Re: I agree with Selena and Dick

[Guest guest]

There is some significant insight into EHR Adoption in the following. Not

earthshaking since pretty much every " change " requires some movement

through the grieving process but worth reading.

The Kübler-Ross Model of EHR Adoption | The Health Care Blog

http://post.ly/1wk9D

Kovacek, PT, DPT, MSA

PKovacek@...

Cell (313) 492-4293

Personal Fax

www.PTManager.com

On Mon, Apr 25, 2011 at 7:31 AM, Tim <

timrichpt@...> wrote:

>

>

> This thread on EMR has taken an interesting turn - the certification

> box on the Plan of Care or the Re-certification box - what

> instructions do we give to the physician for signature?

>

> I agree that we send a subconscious message to the physician with the

> boilerplate text we use.

>

> Mine is as basic as I can make it " I certify this Plan of Care for

> the above patient " where the physician puts her name.

>

> My EMR is A2C Clinic Controller and all of our templates are 100% handmade.

>

> Tim , PT

> www.PhysicalTherapyDiagnosis.com

>

> --

> Tim , PT

>

> Get your free tutorial for improved physical therapist decision making

> at...

> www.BulletproofPT.com

>

> Learn about physical therapists' diagnosis at...

> www.PhysicalTherapyDiagnosis.com

>

> Tim's clinic is at...

> www.MedicalArtsRehab.com

> 506 4th Avenue West, Palmetto, Florida 34221

>

> (f)

>

> 'Get Better Physical Therapy'

>

> Get special advance notice and a premium discount on Tim's new book by

> signing up with your e-mail address at www.BulletproofPT.com .

>

> Bulletproof Expert Systems: Clinical Decision Support for Physical

> Therapists in the Outpatient Setting is a manager's workbook with

> stories, checklists, charts, graphs, tables, and templates describing

> how you can use paper-based or computerized tools to improve your

> clinic's Medicare compliance, process adherence and patient outcomes.

>

>

[Guest guest]

Are we splitting hairs? " Certify " boils down to " agree. " In other words,

physicians (and CRNPs and PAs) plainly have authority to prevent the

implementation of any therapist-written Medicare plan of care (or more

correctly, prevent payment for it). So the question boils down to this: In the

" independent practitioner " /therapist relationship, if the IP is the boss maker,

then who is the boss?

Until the independent practitioner certification requirement is removed, the

therapist is not independent; the relative tendency of IPs to agree with plans

of care notwithstanding, therapists are second in command. That is why we find

ourselves expressing our independence with softball actions such as adjusting

the language of certification, or attempting to send a subliminal message that

the IP must either go along or get along. (Nothing wrong with doing that, by the

way, so long as circumstances are what they are and we aren't sacrificing

referral-source relationships in the process--cutting off our noses to spite our

faces--but we should recognize the realities.) Call certification whatever we

like, but manure by any other name smells as bad.

The bright side of this is that, as Tom implied, mutually respectful

relationships between therapists and referral sources can trump all (this would

be the case whether certification was required or not). When those relationships

are good, the cert requirement gets no more attention than any other small-print

bureaucratese, i.e. it is virtually rubber-stamped and ignored. Build

relationships and build business, and build relationship by meeting needs.

Dave Milano, PT, Rehabilitation Director

Laurel Health System

________________________________

From: PTManager [mailto:PTManager ] On Behalf Of

Tim

Sent: Monday, April 25, 2011 7:31 AM

To: PTManager

Subject: I agree with Selena and Dick

This thread on EMR has taken an interesting turn - the certification

box on the Plan of Care or the Re-certification box - what

instructions do we give to the physician for signature?

I agree that we send a subconscious message to the physician with the

boilerplate text we use.

Mine is as basic as I can make it " I certify this Plan of Care for

the above patient " where the physician puts her name.

My EMR is A2C Clinic Controller and all of our templates are 100% handmade.

