The EMR Episode, Part I

Deciding on an EMR (electronic medical record) or switching to a different EMR is a huge undertaking, one that will take you at least six months to groove into your company, along with the associated tears, cursing, and bleary-eyed late nights screaming at your laptop. There can definitely be a love-hate relationship with them since none of them are perfect and we rely on them so much. In this episode I decided to ask four of my friends about the pros/cons of their EMRs and give you insight into the in vivo experiences of each. There are many more than four out there, and we’ll be doing a Part 2 eventually. If you’re wondering if “the grass is greener,” listen to what these owners have to say about their software.

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Listen to the podcast here:

The EMR Episode, Part I

Informal Reviews of 4 EMRs

We are talking about EMRs. I decided I’d ask a few people in my network about their experience with their EMRs. I’ve got four friends out of my network with four different EMRs so I’m going to ask the same set of questions, essentially trying to figure out the pros and cons of each of their EMRs. If you’re like me, you have a love-hate relationship with your EMR. There’re pros and cons to each one of them. As I go through this, let me lay down some groundwork. Number one, there is no perfect software program. We wish there was. We wish they were faster. We wish they were more customizable, we wish they had better reports, you name it. There’re a lot of things that we wish they had but there’s some give and take with all of them. It depends on what you’re looking for as to whether or not any EMR is going to work well for you. Number two, this is 2019. The content of this episode is going to be limited to some months. I wouldn’t push the relevance past that envelope.

Number three, there are only four EMRs represented here. We’re talking with owners who are using Clinicient, TheraOffice, WebPT and Turbo PT Ultra. A few of those were the big dogs but there are also people in my network that were willing to talk to me in the interview. I have a friend that is using Raintree. I would have like to talk to him but it didn’t work out. If there are any of you out there who would like to talk to me about your software that might be different than these, feel free to reach out to me, Nathan@PTOClub.com. Number four, I have no skin in this game. I’m not affiliated with any of these. I’ve used some of them in the past and I’ll share my experience. I’ve used their office and I mentioned in my interview with Aaron Williams, it’s a reliable workhorse. It did well for me for a period of time. We moved on from that to Clinicient. I liked that, I liked the billing component of Clinicient better than their office and that’s a lot of why we moved over, plus it’s a little bit more customizable when it came to documentation.

We would have maybe even considered going with OptimisPT but didn’t liked their billing software, although the documentation and the reports were great. Nonetheless, that was years ago. It might not even be relevant. I figured I’d share some experiences with my network. One question I didn’t ask that I wish I would have was their mobile capabilities and the ability to use iPads and phones. I know WebPT does that and that’s a pretty awesome thing to do that you can actually complete a note on your phone but I don’t believe Clinicient’s there yet. I’m pretty sure TheraOffice isn’t and I have no clue about Turbo PT. I could be wrong about all of those but check up on the individual websites or call the customer service representatives of those particular software programs if you’re considering any of them. I’m talking too much. Let’s move along into the interviews and ask about EMRs.

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I’ve got Sean Miller from Empower PT. Sean, thanks for coming back on the podcast and talking to me for a little bit.

I appreciate you reach back out to me. I’m excited.

To bring everybody up to speed, you were one of my first podcast episodes. Do you want to bring everybody up to speed on what you’re doing nowadays?

When we talked last time, I can’t remember if I mentioned that we had merged our company together and we formed a new group called Empower Physical Therapy. What’s exciting about it is that we got five private practice owners with the same mindset of putting the physical therapists and our patients first in our business model and how we operate. We want to create something bigger and to take it out on a larger scale of maintaining that private practice feel and that putting the therapist and the patient first in our business model. It’s been exciting.

We’ve got 26 clinics that we started with and we finally got everything organized and structured, set up. We’re starting to take it out and expand it. The cool thing is we’re getting a lot of exciting feedback from other potential clinics about bringing them on our platform as well. You’ve talked to Jerod on one of the podcasts and he mentioned that we’ve got some clinics in Texas that we have coming on board. We’ve got probably about two or three other groups that we’re also close to bringing on board that are excited as well about what we’re trying to do.

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You’re no longer an owner of your individual clinics. What’s your position?

I’m the Chief Operating Officer at Empower Physical Therapy. I oversee all the operations of the clinic on a day-to-day basis and how they’re operating. What’s cool about Empower is all the leadership from top down are therapists. Our CEO is a therapist. I’m a therapist, people who are recruiting are therapists. It’s a cool concept of what we’re doing. That is exciting.

You’re the person I want to talk to because we’re talking about EMRs on this episode. What EMR are you using over at Empower PT?

We are using Clinicient.

You came over from Clinicient in your previous location. That’s not a big transition for you. You’ve got some history. First of all, can you maybe skim over what are some of the pros and cons of Clinicient from your experience?

