Streamlined Documentation and Increased Productivity Drive Double-Digit Case Growth at Bacharach Institute for Rehabilitation

Background

Founded on Mother’s Day in 1924, the Bacharach Institute for Rehabilitation (originally named the Betty Bacharach Home for Afflicted Children) was a hospital for children with polio in Longport, New Jersey. Today, the Institute—which was relocated to the township of Galloway in 1975—serves as a rehabilitation facility with an acute wing, a subacute wing, and an outpatient care department as well as traditional, PT, OT, and speech-language pathology services. With a main campus—and sixteen satellite locations that serve four counties in Southern New Jersey—the institute also provides rehabilitation services for pediatric and cardiac patients as well as a driving program, feeding and skills program, and physiology and audiology services.

Bacharach employs a large team of PTs, OTs, and SLPs with a wide range of experience—new grads to therapists with more than 30 years under their belts—and specialties, including balance and vestibular, lymphedema treatment, geriatrics, sports, and hand therapy. The team also has a traveling therapist on staff who sees patients in their homes.

Challenges

When Bacharach expanded from one centralized location to a main hub with satellite locations, it became clear that the organization’s hospital-based “home-grown” documentation solution was no longer going to cut it. While the system was a step up from handwritten documentation because it ensured everything was legible, it still required therapists to:

• Document assessments and treatment plans on paper,
• Have those notes dictated,
• Review the information for accuracy, and
• Remotely key-in batched charges.

If a note required a co-signature, someone else would have to be roped in. Plus, the documentation system wasn’t connected to the scheduler, so patient notes weren’t linked to appointment times.

When Medicare began requiring G-codes, the system’s limitations became even more apparent. According to Joyce Glick—Bacharach’s VP of Ambulatory Services—the Institute had “pages and pages of bills that were held up because we had to find the therapist and get them to go back and assign the proper G-code.” With the transition to ICD-10 also imminent, the Bacharach team knew they needed to make a change.

“The experience with WebPT to date has been very thorough, and the entire process was thought-out and geared to meet our needs. Everyone we’ve interacted with has been [not only] professional, but also personable in a way that doesn’t make you feel like you’re just a number to them.”

_{‍Mike Mufferi MPT
Director of Satellite Services}‍‍

Solution

The team began researching EMR options, including WebPT and ReDoc. After receiving demos from their top choices, Bacharach’s leadership team provided demos to a handful of their therapists, including individuals who were technologically savvy and those who weren’t. The feedback was unanimous: everyone came back liking WebPT the most. According to Mike Mufferi—Bacharach’s Director of Satellite Services—“WebPT was very user-friendly and seemed to be easier to learn compared to other programs, especially for employees who were less proficient with computer programs.” Additionally, the platform “included scheduling and documentation together in one system” as well as numerous “checks and balances that were desirable.”

Training

Once Bacharach decided to make the switch, WebPT sent two experts onsite to assess the situation—which Mufferi said involved “identifying our current processes for the many locations and services we provide”—and develop a plan for training and implementation roll-out. According to Glick, “WebPT had it down. They knew what they were doing.”

After the assessment, the WebPT team began “superuser” training—that is, training the first batch of therapists who would then assist in training the remainder of the team. With more than 50 therapists who ranged in age and computer literacy (according to Glick, “some people didn’t know where buttons were on the computer”) completing that training was quite a feat. But the WebPT team was extremely patient, accessible, approachable, and adept at answering both workflow and clinical questions. “Our WebPT representative had a very calm demeanor; he was able to calm everyone down,” Glick said. “In some sessions, I was ready to jump in to tell people to relax, and he would just field everyone’s questions, redirect them, and give one-on-one attention where it was needed. Most of the therapists—and support staff—felt so comfortable with him.” Mufferi agreed regarding the top-notch service they received, saying that their WebPT point person “did an exceptional job answering all of the questions—both on the spot and, for the ones that had to be referenced back to a programming level, within a very short period of time.”

