Compiled by Frank Long, Editorial Director

It has been a full year for companies that manufacture software that rehab facilities use for practice management, documentation, billing, scheduling, and more. Executives from some of the nation’s leading software manufacturers reflect on how feedback from their users has helped guide refinements in their products, and discuss the developments they see emerging in the marketplace moving forward. Included in this Rehab Management exclusive are: Jeremy Cader, vice president of product innovation and engineering, Clinicient; Sharif Zeid, business director, MWTherapy by Merlinwave; Steven Presement, president, Practice Perfect EMR; Terrence Sims, president, chief operating officer, Raintree Systems; Doug Cundiff Jr, VP, Net Health 360 Services, Rehab Therapy; Daniel Morrill, chief executive officer, TheraOffice by Hands On Technology; and Heidi Jannenga, president, WebPT.

In 2017, what developments occurred in the software landscape that surprised you, or that helped push a trend forward?

Jeremy Cader: Block chain technology and AI particularly found their way into more use cases in Health Care. Block chain is fueling solutions like Health Coin and Machine Intelligence is being applied to claims processing to minimize denials from payors. I also think wearable technologies are going to be more applicable in data collection for patients in outpatient rehab.

Sharif Zeid: As a market leader and innovator, MWTherapy is always on the forefront. The trend continues from basic EMR adoption to getting more efficiencies out of practice management systems. Many years ago, the idea was to enhance chart organization and legibility of notes—today’s practices are tracking everything from referrals to authorizations to billing. In 2017, it’s all about streamlining. All-in-one systems like MWTherapy make it possible.

Steven Presement: As clinic owners are now finally getting comfortable with the basics of electronic medical records and are adopting them successfully, we are finding they are getting hungry for more advanced functions having to do with patient engagement. For example, patients being able to book their own appointments online, without having to contact the clinic, has gone from virtually no demand to high demand over the course of the last year. The need for enhanced patient relationship management is also becoming more relevant, with clinics turning their attention to enhancing the patient experience beyond just the clinical.

Terrence Sims: One of the trends is the further acceptance of all things digital. While this has been the trend for the last decade, 2017 was the high point for digital acceptance and use of digital tools for everyday tasks within many different healthcare fields. Digital acceptance is being driven by younger generations of providers who grew up in the digital era and now want connected devices, tools, software, and other resources that help them improve patient care, reduce waste, and increase their effectiveness in providing services.

Doug Cundiff Jr: The most important trend in 2017 is the push toward enabling patient engagement. In this industry where patients are consumers, and most have a choice of providers, it is critical that clinics have great tools to facilitate welcome communication outside of visits—all geared to keep patients on track for outcomes. ReDoc’s patient engagement suite facilitates appointment reminders, home exercise explanations, emails, and text messages.

Daniel Morrill: Not as much surprised as disappointed. We thought the interoperability of systems would be further along by now. Systems are still having difficulties moving data that can influence the care we provide for our patients. HL7, Direct Messaging, and proprietary connections have made strides in some markets. However, the masses still do not have access to all their health records. Today more than ever, individuals and families have the ability to seek the care that is best for them, and that care is not always delivered under one roof. It is vital that we find a solution that can influence secure, accurate, and effective healthcare across all patients and providers.

Heidi Jannenga: While this wasn’t a surprise, the need to share and exchange patient information and data across healthcare sectors that were previously siloed has continued to grow. Thus, the entire healthcare software industry has experienced a push toward interoperability. That being said, there are still hurdles the industry needs to overcome—in terms of technology, security, and legislation—before we can achieve this feat, although we are moving in the right direction (ie, toward a free-data model).

What have you learned in the recent past that will help improve or guide the development of your product in the future?

Jeremy Cader: Our clients rely on our regulatory expertise. To reduce regulatory burdens and help clients get paid what they’re rightfully owed, we continuously update and refine our compliance management tools. One area of focus for our engineering team is the automation of calendar-based events in our product so that regulatory changes, such as ICD-10, are even easier and simpler to manage using our tools.

Sharif Zeid: Clients are always providing us feedback, and this informs our direction. We’re big on putting clients first. As always, healthcare is a very dynamic world with things constantly changing. The best practices have the best systems that allow them to evolve over time. MWTherapy is regularly adding new features to meet new needs and new realities.