There’s no perfect EMR software out there in my mind. I’ve shopped all of them. What I love about Clinicient is from a business mind perspective and the therapist mind perspective, it offered everything across the gamut that I would want to see in an EMR. What I mean to that in terms of the business aspect is the access to data and the ability to run multiple reports and drill down to almost any piece of information I want to know in the business is readily available. That’s a huge strong point for Clinicient. The other side, a strong point was on the therapist side was some people may or may not like this, I don’t know but we like it. That is the documentation aspect is very customizable. It takes some time to build out. That’s probably the tedious portion of it but you can fully make the evaluation or daily notes the way you want them to have the content tender that you want.

We’re able to do our notes very efficiently. It’s compliant, which is also a big piece of structure and manner. Most therapists tell you, “I love being a therapist if I don’t have to document all the time.” What we’ve done with Clinicient is streamline it so that the documentation process is fully compliant with all the insurance guidelines but it’s also fast and efficient for our therapists. The majority of our therapists, I would say would walk out at the end of the day with all their notes done that day and they’re not taking stuff home. That’s one of our goals.

Have you gotten any feedback from the companies that have come on to Clinicient? I know you’re early in those stages and so it can be a rough transition. Those who have transitioned from a different software to Clinicient, have you found that transition working okay?

Two of the companies were already on Clinicient and three of the ones weren’t. The ones bringing them over, they’re always a little hesitant or fearful of how they’re going to like it. It’s been overwhelmingly positive. They’ve all liked the way I was telling you about the documentation, how we can streamline, it’s faster, it’s more efficient and they’re liking it.

What are some of the things that you’ve experienced? None of the software is perfect, we do have to address both the pros and the cons. What are some of the things that Clinicient could work on?

The customer service side is getting better. There are sometimes delays when you need help or you want someone to get to you in a timely fashion. There’s a ticket item where you log into a website and submit support tickets. Part is growing pains for Clinicient because they’ve had been growing quite a bit. That’s probably been the biggest problem or issue sometimes is you’ll get glitches and issues and you’re like, “I need a fix now.” You’ve got to wait the time and the process, but I imagine most software are that way. I think most software have that difficulty of trying to figure out how to do the customer service side of when there are glitches and problems in the software.

I can speak to that a little bit as well because we were using Clinicient a few years ago. I noticed the same thing. There’s not a timely customer service element when it comes to Clinicient. At least that was my experience. If there was one thing that I wish Clinicient could shore up a little bit was their customer service timeliness, their ability to react to a small glitch. Like you said, “Why can’t I call somebody and work this out quickly but rather I have to put in a ticket and wait?” Compared to other EMRs that you studied in the past or that you’re dealing with, that you’ve looked at because of the merger how does it compare cost-wise? Can you speak to that?

The cost-wise is pretty comparable to most of the top three or four that I know of that are going into it. Software has changed over the years. I used to be on a flat fixed fee every month that you would pay.

Like a per therapist rate.

Per therapist, per user rate and what most of them are switching to is they’re starting to charge you a per visit note charge. Every visit you do, you get charged $0.50 to $1 per note that goes towards your software use. The way they’re structuring it is the more notes you do, the lower that cost goes. They have a threshold of, “If you do 10,000 visits in a month, you pay this rate. If you do 15,000 you pay a lower rate.” That’s how they’re structuring things.

That’s a lot of business. You guys are pushing them out.

We’re pushing up close to 4,000 or 5,000 a week.

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Even at your scale, you’ve been pretty happy with the reports and the ability to manage the data and all that stuff, stay on top of your KPIs.

Clinicient formed an advisory board and I was on this advisory board. What we’re doing is we’re helping them build out a dashboard of statistical physical data. When you log in instead of looking at numbers, it’s actually going to be graphical data of your clinics. That’s going to be coming out. It’s going to take Clinicient in my mind to another level as far as a business owner’s ability to log in. I instantly have all the data on visits, travels, referrals, conversion, my billing, my AR. It’s all quick clicks. Then what’s cool is you can drill down the data from say you’ve got five clinics, you can look out what’s my total clinics. You can go from that to one clinic down to an individual therapist by a couple of clicks of the button.

That would be huge. The ability to scale down would be awesome. The power of that is if you look globally at your entire company, your company could be doing well. When you drill down to the individual clinics that could be saying that four clinics are doing great, one may be off and not doing so well. You can go into that individual clinic and maybe within that clinic, it’s one or two therapists that aren’t doing so well that could be bringing the whole clinic down. That’s the power that you get when you can drill down on a dashboard like you’re talking about.

Most owners of clinic therapy companies don’t realize that piece. They’ll see their visits are down so they blast an email to the entire company, “The visits are down, we’re not doing well.” Meanwhile, three of your four clinics were actually doing extremely well and now they got an email from you saying they’re not doing well but they are. The ability to drill down and we call it being a sniper versus a shotgun type of boss. The sniper will find exactly who and what the cause is and the drill down data that comes from that is how you do that. We’re excited to see that piece come out.

