What sometimes goes unnoticed in the day-to-day routine of running a successful multisite physical therapy practice is the many opportunities for improved efficiency in all of the tasks involved in providing proper treatment to patients and in submitting claims for reimbursement. Identifying these “time leaks”—time intervals that are lost due to inefficiencies in the process—can be complicated, especially when managing multiple locations. Subjecting all of the key areas of practice management to a detailed examination to identify time leaks, however, can prove to be beneficial in the long run.
A valuable tool in the fight against time leaks is an electronic medical records (EMR) system, which can help streamline workflow and improve productivity. An EMR system keeps all patient records in a single, easy-to-use database, reducing the time needed to search for records. In addition to looking up patient records, software programs can centralize scheduling—allowing you to check the availability of practitioners, rooms, and resources across locations, or to send appointment reminders—and simplify the processes of filing claims, writing documentation, and producing reports.
Choosing a system may appear to be a daunting task, and if your multisite practice is well established, the thought of switching a large number of manual records over to a new electronic system may be even more intimidating. The long-term benefits of an EMR system, however, outweigh the short-term adjustments needed to switch over from a paper-based system. Depending on your needs, it may take a few months or up to a year to research and select the right system for you, but the end result will be a decrease in time leaks and an increase in efficiency.
A major source of time leaks within a multisite practice is in workflow-related functions, such as appointment scheduling, patient registration, clinical encounters, and billing. Adopting an EMR system for these duties can improve staff and patient experiences by streamlining the aforementioned processes so that patients receive more organized and immediate care.
For example, appointment scheduling for an entire practice can be at your fingertips from a single location. Software programs allow you to check the availability of appointments at multiple facilities from a computer situated at one central site, decreasing the number of phone calls and the length of patient wait times that occur when scheduling is performed via telephone and paper appointment books. The increased efficiency in the appointment-making process lets your administration team focus on more important office-management duties.
Patient-registration procedures can also benefit from the use of an EMR system. Upon an initial visit, the patient can be registered electronically via a software form (sometimes based online) without the need for the usual mountain of registration material including file folders and registration sheets. Once the patient completes the registration form, the information is immediately on hand at all locations. The need to manually rummage through an overfilled filing cabinet is eliminated, reducing not just time leaks, but hassles too.
Manual documentation can be a time-consuming procedure, frequently demanding the notation of lengthy or repetitive comments. The human element of the tedious process makes the documentation inconsistent and susceptible to error, such as improper usage of highly particular semantics. Also, much time is wasted down the line in trying to keep pace with a growing pile of documentation waiting to be processed, not to mention the time squandered while trying to interpret the handwriting of different therapists. This can create problems for both therapists and their health care providers.
Moving from printed material to an EMR system’s electronic entry and recording offers the same benefits as moving from snail mail to e-mail. Input and access are faster, the risk of human error is reduced, and the documentation has a high level of consistency, with no time spent decoding individuals’ unique scripts. In addition, accessing patient information from a different office using an electronic file will be much easier.
Consider a staff therapist’s need to coordinate with another department for a patient’s care. An EMR system allows the staff PT to look up multidepartmental information from their current location, and they can check the patient’s daily activities and progress without worrying about the other PTs filling out forms incorrectly, removing much uncertainty and inefficiency from the routine.
It is not uncommon for a physical therapy practice to be backed up in the processing of medical records for many weeks. The number of average patient visits per week across multiple locations can reach into the hundreds. With such a high level of traffic, it is extremely easy for patient charts to start floating around the practice and eventually end up somewhere other than in the appropriate filing cabinet. If your office is not equipped with the right type of storage area, you also could be circulating hundreds of charts throughout the facility per day. Successful marketing efforts that bring in new patients mean that the paperwork will continue to add up, making claims processing that much more difficult.
The large queue of paperwork also can create a negative ripple effect on the staff. The high stress involved in dealing with that bureaucratic nightmare can lead to low job satisfaction. No matter how hard a person works, the paperwork processing would always be behind schedule because of the volume of patients with which your practice deals, so they will subsequently feel overworked and dissatisfied with their productivity.
Information is entered quickly and accessed even more rapidly with an EMR system. This increase in speed removes a large obstruction in the flow of paperwork and makes the process more enjoyable, which alleviates the pressure on medical records personnel, resulting in people who feel challenged and productive during their workday, and most likely decreases the stress level of the staff.
Some claims also can be paid earlier since processing is faster and the claims data is generally more accurate than hand-written records. It is important to set up out of the box software with the most current CMS coding. This will prompt therapists to use the correct codes, ensuring a higher number of payments and a decrease in denial rates, since there is a reduction in ambiguity. Additionally, immediate validation of a patient’s insurance eligibility can facilitate more timely payments and less insurance paperwork.
The creation of reports is another aspect of practice management with rampant time leaks. With a multisite practice, the types of reports to run can vary tremendously. A therapist might also have many different ways to measure practice efficiency. Having all the elements necessary to run the various reports present in a single, easily accessible database cuts the amount of time involved massively. As many different reports are run daily, weekly, monthly, or yearly, a proper EMR system helps keep data points in place throughout the year, simplifying the reports running process and making sure it is at the highest level of efficiency.
Reporting requirements for multisite practices also need to be more robust. Ideally, your EMR software will both consolidate all departmental statistics to create reports for the entire practice and break out the data by location or department. Some software programs include numerous report templates, which cover patient results, referrals, appointment cancellations, resource usage, and much more. Custom reports based on an individual practice’s needs are a standard feature in most systems.
An EMR system also facilitates the creation of the most specific and comprehensive practice-management reports available for rehabilitation. Data-collection tools are built into the system, eliminating time-consuming data-collection tasks. The data can then be used to analyze outcomes along multiple dimensions, or to review referral patterns, financial statistics, patient satisfaction, and clinical outcomes.
Producing clinical documentation using EMR software reduces the number of hours therapists spend performing administrative tasks. This reduction in time leaks results in fewer overtime hours worked and a greater focus on the treatment of patients. A streamlined clinical workflow can mean additional capacity for patient visits as well.
Electronic clinical documentation has all the same benefits of other documentation produced and stored electronically rather than manually, such as accuracy, consistency, and legibility. For example, errors are reduced due to elimination of faulty transcription from prior data acquisition. In addition, the instant availability of comprehensive records allows for more rapid recycling of rejected claims.
The billing staff also can reap the benefits of features like electronic signatures, which greatly reduces the time and expense of locating and transferring clinical documentation. The cost savings from an electronic billing interface are an added bonus, and should not be overlooked.
Acquiring EMR technology links multiple locations and departments into a single system, which allows for the effortless sharing of information that leads to less time spent on dealing with paperwork, documentation, and reports, and more time spent treating a greater number of patients.
But although EMR companies are creating products specifically to suit the needs of multisite practices, choosing the right system is still difficult. In addition to identifying the appropriate mix of features, one must also make sure that the system includes a proper support staff and that training for the system is continually available.
Still, by selecting the right software solutions, your multisite practice can run with fewer time leaks, boosting its efficiency and making for more satisfied patients, a more productive staff, and, ultimately, happier therapists.
Mark Finn is a contributing writer for Rehab Management. For more information, contact .