Are Physical Therapists Waiting for Electronic Medical Records?

"It's not that we don't care, we just know that the fight ain't fair... so we keep on waiting - waiting on the world to change"

Get Where The Light Is: John Mayer Live In Los AngelesDVD.

Physical therapists aren't the only ones waiting... Physicians, too, have traditionally waited before purchasing an electronic medical record (EMR).

However, physical therapists can take heart that we are not too far behind the curve set by physicians in the United States.

Until recently, physician adoption of EMRs has been fairly slow. But, all that changed on February 17, 2009 when President Obama signed the The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, to promote the adoption and meaningful use of health information technology.

"Pursuant to the HiTECH Act, providers can be eligible of incentives of up to $44,000."

Provider, however, is ONLY defined as physicians - not physical therapists...

• Doctor of Medicine
• Doctor of Osteopathy
• Doctor of Podiatric Medicine
• Doctor of Optometry
• Doctor of Oral Surgery
• Doctor of Dental Medicine

For the Medicare reimbursement of up to $44,000, the term eligible professional refers only to physicians as defined by section 1861(r) of the Social Security Act.

Physicians across the nation have increased their adoption of Electronic Medical Records (EMR) according to the Electronic Medical Record Systems of Office-based Physicians: 2009 - 2010:

"Additional survey data from National Center for Health Statistics show that significantly increasing numbers of primary care physicians have already adopted a basic EHR, rising by 50 percent from 19.8 percent of primary care physicians in 2008 to 29.6 percent in 2010."

This data was published by the Centers for Disease Control and Prevention on December 8th, 2010.

Dr. John D. Halamka of Harvard Medical School, estimates that only 2% of physicians have a "full-featured" EMR (2010).

"Full-featured" EMRs have all the bells and whistles that define the Meaningful Use criteria (from Dr. Halanka's blog):

1. Computerized Physician Order Entry (CPOE) - and different orders, such as physical therapy electronically.
2. Drug-drug interaction checks
3. Drug-allergy interaction checks
4. e-Prescribing
5. Report patient demographics
6. Report PQRI quality measures electronically
7. Maintain active problem lists
8. Maintain active medication lists
9. Maintain active allergy lists
10. Check smoking status
11. Check vital signs
12. Clinical Decision Support systems (CDS) to improve quality and save time - right now, most physical therapist EMRs provide reminders and prompts for charge capture and revenue enhancement which, while perfectly rational, do little to enhance clinical quality.
13. Formulary checks
14. Advanced directives
15. Incorporate lab results as structured data
16. Generate patient lists
17. Send patient reminders
18. Electronic outpatient notes
19. Electronic inpatient notes
20. Electronic Medication Administration Records
21. Provide an electronic copy of health information
22. Provide a copy of discharge instructions
23. Patient specific educational resources
24. Web-based download of inpatient records
25. Provide clinical summaries for each office visit
26. Timely electronic access
27. Measures for clinical summaries and timely electronic access
28. Online Secure messaging
29. Patient preference for communication medium
30. Patient Engagement
31. Perform test of HIE
32. Perform Medication reconciliation
33. Provide summary of care record
34. List Care members
35. Longitudinal care plan
36. Submit immunization data
37. Submit reportable lab data
38. Submit syndromic surveillance data
39. Ensure privacy

Many of these Meaningful Use mandates do not apply to physical therapy and physical therapists are not considered "eligible professionals" but many of us are still forging ahead with EMR and CDS purchases..

PhysicalTherapyProductsOnline poll of 19,000 rehab professionals

I'm not waiting on the world to define my future - I'm defining my future by investing in the tools of tomorrow.

In 2011, I'll spend several thousand dollars on software coding for a proprietary Clinical Decision Support system that is HITECH compliant using Treatment Based Classification to improve quality and get better outcomes.

How about the rest of us?

Will you spend money on Electronic Medical Records software in 2011?