You talked a little bit about compliance and you’ve been happy with that. What can you say about the billing? You’re doing billing in-house.

I used to have Clinicient actually doing my billing and they did a great job. A lot of the software, their billing platform wasn’t integrated into their documentation platform. With Clinicient, it is integrated together. It’s much nicer and much easier. You can work claims quicker and faster.

I can speak to that as well. We did billing in-house and my billing department was happy with Clinicient, with the reports that we were able to see the receipt or to create and the detail at which they were able to do their billing. They liked it a lot. It was ease of use. It was great. I can’t speak to Clinicient’s billing services that they provide. I have heard people that didn’t like them as much but you were happy with them at the time.

I was happy with them. Anytime you outsource, there are give and takes with it but the same thing. If you bring it in-house, you have the other issues you have to deal with. We’re collecting 98% of what we build with these high standards. Most of billing is what you put in the system on an upfront basis. If you’ve got the right information, the right data and you have authorization, you’re going to get paid.

There’s a lot of pre-work that needs to be done in order for the billing company to work properly. You talked about the notes. The clinicians are able to get out of the day, if not all of their notes being done for the day. What training does Clinicient provide and as far as helping people get on their software?

They have different levels of that when you come on with them. Obviously the more you want them to do, the more you pay a bigger price for that because they’re investing more people in time. It depends on your level. When we did this merger because we had two companies already on it, we actually used the majority of our own people to do the training. The first time I got on Clinicient, part of the deal, which was a very reasonable and good price and they sent two people out. They spent three days with us, training us on the software and they spend a couple of months before you go on the software. Building the database, getting your hands into it. Taking your time, understanding how to use the software and things. They did a pretty good job and like most software, you got to start using it in my opinion, to figure out how to use it.

PTO 41 | EMR — EMR: You need something in-house so that when the internet goes down, you still have notes.

This was a number of years ago but we had weekly webinars or conference calls, where we sit down together with someone who was up in Oregon. We go over the software on a shared screen. Definitely having somebody come down and be on site can be a huge plus.

It wasn’t efficient the first time but we did it for sure. I definitely recommend that if you’re going to do it, get somebody to come down on site for a few days and show you how to do everything.

It’s worth it for sure. Any other bells and whistles or anything extracurricular stuff regarding Clinicient that you want to share?

They had the inside tasking the process, which is nice, especially with HIPAA compliance and rules. You can talk patient information and data with the task piece, which is cool versus email or whatever.

You’re talking inner-company messaging.

It’s through Clinicient, so it’s actually right there on the software. That’s a nice little feature with it. I’d like to see them do a little bit more with the referral tracking. Most PT companies track new patients but not tracking the referrals, which is interesting. If you get 50 referrals and only 25 become new patients you think, “We have 25 new patients. That’s great,” but you missed 25 other possible new patients as well. That’d be an interesting piece if they could somehow integrate that. It’s in there somewhere a little bit but it’d be nicer if it was a different, separate feature of it.

That’s something that you don’t see a push on EMRs. I’ve always felt if I was going to track something like that, I’d have to create my own spreadsheet and then train my front office staff on how to track those referrals. It would be a nice complement to any EMR.

That’s what we currently do we track it on an Excel spreadsheet. We convert them, not converting them and then entering the system it’s a lot easier. The other new thing too that therapists should be aware of is with MIPS. If they have to do MIPS reporting, Clinicient acquired a software company called Keet. Keet is a patient engagement software. What’s great about that software is it is a way to engage with your patients through a home exercise program. It actually also does all your outcome tools. Your Oswestry, LEFS, neck disability index, it’s electronic format for your patient to do those. Keet then takes and reports those to Medicare on our behalf. With the MIPS reporting coming out, we’re going to be compliant with that so that when Medicare goes back through in 2020 and says, “You should have been doing MIPS, did you report?” You’re eligible for the increase in pay. If you don’t do MIPS, you’re not eligible for an increase in pay.

You might even get a decrease in pay.

That was a new feature that Clinicient added called Keet, which was a nice add on for us considering our size.

Thanks for your time, Sean.

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I hope it’s helpful. If anyone has any questions, I’m more than happy to help out and talk to anybody.

Are you willing to share some of your contact info?

My email is SMiller@EmpowerPT.com. If they want to call me or email me on that, I’d be happy to reach out and talk to them if they got questions on Clinicient and how it’s been for us.

Thanks, Sean. I appreciate it.

It’s good talking to you. Thanks, Nathan.

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I’ve got Jeanine McLellan, physical therapist out of New York and talk about her EMR. Thank you, Jeanine, for being with me.

You’re very welcome, Nathan. It’s my pleasure.

Do you mind telling the audience a little bit about your company and where you’re located, clinics that you have?

I own Northern Physical Therapy and we are located in Northern New York. We started our first practice in 1996 in our hometown of Ogdensburg. We quickly found that we needed to branch out to service the community. It’s a rural setting up here. We expanded into the Clayton New York market, which services The Thousand Islands region and most recently we’ve expanded over towards the Fort Drum military base in Evans Mills, New York. We currently have a total of three practices and we employed twelve physical therapists.