Tim , PT

www.PhysicalTherapyDiagnosis.com

--

Tim , PT

Get your free tutorial for improved physical therapist decision making at...

www.BulletproofPT.com

Learn about physical therapists' diagnosis at...

www.PhysicalTherapyDiagnosis.com

Tim's clinic is at...

www.MedicalArtsRehab.com

506 4th Avenue West, Palmetto, Florida 34221

(f)

'Get Better Physical Therapy'

Get special advance notice and a premium discount on Tim's new book by

signing up with your e-mail address at www.BulletproofPT.com .

Bulletproof Expert Systems: Clinical Decision Support for Physical

Therapists in the Outpatient Setting is a manager's workbook with

stories, checklists, charts, graphs, tables, and templates describing

how you can use paper-based or computerized tools to improve your

clinic's Medicare compliance, process adherence and patient outcomes.

________________________________

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please delete the message immediately and notify us by telephone. Thank you.

[Guest guest]

,

Grieving? What?? I most certainly am not " grieving. " I am disagreeing with

certain aspects that have been implemented by a company - aspects that are NOT

necessary or required. Why subconsciously send a message that physical

therapists are more technicianist than they really are? I am also taking a

stance... until I am given some control over my documentation, I'm not buying

it.

From Medicare Benefits Manual:

Certification requires a dated signature on the plan of care or some other

document that indicates approval of the plan of care.

AND

The format of all certifications and recertifications and the method by which

they are obtained is determined by the individual facility and/or practitioner.

We make things more difficult for ourselves. It's urban legend to have the

agree/disagree check boxes and all the gobbly-gook language. It's very, very

simple... all that is required is a dated signature.

I appreciate change if it is going in the right direction. Do you realize what

EHR in our profession don't have? They aren't complete with useful information

yet. The outcome data that you might input into the record isn't used to create

any clinical reports to help drive your clinical practice clinically. So many

systems can give you all sorts of data about your business financially yet sadly

don't give squat on another real aspect of your business - what you do

clinically. Why not? Why isn't anyone screaming for clinical information?

In a way, it's too bad WebPT isn't in the know about some aspects of business.

Don't you think they'd love to have me as an evangelist for them? I disagree in

public every time their product is mentioned. I can turn on a dime and be as

loyal as loyal can be IF I can have control of my brand... and hey, I'm willing

to assume the risk on this particular area of certifications and

recertifications. I know I'm right... WebPT has nothing to lose in letting

practitioners have a bit of control. In fact, we SHOULD have control over

anything that leaves our offices!

Selena Horner, PT

ton, MI

>

> >

> >

> > This thread on EMR has taken an interesting turn - the certification

> > box on the Plan of Care or the Re-certification box - what

> > instructions do we give to the physician for signature?

> >

> > I agree that we send a subconscious message to the physician with the

> > boilerplate text we use.

> >

> > Mine is as basic as I can make it " I certify this Plan of Care for

> > the above patient " where the physician puts her name.

> >

> > My EMR is A2C Clinic Controller and all of our templates are 100% handmade.

> >

> > Tim , PT

> > www.PhysicalTherapyDiagnosis.com

> >

> > --

> > Tim , PT

> >

> > Get your free tutorial for improved physical therapist decision making

> > at...

> > www.BulletproofPT.com

> >

> > Learn about physical therapists' diagnosis at...

> > www.PhysicalTherapyDiagnosis.com

> >

> > Tim's clinic is at...

> > www.MedicalArtsRehab.com

> > 506 4th Avenue West, Palmetto, Florida 34221

> >

> > (f)

> >

> > 'Get Better Physical Therapy'

> >

> > Get special advance notice and a premium discount on Tim's new book by

> > signing up with your e-mail address at www.BulletproofPT.com .

> >

> > Bulletproof Expert Systems: Clinical Decision Support for Physical

> > Therapists in the Outpatient Setting is a manager's workbook with

> > stories, checklists, charts, graphs, tables, and templates describing

> > how you can use paper-based or computerized tools to improve your

> > clinic's Medicare compliance, process adherence and patient outcomes.

> >

> >

>

>

>