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Moving the PT Industry from the EMR to the Next Level: PXM

November 1, 2023 • Clinical Management • Heidi Jannenga

Heraclitus, a Greek philosopher, is quoted as saying “Change is the only constant in life.” Over the last decade, we in rehab therapy have seen our fair share of change, with technologies like data informatics and artificial intelligence introduced into healthcare as well as new initiatives around value-based care. And if we’re talking about big change, we can throw in a global pandemic—that forced providers to become remote care experts overnight—for good measure.

Change may be constant, but that doesn’t make it easy. As Mary Shelly eloquently wrote in Frankenstein, “Nothing is so painful to the human mind as a great and sudden change.”

This sentiment perhaps helps us make sense of the current state of the rehab therapy industry. On one hand, the value proposition of PT has finally started to resonate with patients, and a growing number are seeking out our care. We’re finally being asked to embrace the MSK primary care provider role with direct-to-employer contracts becoming more mainstream.

However, with the increased demand, patient expectations around convenience and customer service now supersede great clinical outcomes. On top of that, a perfect storm has emerged in which therapists are constantly asked to do more with less and are ill-equipped with the tools necessary to be successful. Payment for our services continues to decline as administrative burdens increase—which has only exacerbated the exodus of top talent leaving to pursue non-clinical roles outside of our industry.

Our industry has seen similar situations in the past with technology rising to meet those needs—most recently, the Electronic Medical Record (EMR). Unfortunately, the EMR alone is no longer enough. Clinic owners and managers are flooded with a multitude of technology solutions when what they really need is an integrated system that can drive greater patient engagement, improved clinic efficiency, decreased administrative burden on clinicians and ultimately sustainable clinic growth. That’s where something we at WebPT are calling practice experience management (PXM) takes center stage. To find out what that is, and how we can elevate beyond the EMR, let’s start where it all began.

The EMR changed practice management.

In 2008, WebPT launched the first web-based EMR in the PT market at a time when 80% of outpatient therapists were documenting on pen and paper.  Soon after, regulatory bodies pushed a mandate to digitize patient records with the passing of the HiTech Act in 2009. In 2010, CMS financially incentivized the adoption of an EMR for physicians and other healthcare providers (although PTs, OTs, and SLPs were left off this list).

The technology transformation had begun—and it didn’t take long for our EMR to take off due to the product market fit, affordable pricing, and ease of use. That was 15 years ago, and as the industry evolved, so did our technology.

An EMR alone just isn’t enough.

The introduction of digital documentation ushered in an exponential increase in the administrative burden on clinicians—whether through prior authorizations, plan of care recertifications, or complicated modifier rules. Because there was never a monetary incentive for rehab therapists to adopt an EMR, the current 85-90% EMR adoption rate is largely due to this surge in administrative and complex billing requirements. Without technological assistance, it would be nearly impossible to get it right.

And yet, even with all this technology, providers remain subject to considerable administrative harm. According to this year’s State of Rehab Therapy Report, over 70% of respondents admitted documenting to some degree outside of work hours. Furthering that point, among the 36.1% of respondents who reported feeling burnt out, the top three reasons cited for that burnout were:

  • low salary,
  • high patient load, and
  • burdensome documentation and regulatory requirements.

To cap it all off, the pandemic single-handedly accelerated a wave of technology that made remote connections and convenience the new expectation. Patients were left to wonder why there was so much technology in their everyday lives but so little in health care. They want and need more from their healthcare providers. With so many changes brought to bear on rehab practices, the EMR alone will no longer meet the needs of a successful practice.

Clinicians and patients are united in seeking change.

Getting out from under a mountain of unnecessary administrative tasks and back to a patient-centered care mindset is an initiative therapists and patients alike have been advocating for with industry leaders. When asked about the relationship between administrative burden and burnout in the State of Rehab Therapy report, Rick Lybbert, PT, OCS, president and CEO of Mountain Land Physical Therapy stated, “Therapists love treating patients!  Most of us would treat patients for free if we didn’t have to do paperwork. It’s not the volume of patients, it’s the volume of paperwork that negatively affects our job satisfaction.”

Patients might not be burdened with the same level of administrative work that their providers are contending with, but they’re also looking for a simplified practice experience—one that starts in the digital sphere. In the WebPT and Clinicient Patient Experience Report, the 550 patient participants put convenience and digital tools as their most desired improvements to the PT experience. Regardless of age, the participants had these four top preferences:

  • 81% prefer digital reminders, with texting as the top choice;
  • 79% prefer to fill out intake paperwork at home, digitally;
  • 70% prefer to pay with a digital option; and
  • 61% prefer to schedule online when not scheduling in-person.


