5 Questions with John Brickley, VP, Ambulatory Operations & Network Development, MedStar National Rehabilitation Network

John Brickley is vice president of ambulatory operations and network development at Washington, DC-based MedStar National Rehabilitation Network, which includes one hospital and 50 outpatient facilities in DC, Maryland, Northern Virginia, and Delaware. As part of the larger MedStar Health system, MedStar NRH employs 1,200 FTEs across its network, and sees 500,000 patients at its ambulatory locations each year. The company implemented WebPT’s EHR for physical, occupational, and speech therapists last month. Its outpatient physicians also use Cerner Millenium.

Why did MedStar NRH decide the time was right to implement new EHR technology?
The payer and regulatory environment continues to become more and more complex. Manual systems, or even EHRs that are not specifically suited to the nuances of an outpatient therapy environment, do not allow the therapy provider to effectively and efficiently migrate this environment. Even though our healthcare system was deploying an enterprise-wide solution, after extensive analysis, we determined that WebPT was the tool that best positioned us for long-term success and to support our continued growth. We will continue to determine ways to best integrate their technology into our system’s enterprise solution to maximize communication among caregivers. Through this process, we will promote the safe, high quality and efficient provision of care across not only all of MedStar’s network but throughout MedStar Health.

How do you anticipate it will affect provider workflows and patient outcomes?
We feel that it enhances communication among caregivers and provides both clinicians and administrative operations support personnel with much appreciated efficiencies. In turn, this provides additional direct patient care time for our providers. We believe this will have positive impacts upon care delivery and thus patient outcomes. A key driver in this is finding an EHR/PM system that has a positive versus a negative impact on both MedStar NRH team member efficiency and revenue capture.  

Is this implementation part of the group’s larger preparation for MACRA and its value-based care/payment programs?
Ultimately, we feel the information provided and the overall improvements in clinical, administrative operations, and revenue cycle functionality, positions us all the better for upcoming changes in payer requirements and value-based reimbursement models.

Do PT practices face unique healthcare IT implementation challenges? Can you share a few examples?
Definitely. Many EHRs, particularly those focused on providing an enterprise-wide healthcare solution, tend to be very physician practice focused. The therapy reimbursement and practice environment are very different from that of what physicians use. To effectively provide day-to-day operational efficiencies for therapists, and to address the unique payer environment to best meet the needs of accounts receivable nuances, we felt it was vital to tailor the system to the therapy environment. Additionally, central billing functions need to be tailored for these unique payer requirements and limitations. The EHR must effectively link to the backend AR world, and the billing function must be designed to address the payer requirements specific only to the therapy world.  Some things we did to adapt include:

• Select an EHR that was dedicated to meeting the needs of the therapy environment.
• Create a go-live preparation, launch, and ongoing operational team comprised of clinical, administrative, and revenue cycle personnel. Dedicated time and attention has been extensive, but has led to a very successful launch up to this point in time.
• Create a relationship with the EHR vendor that will promote ongoing evolution of their tools to best meet not only our needs, but those of the evolving therapy environment. We and our EHR vendor have ongoing, open dialogue and working sessions to continue to improve their system, and in essence, a partnership approach to making one another better. Our size, scope, and full spectrum of therapy services and programs has been a tremendous benefit in this relationship.  We have ongoing lists of enhancements that we prioritize together. These enhancements make us both stronger in the marketplace.
• Tie ourselves to a billing component (AdvancedMD) that interfaces very well with both the EHR and ultimately the backend of our EHR.
• Customized billing office operations at this time are distinct from the entire MedStar Health system’s CBO. In time, we plan to integrate these, but not until the overall CBO is prepared.

Christmas is coming! What is on your health IT wish list?
I would like to see us effectively migrate the waters to best integrate for system-wide caregivers, our therapy-specific EHR and PM system, and MedStar Health’s enterprise-wide solution. We feel this is extremely important to our operations.

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Contacts

Jenn, Mr. H, Lorre

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