Implementation

Bacharach actually did two conversions to WebPT. According to Systems Analyst Bruce Porter, Bacharach was still using its home-grown hospital information system when the team started using WebPT:

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“WebPT is clearly designed by a physical therapist. WebPT understands from a technical perspective what's necessary to make the system work. I trust the system. I trust that WebPT has our back. There hasn't been a single instance where we couldn't call and get the support we needed and our questions answered.”

_{Joyce Glick
Vice President of Ambulatory Services, Bacharach Institute for Rehabilitation}

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As a result, “it became apparent that there was a difference in philosophy between WebPT and the old-style classical data system that we had. WebPT gave us excellent support and were very flexible as we developed a bridge-solution to use until we finally converted to our new hospital information system (HIS) eight to nine months later.”

While integrating a hospital system with any other system can be quite a challenge, WebPT made the process easy. As a software developer, Porter recommends other enterprise-level organizations use an integration engine to link WebPT and the target HIS: doing so has enabled the Bacharach team to receive “standardized transactions from both parties and customize them to the needs of the other based upon the differences between the packages.” Ultimately, “the design team and support staff at WebPT have been outstanding to work with,” he said. “They made a potentially traumatic experience proceed smoothly and (relatively) painlessly.”

Benefits

Compliance

With WebPT, Bacharach is no longer losing money as a result of technical errors. “We’re able to identify missed notes or accounts that haven’t been discharged via the reports WebPT provides,” Mufferi said. Plus, the team can stay ahead of all Medicare compliance demands—and therapists no longer need to spend additional hours tracking and fixing errors related to documentation requirements.

As the primary person responsible for rectifying the G-code issues Bacharach experienced with its previous system, Mufferi is very pleased with the way WebPT enables therapists to enter this data correctly and prevent future errors: “It helped me confirm that we made the right choice,” he said. Glick agrees: “One of the things that we really like about WebPT is that it takes care of G-coding and mandates that our therapists can’t get through the record without including them,” she said. “It’s saved a tremendous amount of manpower in our billing and administrative departments…”

“[Before WebPT], it was a nightmare,” Glick said. “All the bills got held up. Mike [Mufferi] had to stare at a screen; he had bloodshot eyes at the end of the day, trying to figure out what the G-codes should have been.”

Productivity

Glick believes that WebPT’s ability to streamline therapists’ documentation has also helped them become more productive. This increased productivity—along with opening new sites and improving referral relations—has significantly increased Bacharach’s total number of new patient cases. In fact, Bacharach saw a 10% increase in cases across its entire network, when comparing January 2016 (8,985 cases) to January 2017 (9,862 cases). According to a recent analysis, Bacharach’s reimbursements range from $80 to $125 per visit, depending on payer mix. Using a conservative estimate of $90 per visit, that increase in cases amounts to a $78,930 increase in revenue for the month of January alone. In one location, the team saw a 16% increase in patients (February 2016 vs. February 2017). Using the same per-visit average, that’s $34,830 more in a single month.

WebPT has also been extremely helpful for Bacharach’s home therapist because—according to Glick—“they can quickly document like their office is their car.” In fact, Glick and her team had a meeting with their home therapist recently, and she showed them how she was using WebPT on her iPhone to navigate between patient records, access the information she needed during her appointments, and “quickly type a subjective statement and take some notes.” That way, she wouldn’t need to bring her laptop into the house, and she could complete the remainder of her notes when she returned to her car.

Efficiency

Mufferi also pointed out that the entire team has benefited from having scheduling, documentation, and record scanning functionality all in one place: “It’s ideal and more efficient,” he said. According to Glick, the WebPT Scheduler has also helped the Bacharach team book a patient’s first appointment at the first point of contact; the team is currently doing this about 80% of the time, but they hope to reach 100% through additional cross-training and by adding more staff to answer phones.

Mufferi also noted that the Institute has seen a decrease in patient no-shows, which he attributes to the fact that with WebPT, “therapists can identify missed and canceled appointments easier from the records page, and then review that information with their patients to ensure compliance with attendance.” On that note, the team also regularly reviews the missed notes and lost patient logs to “minimize lost revenue and ensure completion of documentation.”

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