What EMR are you using?

We are using WebPT. We’ve used WebPT since when we went electronic back in 2011. We started with WebPT, went right from paper to them and we’ve been with them ever since.

I thought you were new to them but you’ve been with them for the long haul. At the stage where they’re at, they’ve made a ton of changes and I know they’ve done a lot of updating. What are some of the pros? What are some of the cons that you have in working with WebPT?

What we love about WebPT is their customer service. I find that is exceptional for them. They’re very responsive to any issues that we may have and their communication is great. They’ll notify us ahead of time when they’re going to have any downtime, if they’re going to do any software updates. If they’re having some issues across their programming, they’ll send out an immediate email, “We’re aware of the problem. Hold tight.” That constant communication is a big help when you’re sitting back wondering, “Why won’t my note finalize, what is going on? Are you having this problem? I’m having this problem,” that’s helpful. The communication aspect.

I’ve used a little bit of it myself. What I recall is it’s fairly easy to use.

The learning curve is so easy. Whenever we have students or new staff come on, they’re always a little bit intimidated. It’s a new program but they’re all very surprised at how easy it is and I think that’s because it’s strictly designed for therapy clinics. What I also like is we’ve been able to use most of their templates with regard to body parts for evaluations. It does allow us to also upload our own, if we wanted to create our own templates, which we did have a therapist who had an interest in that. She was able to put her templates into the program as well.

I was going to go down the road. You find that it’s customizable, it provides you some templates but you’re also able to do some of your own and create those on your own.

You can customize.

Any cons to your usage with WebPT?

I myself don’t have any. I love WebPT. That’s probably why we’ve never switched. We’ve looked at other ones because you always hear about the latest and greatest but I have no reason to switch. When Medicare was doing their PQRS reporting that they did a few years back, apparently we were reporting but for some reason, there was a glitch with WebPT that our reports never got put through to Medicare. We were not even aware of that because on our end they looked like they went through. I got a personal phone call from Heidi Jannenga to myself who said, “We identified that this was a problem and as a result, you’re not going to get that 2% from Medicare. Because you’re not going to get it from Medicare, we want to make it up to you. We’re going to give you that 2%.” No questions asked, they figured it out yet. They sat with us and said, “This is how we figured out the lost revenue that you’re going to experience as a result of this is.” They cut a check and mailed it the next week. That’s pretty impressive because on our end we wouldn’t even have found that out probably for another at least eight months.

That’s a great testimonial. A notch for customer service that they provided. What is your cost? Do you pay on a per provider basis or on a per-note basis?

We pay on a per provider basis.

Are you willing to share with us that?

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It’s $100 per provider. A provider being your PTs because PTAs cannot bill in New York State. It has to be signed off by a PT. The other thing that’s great about WebPT is that they keep track if there’s anything wrong with it, it won’t allow it to finalize. It will come back and it will tell you in red, “These are the issues you need to fix in order to get it finalized.”

They’ve got some good compliance integrated into the documentation right off the bat. How do you feel about the reports that you’re able to get so you can manage with your KPIs and whatnot?

I like the reporting factors. There are a lot more reports available than what we actually use. If I sit down, I could probably find some. I’m sure they’re all valuable but I use what I need immediately at the moment and I’m very pleased with what’s available to me.

How far are you able to drill down in your statistics? Are you able to get to a per provider status on different KPIs?

That’s how we bonus. We look at patient visits per hour per provider. I can look at each individual therapist production each day and we put that into a stat format.

Are you billing through them or are you billing in house?

We do our own billing. We actually started Therabill, which is the WebPT program for billing that they came out with.

You’re using their software to do in-house billing?

Correct. We’ve started that process. There’s always a learning curve whenever you switch your billing program. We are in the process of that. I can’t say it’s been a completely 100% smooth, no glitches transition. This isn’t the first time I’ve transitioned billing programs so it’s not anything unusual in comparison with what we’ve done before.

You can’t totally speak to the capability of using the Therabill and whatnot but you are doing it and there’s a learning curve. I’ll probably have to do another interview with you. That was the one big hang up for us in using WebPT in the past was there wasn’t an integrated billing software. It’s so much smoother when you can tie those two together, your documentation software with your billing software so it’s all smooth.

I’m hopeful that Therabill will answer that for us. If they follow the same customer service model that they have for WebPT, I think that will be successful. It’s very new to them. We’re teaching them as much as they’re training us on things that we need as a clinic.

Speaking of training, do they provide you a significant amount of training when you switch over to WebPT or do updates and whatnot?

They have a very coordinated, organized, “We’re going to meet on this day and go through this,” structured format that you do. They want you to use the program for a little bit before then you formulate your questions, go back and get the answers based on the experience of what you’re signing.

