CloudOf the 204,000 Physical Therapists, 113,000 Occupational Therapist, and 134,000 Speech & Language Therapist, more use paper charts to capture therapy notes than use electronic medical records. But when it comes to billing, the case is exactly the opposite as electronic billing has essentially been adopted in mass, across the board. The cause of this paradox can be explained by Payer mandates regarding electronic billing. Getting paid is a top priority, so when Medicare, Medicaid, and BCBS dictate electronic claims, electronic billing software becomes more or less mission critical.
Many physical rehabilitation therapists however still view electronic documentation of patient treatment as an optional agenda that can be deferred, or something that’s too overwhelming.  The notion that recording therapy notes using software requires a fair amount of computer skill and comes at a high price keeps many therapist from realizing the benefits of a fully automated practice.
But as per Medical Economics, the annual cost of maintaining a paper chart is $16 per year in comparison to an electronic chart which is estimated at $2 per chart.  Additionally, the increased complexity of payer documentation requirements, ever shrinking reimbursements, and rising cost pressure across the board, require greater efficiency in the documentation process that can mean the difference between practice failure or success.
Granted, implementing and learning electronic documentation tools (i.e. software) can be both painful and invasive, plus they have a tendency to cause latency during the initial 6 to 8 weeks of ramp-up; however the value that electronic documentation brings can be immense and invaluable to any practice, and according to the APTA, though PTs are not yet required meet Medicare’s Meaningful Use requirements, eligible providers in the CMS Program will expect the PTs with whom they share patients to use compatible EHR systems.
Patient therapy documentation software comes in two flavors; Server based systems that are housed on location at the practice, or web-based applications that are securely hosted on the ‘Cloud’. Server-based solutions are still the most prevalent, but that’s changing due to their many drawbacks, such as high purchase price and overall cost of upkeep, which include network maintenance and annual software updates.
With the advent of large-scale adoption of cloud-based software, the cost of software acquisition is dramatically decreasing.  Healthcare is a highly regulated industry and having patient data stored on the web is a concern of everyone, but the risk can be mitigated by finding a technology partner who offers HIPAA and OMNIBUS compliant data hosting and who adopts industry standard best practices to protect and safeguard patient data.
For instance, few therapist know that PHI stored a PC or on a server at the office typically meet only 17 of the HIPAA technical requirements, but properly maintained cloud solutions automatically meet 37 of therequirements.
The OMNIBUS rule within HIPAA in particular, mandates specific rules defining the governance of physical and logical access, backup, and secure transmission to ensure strict PHI data security. The complex issue of data-security is best met by engaging a technology partner who is expert at it. Following are some of the key factors to keep in mind when considering a Cloud-based software:

  • All PHI data access must have a complete audit trial.
  • Data must be stored for at least 7 years. Purging data should be avoided at all costs. There are a number of extremely affordable ways to store PHI data in a HIPAA compliant fashion.
  • Access to PHI must be restricted to clinical professionals who have signed the required Business Associate Agreement. Access of employees no longer with the practice must be terminated.
  • The best web-based systems have security settings that enable practice managers to restrict user access at a granular level for each user. This should be a key considerations when choosing a rehabilitation therapy software.
  • Most importantly, web-based software should have fewer windows to navigate through to complete a chart.  An intuitive interface that is easy to navigate will ensure that your documentation time is not at the cost of patient care.
  • Failsafe redundancy and automatic incremental and daily backups are a huge advantage of web-based systems. Anyone who has lost precious patient data due to a server crash will vouch for the immense value of automated and redundant system backups.

In Healthcare IT, more and more emphasis is being placed on web-based systems as most of the largest corporations have already made the shift to ‘the cloud’, to take advantage of simplicity, greater access to data, better security compliance, and tremendous cost savings.
As a small business, a Physical Therapy practice can also benefit by moving away from the traditional server-based model to the new era of Cloud Computing: You don’t have to be an IT expert to use web based software, it is generally accessible anywhere there is internet access, and it has the extra advantage of being easy to get out of if you don’t like the application or find that it doesn’t meet your specific circumstance.
Although therapists are not included the American Recovery and Reinvestment Act which provides incentive to help eligible physicians adopt electronic records by 2015, the adoption of therapy software in the near future is going to become a necessity for PT’s in particular to remain competitive. The APTA vision for 2020 mandates ‘Doctors of Physical Therapy’ for all therapy services.
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Last Updated on February 28, 2014