Steven Presement: The push now needs to be on automated features that elevate one clinic above its competition, and not just merely clinically. Functions and automation need to be developed that will enhance the patient’s perception of the clinic, such as automated communication, surveys, appointment reminders, self-service, the “personal touch,” and not at the expense of admin time, in fact potentially reducing the burden on the administrative staff.

Terrence Sims: One of the things we have learned is that not only do you have to listen to your customers, you also have to connect your customers with your other customers and listen to them talk to each other about their practice, their patients, and your products. This interaction leads to interesting insights, suggestions, and gives you a unique perspective on trends and industry challenges.

Doug Cundiff Jr: We learned to move deeper into our sweet spot and show clinics how to maximize efficiency and do more with the resources they already have in-house. Clinics have the power to see greater patient throughput and increased revenue without adding providers or staff. What helps? Documentation efficiencies, great business insights data that supports decision making, confidence in compliance elements (G-codes, modifiers, therapy cap tracking), and utilizing outcomes benchmarking are all factors.

Daniel Morrill: Customer feedback, experimenting with new technologies, and closely monitoring changes to regulations are the areas we focus on. Creating solutions for our clients to help navigate the complexity of healthcare regulations and their business is what generates our drive and passion. I like to think we built TheraOffice so that therapists, administrators, and staff can truly have a voice in their PM and EMR system.

Heidi Jannenga: From our recent survey of more than 52,000 rehab therapy professionals, we learned that many therapists don’t consider themselves business people—despite the fact that many own and operate private practices. Thus, we’ve upped our game when it comes to providing stellar business tools and products. In addition to our top-notch practice management suite, we launched a full-scale analytics product and acquired Strive Labs to offer much-needed patient relationship/engagement management software.

What short-term or long-term developments do you see on the horizon that will affect the software market?

Jeremy Cader: I think Patient Engagement solutions with EHR automations will be an area where you will see advancements and improvements for clinic efficiencies and revenue growth. There will also be more machine learning solutions coming from startups that will challenge the existing large platforms. I also see a consolidation in the marketplace, as big players begin acquiring smaller players.

Sharif Zeid: While technology is always moving forward, a lot of the developments remain similar—regulatory changes, Medicare payment schemes, and other payor changes are always moving targets. There are also market considerations as patient expectations evolve and more practices opt for a cash-basis route. We’re always listening to keep our system in line with current needs while keeping our product priced competitively.

Steven Presement: We always have to do the Medicare dance, that is first and foremost. Medicare introduces PQRS, we had to accommodate. Medicare adds MIPS, changes CPT or ICD codes, we have to accommodate. If a client can’t bill a specific insurer because of an odd field requirement, we have to make it happen—these are all short-term. Long term, I do see the trend towards enhanced patient relationship management: secure email, two-way texting, automated check-ins, self-service accounting and appointment booking, that sort of thing. Also, there will undoubtedly be more required of the patient to verify attendance and minimize fraud, for example having patients sign-off on their own clinical notes, that sort of thing. And when it happens, we’ll be there.

Terrence Sims: The obvious answer is what will happen with the Affordable Care Act (ACA). However, regardless of what happens with the ACA, the trend of moving to evidence- and results-based medicine is not going away. This trend has been moving for a while, and with the rollout of MIPS the challenge for the software industry is to develop and enhance their tools to allow their customers to operate within an evidence and results-based structure.

Doug Cundiff Jr: What’s unavoidable on our horizon is the focus on quality. CMS introduced tiered CPT codes this year to understand the complexity of various procedures that therapists encounter. The APTA PT Outcomes Registry supports the submission of MIPS program data for therapists who choose to participate. These and other avenues lead to an important bigger picture—data that will help CMS determine appropriate future payment structures for providers. ReDoc supports data collection on these fronts.

Daniel Morrill: The evolution of cloud and new technologies that allow better data analysis seems to be the long-term strategy. Giving practices the ability to look at their data and follow trends to understand successes and correct inefficiencies will be more vital than it currently is today. Decreasing reimbursement, increasing costs, and barriers to care are all pushing the healthcare business to operate with an optimized workflow process. Software is positioned nicely to be able to deliver the data that is needed to optimize the delivery of care and the growth of businesses.

Heidi Jannenga: Back on the interoperability front, over the next several years, software automation that enables seamless information transfer will be immensely helpful—for providers, payors, and patients alike. It has the potential to produce large quantities of meaningful data at every level, from the way the healthcare system as a structure is faring, all the way down to the manner in which a single patient is responding to a specific course of treatment or plan of care. RM