You already talked to that it’s a little bit customizable for your templates and whatnot. I know they have some extra bells and whistles with regards to the marketplace, home exercise programs and whatnot. Do you utilize any of those other extra things?

We don’t utilize that. We looked into the marketplace and we found from our own personal experience, we had a different venue that we were using that was more cost effective for us.

Anything else you want to share with us about WebPT and your usage of it?

I could probably be the little poster child for WebPT. It was a scary transition at the time we made the transition, we did it early, we did it before it was actually required. I was nervous to wait and then be caught up thinking. My thought process was that if everybody switches all at the same time, there are going to be glitches. I wanted to have all that worked out ahead of time. If I had known that this was going to be such an easy transition and so much more efficient, I would have done it even before we did it. I can’t even imagine going back to paper.

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What you speak to is their customer service and I think that can set somebody apart, especially when you get to these bigger companies.

I would say that it has because we’ve dealt with enough other companies to know when you’re getting good customer service versus when you’re not.

Thank you for your time, Jeanine. I appreciate it.

You’re welcome anytime. Thank you.

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I’ve got Aaron Williams with OSR Physical Therapy out of Arizona. Thanks for joining me, Aaron.

Nathan, thanks for having me. I appreciate it.

Do you mind sharing with the audience a little bit about your clinics, how many you’ve got? You’re super successful and all that, give us the details.

We have seven offices in Phoenix. I started the practice in 2002, we’d been in business for several years. My wife and I are both PTs, we started as a small private practice and have grown our private practice, solely owned by us. We have seven locations around Phoenix. We’re right in the thick of it like everybody.

You’re using TheraOffice, right?

Yes.

Tell me a little bit about TheraOffice, how long have you been with them and maybe some of the pros and cons that you’re experiencing?

TheraOffice is the only EMR we’ve ever had. We happen to find them in about 2008. It’s been a while. What prompted us was we were going to open a second office and we were literally using paper charts, before that handwritten, dictation and stuff like that. We knew that we would need to be going to an EMR of some sort someday. The idea of having a system where we can have multiple offices and started that process for us prompted us to look into EMR. At the time we shopped a handful of them and some of those aren’t around anymore. There’s a bunch more that are. For us, fortunately TheraOffice seemed to fit all the needs that we had. We’ve been able to grow with it. We’re with them and we can talk more about that. That’s how we started.

Pros and cons that you’re experiencing with them?

Pros, it’s very user-friendly. Our therapists seemed to love the documentation side of it. People that were fired from other companies or that have been around, moved in or whatnot and have used different systems seem to think that TheraOffice is as good or better than any of the ones that they’ve had out there. I haven’t had people say, “I wish you were on this one because it’s so much better than TheraOffice or anything that.” We seem to get good feedback from the therapists that it’s pretty user-friendly and they like the format of the documentation.

From that perspective, it’s a pro. It’s cost effective as far as, when we got on board back then it was one of the more affordable options. I’m not sure where it’s priced out but it’s expandable so you can have multiple clinics. The other thing we like was that it had everything in one; documentation, scheduling and billing. All components of the same software. We didn’t have to use the documentation software in a separate scheduler and a separate billing platform. It was all together in one and that might have been the biggest reason we jumped on with them in the beginning as well.

I think the first EMR that I went with was TheraOffice. One of the reasons that I went with them initially was that it was all integrated. I did my billing in-house. Do you do your billing in-house?

Yes, we do.

It was a way to seamlessly work between all of those components of it. I was relatively happy with it, that’s for sure. Any cons that you have?

The reporting side of things, it can be a little bit clunky. Some of the reports are not relevant to us. They do customize reports for you. If you do want certain things, they can build the report that’s specific to what you want. It’s not the glamorous looking dashboard product that you might find out there that spits everything back and is in some charts, graphs and everything looks perfect. As far as the management reporting side of things, we wish that was a little bit better. With the basic information we need out of it, that’s good. That satisfied our needs up to this point.

You’re able to get what you need as far as the KPIs and whatnot. I’ve asked a few of the other people, can you drill down and get some individual practitioner data in order to assess individual statistics in the clinic?

You can. It’s the data that you used to manage with. Whatever the report shows but it doesn’t mean that that’s what you want to see or what you use, whatever you’ve learned to manage with. If you didn’t have anything else then it would be good to look at those things and at least manage off of that. We primarily use it to gather weekend, month-end, quarter, year-end type of data such as patient percentage arrival of our billing data and so forth.

How do you feel their customer service does?

I would say fair. Fortunately, we haven’t had to use them a ton but when we do have to use them for a customizable report or something, it’s nothing extraordinary. I don’t want to say that they are responsive but sometimes it does take a little while.

It is telling that it’s not very glitchy. The fact that you haven’t had to use them a lot is probably good.

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That’s a good thing and we certainly have our times and some things that we’d ran across but the reliability of the system up and running and working, it’s done a pretty good job that way. We don’t have major crashes or major problems with that shut us down or anything like that because of that particular software.

