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PT Practice Transformation

February 11, 2011
by Jennifer Prestigiacomo
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How one PT practice transformed through the use of an EMR and the iPad

Kenji Carp, P.T., O.C.S., A.T.C., opened his own physical therapy practice Cooperative Performance & Rehabilitation in Eugene, Ore. in June 2010. His practice is 70 percent orthopedics patients and 30 percent vestibular patients. Carp has grown his practice from one therapist and one billing manager to four therapists and three front desk administrators in a relatively brief time with the help of WebPT (Phoenix, Ariz.), practice management/electronic medical record (EMR) software, and Apple’s iPad. Carp spoke with HCI Associate Editor Jennifer Prestigiacomo about the efficiencies that have resulted from integrating an EHR and a tablet into his practice’s workflow.

Healthcare Informatics: When did you implement an EMR in your practice?

Kenji Carp: Recently, I opened my own my own private practice, and when you do that there’s always concerns with carrying over the quality—can you keep the referrals and those lines of communication? I think [my EMR] has been a big part of that clinically and in growing our business. We really thought that that was a big part of our due diligence. I went the previous year to the American Physical Therapy Association Combined Sections Meeting and looked at a lot of varieties for electronic medical records. I think there’s a lot of them out there that are a rehash of different medical [products]. You can tell the designers of [WebPT] have given thought to people in my situation, who want to grow a practice. There are a lot of powerful tools that help us track referrals and track how we’re doing on productivity and cancellation and no-show rates. I think it’s a great tool for all my staff therapists to document correctly and give quality care. It’s also a great tool for private practices like ours that have to be cognizant of the bottom line and business success and what return we get on the different vendors we invest in.

We’ve also taken on a sublessor as a client [Willamette Hand Therapy, Eugene, Oreg.], who pays us to do scheduling, office management, and billing for them. That’s a source of revenue for our business. They deal with hands, which are also a nice synergy for us; and we’re able to offer them a value-added service. A lot of businesses are looking for turnkey revenue, where you’ve invested in a system, and you have another way to generate a revenue stream. It’s easy because these are just things we already have going.

Our EMR has the ability to really translate what we want our clinicians doing with evidenced-based practice into the way that they’re charting and thinking about patients. A good example is we want all our therapists to use standardized outcomes measures, not just on their Medicare patients, but all their patients. Those are integrated in WebPT; it’s almost hard for staff therapists not to do that because they come up within the charting automatically. We treat a lot of patients with orthopedic and vestibular problems, and they have balance issues; so one of the outcomes measures that a lot of therapists use is the dynamic gate index (DGI). With WebPT, when I’m doing an evaluation, I can click one little tab on my iPad that says “outcomes measures,” and it pulls up all the available things I can use to document that progress. I can just enter a raw score, and I can come back later and see an outcomes measure, either an evaluation to document where they’re at and the functional limitation and the risk for falls. And hopefully four to six weeks later when I’ve trained them, I can document the improvement they’ve made. Just having that integrated so easily within the documentation suite, means that automatically my people are using a good measure to quantify the risk for falls. The nice thing is instead of having 30 staff meetings about compliance and haranguing people to use these measures; it’s just easy in WebPT because they come up as options.

Kenji Carp

HCI: So, you use the iPad for documentation. Can you tell me about that process?