Our profession must evolve.

Over the last 15 years, the rehab therapy profession has seen a wave of technology adoption to enhance many aspects of both the front office and clinical workflow. The current problem isn’t a lack of available technology; it’s that these various tools aren’t working well together, making it impossible to have an efficient, unified view of the entire patient journey and its connection to the practice.

The call to action for any technology partner you choose should always be to improve the everyday lives of its users and bring value to the practice and the patients they serve. Over the years at WebPT, that meant adding more tools, features, and solutions under our umbrella to help clinicians and business leaders handle every aspect of the practice.

We’re setting the standard of what every rehab therapist and clinical leader should expect from their technology partner. This natural evolution has resulted in an integrated suite of solutions that provides each provider and business leader cohesive, end-to-end access to the solutions, data, and insights they need to empower executive and clinical decision-making, improve patient care, and enhance the patient experience. That unified journey has been our vision for years, and we now have a name for it: practice experience management.

PXM restores freedom to both patients and providers

The idea of a shared experience on one platform is not necessarily new. Even with the head start hospital networks and regulators have had in digitizing and integrating care, most systems remain fragmented for many healthcare providers. An ideal PXM scenario combines the many siloed experiences into one seamless picture on a single platform.

In fact, let’s envision what one patient’s journey might look like with a practice that has adopted PXM:

  • Ryan (our example person) injures his back and is interested in PT services but is unsure how to start. He turns to Google and finds a list of five clinics within five miles of his home. With the help of the right software, one practice rises above the rest with stellar Google reviews and ratings readily available.
  • Ryan chooses that clinic, visits the practice’s website and schedules an appointment online. He then uses digital patient intake for seamless and contactless enrollment.
  • On the date of arrival, the front office staff has the appointment confirmed, Ryan’s insurance has been verified electronically, a functional outcome measure has been pre-recorded, and the necessary forms have been completed online.
  • The evaluating therapist opens the note with a clear picture of what Ryan is coming to PT for including current complaints, a complete medical history, a list of medications, and more.
  • Based on the insurance carrier, past medical history and current complaints, there are suggested tests and measures for Ryan to perform for optimal reimbursement.
  • Once the verbal interaction begins between patient and therapist, there is less time staring into a screen and more time building rapport and a therapeutic alliance.
  • Ryan leaves feeling confident that he chose the right practice, with a thorough understanding of his digital HEP (including video and tracking capabilities) and how to communicate with his PT right from his phone should he have any questions.
  • With a plan of care (POC) signed, submitted to insurance, and authorization received, payment for services is timely and accurate—and options to augment that care are available with services like remote therapeutic monitoring and patient satisfaction surveys in the form of NPS scores over the course of the patient’s care.
  • Midway through the POC, Ryan has a follow-up with his primary care physician. The treating therapist sends a direct secure messageincluding a progress note—to ensure care coordination is seamless and the patient and physician are satisfied with their care.
  • Ryan finishes his in-person visits progressing toward an optimal outcome, but the relationship does not end there. The therapist can continue to interact with Ryan and ensure ongoing progress with remote therapeutic monitoring (RTM). As he completes his POC, the front office coordinator uses the patient relationship management (PRM) software to ask Ryan for a positive online review of his experience.
  • More patients come to this clinic to seek the same results Ryan had thanks to internal referrals, online reviews, and physician referrals. Data analytics leverage all of the clinical and patient engagement data points to help negotiate improved payer contracts and are used in advocacy efforts.
  • With the increased visit numbers, improved payment, and cost savings of having a PXM platform, bonuses to all employees were made possible; which helped to maintain 100% clinic employee retention.

Under PXM, all these interactions and touchpoints aren’t occurring across several disjointed digital solutions but rather software that works in harmony and shares data to create a singular view of the patient.

The concept of PXM is not new to practices, but until now it has not been something readily available to our market. PXM’s core principles revolve around the idea of true connectivity. This concept of connectivity brings technology solutions to clinic workflows, provider-to-patient communications, provider-to-provider communications, and data for practice intelligence to elevate rehab therapy to a patient-centered care mindset.

Patients and providers have been clamoring for better connectivity between provider, patient, and practice. PXM is simply the next step in our ongoing quest to move the rehab industry forward and create a better future for our profession.

Heidi Jannenga

Heidi Jannenga, PT, DPT, ATC, is the co-founder and Chief Clinical Officer of WebPT, the leading practice management solution for physical, occupational, and speech therapists. Heidi advises on WebPT’s product vision, company culture, branding efforts and internal operations, while advocating for the rehab therapy profession on a national and international scale. She’s an APTA member,...

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