You pay on a per provider basis, is that right?

Yeah, that’s the way it was set up in the beginning. They might have some different models but we pay basically a flat fee per provider per month. PTs were about $100 and PTAs were about $50. You can also have a part-time provider, which is I believe $50 as well. Your admin staff, you can have an unlimited number of those, but I don’t know if there’s a different pricing structure. They also have a more of a Cloud web-based version of the software, which I’m not sure how that’s priced. I think it’s a little bit different. We’re on the server-based.

That’s a big difference. I know they went to a Cloud option but they still provide the server option. Do you prefer that?

You can do that, I don’t know that we prefer it. We’re creatures of habit.

It’s what you’ve been doing.

It’s something we started and we stuck with it. We didn’t want to have the hassle of a change or whatnot but it still works and everything works fine with it. They do allow us to do that.

How do they do as far as compliance? Have there been any issues there?

No. I can’t say that we’ve had any compliance issues. They seem to have regular updates that address any compliance type of things that are coming down that we’re aware of. They do provide education, training as well, have a webcast and so forth to educate their members on the different updates and what that means, whether it be a compliance thing, billing or document page, whatever.

Do they help the therapists in the course of doing documentation to make sure that the individual notes are compliant, guide them and direct them along that path?

Yeah. There are some built-in mechanisms for billing in particular. I guess compliance might be the right word but also billing parameters so that if there are certain insurance that you want to set a parameter on, it will allow certain a number of units. You can set that parameter and it guides them so they’re billing correctly, which is helpful and at least it doesn’t make them bill a certain way. The therapist has to understand that and know what to do but at least it guides them in the right direction, which is helpful.

Did it do something extra to help you out with the MIPS reporting?

They do have MIPS, although we’re not participating in MIPS ourselves. They had a whole update for that.

There’s an option for that?

Leading up to that, yes. They built that in and they are a registry themselves. I know that was one of the questions we had when we were looking into it. Some EMRs you have to go through, a separate registry if you’re going to do a registry and they did have the registry in-house.

What do your therapists think of the software? You said they’re pretty happy with it but as far as the speed component, is it pretty quick for them to do their daily notes and their evaluations? Can they customize their documentation so they can put their own templates in and stuff like that?

They can do all that. I would say most haven’t or don’t. Early on, we probably did that a little bit as far as customized, a handful of different templates for evaluations, daily notes and so forth. They use the same ones that maybe we originally put together. As far as the speed goes, it’s probably comparable to other ones that I’ve heard of out there. Anywhere from the pretty quick daily note to a minute or two in evaluations. When they’re first learning the system could be ten, fifteen minutes but you can get them under ten minutes I would say once you’re pretty proficient with it.

Do they provide some training for a new employee? Do they have webinars in place to train that person or is that on you during that person?

They do have training modules, I’ll say that. You can direct your employees to their training modules and that can lead them through them. I find that we do most of the training ourselves because we train them how we use it, not necessarily how it was written by a coder to you.

Especially since you’ve been with them for so long, you guys have a way of using the system that it’s smooth, easy and you can predict the results.

The tips, tricks and shortcuts that help. We ended up doing a fair amount of that training with our people.

Any other bells and whistles from TheraOffice that we didn’t cover?

I don’t think so. I don’t know the cloud-based version. They have a product called PracticeVibe, which is more their online cloud-based version, which I can’t speak to as far as what that does for its users. I’ve heard good things about that. Overall, it’s one of those good all-around platforms for either a beginning company to start up and use or if you have some size. If you have several clinics and you want a good reliable platform to utilize, I think it’s a good one. It’s probably not robust for the people that are looking for 20 or 30 clinics and need multiple reporting functions and so forth. We’ve certainly entertained and looked into other EMRs and haven’t found anything yet or gone into depth on other EMRs to make a change.

Take your time and understand how to use the software and things. Click To Tweet

It seems it’s a reliable workhorse. It’s everything that’s needed. It’s got all the bases covered. It’s not going to be your glitzy, glamory stuff that you’re going to get everything you need out of it and you’re going to run well.

That’s the way we look at it. It’s one of the more affordable options that get the job done and if that’s what you need, it would work well for most anybody.

Thanks for your time.

No problem. I should say that it also has speech, OT and PT involved.

The other disciplines are involved as well.

They have practice with multiple disciplines, they have that built in. I appreciate you asking me to jump on. It’s fun to talk to you again.

Thanks.

—

I’ve got Rob Brown PTA out of Wasilla, Alaska with Wasilla Physical Therapy. Thanks for joining me, Rob.

Thanks for having me.

Share what EMR are you using?

We use TurboPT Ultra.

What turned you on to TurboPT Ultra to begin with?

I had a consultant that I hired a couple of years ago and he recommended it at the time. He was able to give me a little bit of a discount on it. They had about 7% to 10% window. I initially purchased it to have it as server-based but now they’re cloud-based.

