Hospital Outpatient Rehab Clinics Can Move From Paper to Computer With Physical Therapy Software

Treatment for aching bones, joints and  muscles is the sole specialty of the Orthopaedic Hospital of Wisconsin. The Glendale, Wis.-based hospital sees a steady stream of patients who require physical and occupational therapy. Because of high patient demand, the hospital’s state-of-the-art rehabilitation clinic grew from having a handful of therapists on staff to having 16 clinicians in just a few years. During the growth spurt, the clinic experienced problems with its manual processes for information management. Therapy clinic scheduling was the thorniest challenge. Patients were turning up for appointments that weren’t on the books.

Front-desk staff and clinicians were at odds over who was to blame. Todd Heikkinen, director of rehabilitation services, decided it was time to toss the clinic’s scheduling books in favor of a physical therapy software system. As a result, those errors have fallen off to near zero. What’s more, the department has witnessed an 80 percent improvement in the timeliness and accuracy of therapist documentation by implementing the therapy software. The new system also came with the unexpected advantage of ensuring complete accuracy in therapist billing and coding, says Heikkinen. He calls that fact huge and says it allows him to rest easy about the prospect of a visit from JCAHO or Medicare.

The Orthopaedic Hospital of Wisconsin is a relatively young facility, and since they were only beginning with a small clinic (a staff of six or seven clinicians), the hospital’s rehabilitation department chugged along with old-fashioned information management processes. “We used paper scheduling books and paper charts,” says Heikkinen. “All of our statistics were compiled manually out of the scheduling books.” The paper-based system wasn’t ideal, but it worked – for a time. With each new therapist hired, however, the office began to experience an exponential increase in scheduling errors.

Just eight months after opening its doors, the clinic reached a crisis point with its manual recordkeeping methods. It needed an automated information management solution, and fast. “Front desk employees had to deal with patients who were coming in at incorrect times or whose appointments had been erased,” says Heikkinen. “It created friction between patients, the front desk and clinicians. These errors triggered tense moments.” When the clinic’s staff reached critical mass at about 14 or 15 therapists, the system had cracked. “The small systems just weren’t working for us anymore,” says Heikkinen.

Heikkinen wanted a new system that would improve the accuracy and dependability of the clinic’s scheduling system. He also wanted help monitoring the clinic’s workflow and performance. Finally, he hoped to find a system whose reporting capabilities would allow him to provide an accurate portrait of the practice – on demand – to Orthopaedic Hospital’s CEO and owners. “My concern was for accuracy above all else,” says Heikkinen. “I wanted a fail-safe system for therapy scheduling, clinical documentation and administration.” The industry movement toward an electronic health record also swayed Heikkinen’s decision. “I don’t think anyone disagrees that the electronic health record is going to be a standard feature everywhere in a short period of time,” he says. “It’s important not to end up so far behind that it’s difficult to catch up.”

After examining several products, Heikkinen selected a comprehensive physical therapy software  to solve his clinic’s scheduling woes and other errorprone processes. He found a system that had everything he wanted. Some products he looked at had great scheduling programs; others had great documentation modules. But there was only one proven software program superior in tying all of the administrative and clinical information management aspects together.  He had found a therapy software system that had seamless integration.

What the front desk enters into the system automatically appears in the clinicians’ systems and in the administrator’s system. There’s no duplication of data entry or room for more errors. It all happens behind the scenes electronically in one unified suite of software. Four or five key staff members attended a demonstration for the software to confirmed Heikkinen’s choice.  As clinicians, they particularly liked the point-and-click menu system, which meant they wouldn’t have to type so much. “They appreciated being able to click boxes instead of typing sentences,” says Heikkinen. “The knowledge base is very thorough. It’s rare that a clinician would have to type in a sentence that doesn’t fit the normal flow of the knowledge base.” Some of the systems Heikkinen rejected had clunky interfaces that required clinicians to use a lot of keyboard commands. “Those systems would never fly at my practice,” he says.

After implementing the software, the rehabilitation clinic decided to eliminate even more manual processes. It asked the software company to integrate to the main hospital system, one for medical records and one for billing. “We were an island that was functioning well, but to get billing information from the rehab software to our hospital system, was a manual process,” says Heikkinen. The software interface connected to the hospital’s document management system. Medical records transfers that once required 100 hours of labor now took only 20 minutes with the  interface.

Accuracy in therapy scheduling and in other aspects of clinical information management has improved nearly to the point of perfection since the clinic implemented a physical therapy software system.   “Errors are obviously still going to occur,” says Heikkinen, “but with this system, we can find out where the process is breaking down and deal with it.” Heikkinen has noticed improvements in clinic productivity, even though this was not an explicit goal of the implementation. Therapists who were quick on paper are “fast as lightening on the therapy software,” he says. However, those who always took a lot of time to complete their paperwork still take a lot of time on the electronic system. Nevertheless, says Heikkinen, the clinic has seen an 80 percent improvement in the timeliness and accuracy of therapists’ documentation. Moreover, the system makes it easy to monitor workflow.  

Physical Therapy Software helps root out any issues before they turn into bigger problems, but with paper charts there’s no way to know if somebody’s beginning to drown.” As director of the rehabilitation department, Heikkinen may be asked at any time to give a snapshot of his service line’s business to the CEO or other top executives. The software allows him to do that. Productivity figures, referral patterns and reimbursement rates are just a few of the reports available at his fingertips. “With this therapy software, I can generate a report on anything I want to see, for any time frame, within three or four keystrokes,” says Heikkinen. “The system gives me hard numbers to show exactly how the practice is doing. With a manual practice that’s impossible. You’d be looking at chart audits, and only dealing with a rough estimation.”

One benefit of the rehab software that surprised Heikkinen is its accuracy in therapist billing and coding. The importance of this feature is huge, he says. While working for previous employers, he always dreaded the moment when JCAHO or Medicare would come around to do their inspections. What if they pulled the one chart showing how a therapist billed four units instead of two? “With our new therapy software, there’s literally zero concern over that issue,” says Heikkinen. “All a therapist has to do is enter what they did with the patient. The software automatically converts that into the proper billing amount. It’s all perfectly done, every time.”

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