid lost charges. Chart Links’ edit capabilities that catch errors before claim submissions have enabled Spartanburg to decrease its error rates significantly, which has reduced accounts receivable days.

In addition, Spartanburg eliminated its $10,000 per month transcription costs since all documentation is now electronic. “Chart Links helped make our documentation consistent across all our sites, and it’s easy to access a patient chart from any of our locations,” Sheppard-Fowler said.

Spartanburg implemented the Chart Links electronic scheduling module one year after going live with electronic documentation. “Initially, we utilized the hospital’s centralized department/software to handle our scheduling needs but the existing system did not accommodate our different sites, clinicians and specialties. As a result we encountered extensive scheduling errors. Most of these errors were eliminated once we began using the Chart Links scheduling system,” Sheppard-Fowler said.

Another benefit of using Chart Links is the system’s ability to help track clinician productivity. “Although we haven’t changed our productivity expectations, we have noticed that more clinicians are meeting their productivity goals,” Sheppard-Fowler said. “Prior to Chart Links, clinicians would simply turn in productivity reports to their manager, who would only contact clinicians if they were not meeting their goals. Now, clinicians actively monitor their productivity using Chart Links, which promotes accountability and self-motivation toward obtaining productivity goals.”

Providence Speech and Hearing Center Selects Chart Links Rehabilitation Software for 25 Therapists

September 29, 2009 · Posted in audiology, Documentation, occupational therapy, Speech Therapy, Workflow · Comment 

Chart Links, a provider of rehabilitation workflow management software, announces the selection of its electronic therapy documentation and scheduling system by a team of 25 audiologists, speech therapists and pediatric occupational therapists at Providence Speech and Hearing Center, a not-for-profit leading provider of services to the speech and hearing impaired of Orange County, California. The software implementation will include functionality for electronic therapy documentation, cross-discipline therapy scheduling, referrals, insurance authorizations and charges. It also includes a patient demographic and billing interface to the existing practice management system.

“Our mission is to enrich life through the gifts of speech and hearing,” says Linda H. Smith, CEO of Providence Speech and Hearing Center. “Because of the efficiencies we’ll gain by automating our administrative and clinical workflows with Chart Links, we’re projecting an increase in patient load and a drastic reduction in our wait list of 1000 patients, all of whom are children.”

In 2008, Providence provided services to more than 21,000 people. Approximately 80% of Providence Speech and Hearing Center’s work is dedicated to low-income patients who are either uninsured or underinsured.

“We selected Chart Links over other systems because it was built for therapists practicing in an outpatient setting,” says Smith. “By enhancing their productivity, we expect to increase our time spent with patients and improve outcomes.”

Chart Links software streamlines all of the daily tasks associated with a patient’s physical therapy, occupational therapy, speech language pathology, or audiology visit. The software manages adult and pediatric therapy treatment by automating evaluations, flow sheets, plans of care, progress notes, patient education, and clinical correspondence. It also manages payer compliance, provider reimbursement, outcomes reporting, administrative functions, business intelligence and enterprise productivity.

About Chart Links, LLC
For 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.

About Providence Speech and Hearing Center
Founded in 1965 by Sister Margaret Anne Inman Ph.D., Providence Speech and Hearing Center is the leading service provider to the speech and hearing impaired of Orange County, California. With over 40 years of experience, Providence has grown from a one room house to a multi-million dollar non-profit organization. Providence served over 21,000 appointments in 2008 to over 3,200 unique patients. They offer a full array of speech and hearing services for children and adults alike; and, because they believe everyone deserves the gifts of speech and hearing, they accept most major insurance companies and medical groups as well as providing grants, scholarships and financing options for patients from low-income families. http://

Audiology Documentation Software

September 22, 2009 · Posted in audiology · Comment 

Chart Links offers software that simplifies the management of an audiology clinic.

In addition to our administrative and financial features like patient registration, referral management, insurance authorization, cross-discipline scheduling, charges, reporting/analytics, and outcomes, we offer the following audiology-specific features.

  • Audiology Evaluations. Standard audiology evaluation forms library (i.e., hearing loss, hearing aid assessment). Contains numerous sections with the ability to customize into sets and forms.
  • Device and Inventory Tracking. Monitor devices like hearing aids, hearing aid accessories and batteries. Track stock, new orders, returns and repairs.
  • Audiology Patient Education. Print-on-demand patient handouts (i.e., home programs). Instructional and educational materials are available for customization and distribution. Ability to scan-in existing sheets or create-your-own. Ability to interface to third-party electronic formats.
  • Appointment Recalls. Electronically manage appointment reminders for periodic hearing exams.
  • Scheduling. Ability to schedule patient with Audiologist, hearing/screening booth and audioscope in one easy-to-use feature.
  • Patient Arrival Notification. Audiologist may receive a page on his/her beeper to be notified when a patient has checked in at the front desk. Great for time management when an audiologist is in the hearing booth.
  • Authorizations. Monitor authorized visits for hearing evaluation and follow-up visits.
  • Compliance. Support of compliance efforts with JCAHO, CARF, HIPAA and other rehabilitation professional standards. Helps ensure compliance with Medicare CCI edits and time tracking while documenting.

Contact us to schedule a one-on-one demonstration of how our software works for speech and hearing centers.