You’ve been on it for a few years. What are some of the pros and cons of TurboPT?

It’s fairly user-friendly. There’s not a real big learning curve to it. It doesn’t have as many of the options is I think some of the other bigger EMR companies have. That’s probably what I like about it. Their customer service, once you get to know the guys, there are only two guys that you call and get one or the other and you get to know them by name.

They’re readily available at any time at the drop of a hat to give them a call.

You give them a call. The way it works is you put your name down and then when the time comes, they call you back.

Is that pretty speedy?

Twenty, 30 minutes. It’s not super fast but not super long.

Honestly, Ron, that’s pretty good compared to some of those larger ones out there. You can put in a customer service ticket and they’ll say we’ll get back to you in 24 hours.

These guys are faster than that.

You said it’s missing some of the bells and whistles that maybe that the bigger ones have. Does anything jump out that you wish it had that they had?

If you're going to do install a system, get somebody to come down on site for a few days and show you how to do everything. Click To Tweet

Honestly, I initially purchased it because I could have it server-based because where we were at the time, we lose internet connection. I needed something that was in-house. When the internet goes down, we have notes. Two years after I paid the big lump sum of money, they switched to the cloud-based, which didn’t make me very happy. In using it every time they do an update, there’s a huge learning curve. They’ll move things that you like or don’t like and sometimes it’s a little buggy. It’s with every EMR, there are things you like about it and things you don’t like about it.

Seeing with all the EMRs, there’s no perfect one out there. As a whole, they could do better in general. They all have their pluses and minuses.

When you come to whistles and bells, I will tell you one thing that I wish it would do. I wish it would break down per therapist statistics a little better. It lumps everything in and it will say within this given week, that person’s build this many units. I would like more detail.

The more detail on the reports and data. I was going to go to that eventually. Since you’re there, are you pretty happy with the data in order to manage your KPIs essentially or do you wish there was more to that?

I have adapted to what they offer versus I came in with, I needed this, this and this. It was either I didn’t know how to find it. Maybe they do offer it in this huge maze of programming. I don’t know how to get there but I’ve adapted to what I could get. It got patient visits per week so I know how many people we got coming in. I know if we’re treating them, how many units they’re treating that person. I track the average, how much we bill per patient per week and then how many patients we got coming in the door. The overall charge amount for that week. It gives me how much we received that week.

It doesn’t break it down into greater detail than the clinic. That’s as finite as it will go. It won’t go down to each provider.

It might. I don’t know how to do that. From what I go, what’s easily accessible and very fast for me is to break it down to those things I mentioned.

What’s good to hear is it sounds like you could call one of your buddies on the other side and they’ll probably walk you through it. How do you compare the cost and maybe this is a few years old since you’ve covered costs back then?

We pay the monthly fee. They’re cloud-based and we can’t have it server-based anymore. I’m on that monthly. Should I tell you that?

Some people have, some people haven’t.

I pay $240, $45 a month.

Per provider?

No, that’s total.

That’s pretty cheap.

It’s pretty cheap. You can add things onto it. We’ve added another $50 on to that so that it does the automated texting to all the patients. Total, I pay $270 or something. That’s the reason I’m stuck with them, even though there are things I don’t like. I got to be honest, I’ve taken the tutorials by WebPT and I love it. She’s got a good program there but how much they cost compared to what I’m paying. It’s hard to make that jump.

One of my other interviews is going to be someone who’s using WebPT. You might be able to glean a little bit of information from her as well. WebPT has got some good stuff going on, that’s for sure. How does it do as far as compliance, does it make sure you’re maintaining compliance on that end?

It does the whole compliance thing with Medicare, it alerts you every tenth visit. It won’t let you enter codes unless PT is doing a revaluation or progress notes. You have to redo G-codes.

You do your own billing in-house. Is your billing personnel pretty happy with the billing?

Not the best.

They don’t provide any billing support whatsoever.

We use a separate clearinghouse, TriZetto. It would be nice to lump everything into one but again, finding someone that you’re okay with the price point. You’re looking at another 6% to take for billing or something that.

Everyone’s got to figure that out on their own and there are gives and takes. It’d be nice to turn that over to somebody else and not have to handle the employees, the financial policies, procedures and stuff like that. At the same time, are they going to go after every dime? How were your providers with the speed, ability to do notes and evaluations, is it pretty easy to use in that regard?

It is fairly easy but it’s not the fastest. They’re way faster programs out there.

Is it customizable? Can you put in templates and whatnot to speed the process?

To a certain degree. For example, you don’t have preset sentences that you click on this and it throws things in there. You can bring up the past note and you can cut or paste within that note. You see everything you wrote the last time, you can add to it, take away, edit, do whatever you need.

Can you customize an evaluation if you do typical shoulder protocol, can you throw that up there and not have to find and cut those all up?

You can do it to an extent.

Anything else you want to share in regards to it and its capabilities?

It’s been a good program. We are considering actually switching to another program that we’re hoping we’re happier with. I’ve only been with two different programs so I don’t have a real deep knowledge of all the ones out there. If I was giving it a rating on a scale of one to ten maybe around six, seven.

Hopefully by doing a podcast episode like this where I share people a little bit from each clinic owners’ experience with those EMRs, it might be helpful to you and people like you in the future. Thanks for your time, Rob.

Thanks. I appreciate it.

I appreciate it.

Important Links:

About Sean Miller

Growing up Sean always felt the desire to make an impact in others life. It was in high school when a friend got hurt playing sports that Sean was introduced to the power of physical therapy and the impact it has on people’s lives. From that experience Sean has set a course in his life to be a Physical Therapist and change lives. Receiving his Bachelors of Science from Brigham Young University in 1999, Sean then pursued his dream of getting his education in Physical Therapy. In 2001 Sean graduated from Texas Woman’s University in Dallas, Texas. Moving to Arizona in 2002 working for others Sean became very proficient as a Physical Therapist. He now specializes in treating vertigo, balance, and orthopedic cases involving the shoulders, cervical (neck), and knees. After years of treating patients full time Sean realized that he was just 1 Physical Therapist and only had the ability to treat so many patients at one time; It was this realization that sparked the dream of owning his own practice. “What if we had multiple therapist all with the same skill and passion? The impact would be even bigger than just 1 therapist”. From this Sean along with his brothers opened Kinect Physical Therapy in 2012. “Opening Kinect Physical Therapy has been one of my greatest challenges, but to see the larger impact we have on the communities and in our patients is why I do this.”

Sean when not making an impact on others life’s enjoys spending his time with his wife and their 4 children. He is often found on the sporting fields coaching his boys teams, at the lake wake surfing or headed to the beach to enjoy the waves and surfing. His favorite quote that he lives by is: “We are what we repeatedly do, excellence, therefore, is not an act but a habit.” – Aristotle.

About Jeanine McLellan

Upon returning to the North Country to raise our family, we discovered that the availability of high-quality physical therapy care for the residents of the region was missing. We wanted to make our community a better place and decided to develop our vision of a practice that was devoted to improving the overall health of everyone in the community.

Our dream was to provide a facility that would provide the highest level of care with comprehensive one-on-one evaluations, hands-on manual therapy and advanced techniques provided by the best, highly trained physical therapists in the area. We also dedicated ourselves to our patients by providing them with exceptional customer service and in return, they have dedicated themselves to us and refer their friends and family!

We opened Northern Physical Therapy in Ogdensburg in 1996 and with your support over the past 20 years, we have expanded our community to include Clayton and Leray. Our enthusiastic team of physical therapists is as committed as we are in helping you to live your life without pain or limitation. Thank you for the trust that you put in us and we look forward to helping you to live your life to the fullest!

About Aaron Williams

Aaron founded OSR Physical Therapy in 2002 in Anthem, AZ. He received his BS in Biology from Graceland University in 1998, while playing college basketball. He then went on to receive his doctorate in physical therapy from Northern Arizona University in 2002. From there he worked in an out-patient clinic in Sedona, AZ and at a skilled nursing facility in Mesa, AZ while developing plans for opening OSR Physical Therapy.

His professional interests are in sports medicine and orthopedics. Aaron specializes in out-patient orthopedics as well as post-surgical rehabilitation and functional training following injury.

Aaron is a member of the American Physical Therapy Association (APTA), the National Strength and Conditioning Association (NCSA), and is active in local business groups, Chambers of Commerce, church and charitable organizations. His hobbies and personal interests include: participating in sports, fishing, spending time in the mountains of Colorado, and traveling. Aaron and his wife, Kori, own OSR Physical Therapy, and together love spending time with their children, Emma, Sophie and Maci.

In 2007 Aaron was awarded the “Greater Phoenix Chamber of Commerce at Anthem Small Business Person of the Year Award” for his local support of Anthem and the surrounding communities. This strong community presence and OSR’s mission to provide “Quality Rehabilitation through Personalized Care,” has led to the expansion of OSR Physical Therapy across the greater Phoenix metropolitan area.

About Rob Brown

At Wasilla Physical Therapy in Wasilla, AK, our team includes some of the top physical and injury rehabilitation therapists serving Wasilla, Palmer, and the Matanuska-Susitna Valley area. In fact, we were voted Mat-Su Valley’s Best Physical Therapist and Best Massage Therapist for 2010 by the Valley Frontiersman Newspaper. We have been in business since 1990, and have been helping people around Wasilla and Palmer for over 25 years! Trust in our experience to make you feel better, whether you need help recovering after a car accident, you require custom orthotics, you need help recovering your balance, or you just need some help getting back to an active life.

Wasilla Physical Therapy has the qualifications and experience to treat an extensive range of conditions, as well as an impeccable reputation. Plus we accept most insurance plans! Please call us today to set up a convenient appointment time.

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