An Industry Insights Report
INTRODUCTION
While UpDoc Inc.’s Media and Marketing divisions are primarily known for its industry reporting and digital marketing, something we dip into from time to time is the world of EMR. EMRs are something we all have to use – we are bound to them and by their programming. With some of the recent changes within the legislative and payer landscapes in healthcare, users are starting to feel the strain of not just documentation as a part of the job; but also of being a necessary every day super user of sorts to the EMRs of choice that their workplace has subscribed to.
With an outcry by the general professional body to better connect with EMR companies, this survey reporting aims to bridge identified gaps as a continuation of the effort of past years and reports. So, without further ado… we are pleased to unveil the 2020 EMR Wish List Survey Results!
I. Who Are The Respondents?
As always, it’s nice to know who our respondents are. This round, we had a fairly nice distribution of managers and clinicians, who identified as either developing and seasoned. Funny enough, the graphical representation coincidentally looks like a “peace sign.” 🤷😏 Regardless, it’s nice to know that the EMRs capture the attention of our colleagues in a more or less well rounded way. Noted: Developing professionals who are practicing clinicians and those who are purely serving in management roles take a majority interest to the efficacy of the EMR experience.
II. Numerical Analysis
Disclaimers (as always): This year’s EMR survey gleaned less respondents due to the complexity compared to prior years (to which: thank you respondents for your time and thoughtful input!). While we may not have as much of a scoop in responses, we got much more volume of thought and depth in narratives as it pertains to the quality of responses. It’s worth noting that WebPT and TheraOffice garnered the most responses. However, due to the lower overall sample size — it’s hard to really make any definitive conclusions outside of contextual impressions.
PLEASE NOTE: EMRs not listed did not have representative respondents.
| Composite Average | OVERALL, would you recommend your current EMR platform? | Regarding the features & functionality of its DOCUMENTATION CAPABILITIES, would you recommend your CURRENT EMR platform? | Regarding its capabilities in BILLING ALONE, would you recommend your CURRENT EMR platform? | Regarding PRICING ALONE, would you recommend your CURRENT EMR platform? |
| PTEverywhere | 10 | 10 | 10 | 10 |
| Casamba | 9 | 8 | 8 | 7 |
| IntakeQ | 9 | 10 | 7 | 9 |
| Raintree | 8 | 8 | 9 | 8 |
| WebPT | 6.1 | 6.9 | 6.6 | 7.1 |
| G- Suite | 5.5 | 6.5 | 6 | 7.5 |
| TheraOffice | 7 | 8 | 7.25 | 7.75 |
| Epic | 4 | 8 | 7 | 2 |
| RevFlow | 2 | 7 | 1 | 5 |
| Meditech | 1 | 3 | 2 | 5 |
What is intriguing, however, is that Google Suite ranked similarly to WebPT, Theraoffice, and Casamba in terms of PRICING ALONE. What is also interesting is that there seems to be no singular reason why a user would prefer or recommend one platform over the other. There is a loose correlation between BILLING CAPABILITIES and PRICING ALONE. However, this is closely followed by DOCUMENTATION CAPABILITIES of any given EMR (bar a few exceptions; not entirely at a statistically significant manner at that) — lending the impression that for this survey edition, EMR companies should consider a more holistic view of platform needs when it comes to user experience, satisfaction, and willingness to recommend one’s current platform of choice.
III. User Experience
Below is a table of collected responses. Some of these narratives were merged, others were paraphrased due to similarities of respondents; all of the responses were in regards to a user’s current EMR platform. As many narratives were merged, the grammatical context may have been lost or in proper error — nevertheless, the sentiments represented should be seen as in good context.
| Which EMR are you currently using? | What do you LIKE MOST about your CURRENT EMR platform? | What ANNOYS YOU most about your CURRENT EMR platform? | The feature or function I WISH I COULD HAVE in my current EMR platform would be: |
| Casamba | plan of care/progress note/discharge formatting | Needing to be clocked in to see productivity on the web-based version | more efficient billing of multiple patients at one time – at this time on the online version you have to save and switch between patients one at a time. |
| Epic | Access to pmh and in network notes. | So many clicks. All very time consuming. | |
| G suite | Simplicity, Price and customization | No automaticity, billing | Intake forms be automatically loaded and info in my notes from their forms; Norms for each test available based on demographics and shared protocols from other therapists |
| IntakeQ | Customizability | No undo button | Pre-set platforms |
| Meditech | Dragon Compatible | number of screens required to do documenting | previous note carryover |
| PT Everywhere | Connects me to my patients | ||
| Raintree | Specific user templates | Speed with which customizations can be added | Cpg integration with best practice suggestions prompted for my clinicians |
| RevFlow | Reports and completeness of a note. | Looks like it’s from 1990 and requires Internet Explorer. Can’t change a note type after it’s opened. | Appt text or email reminders |
| TheraOffice | Custom templates, pre-determined templates, customization with exercises/search function with exercises; It’s simple to use; Treatment notes carry over; User customization | Selecting activity/manual/etc and then inputting the time performed; It sometimes “shorts out” or “freezes”.; Inefficient and WAY too much clicking; Tedious to use on tablet | Free typing for activities performed (such as in Epic) then inputting time per code at bottom of note (also per Epic); Empty text boxes without character limits; Better integration with home exercise programs and marketing platforms |
| WebPT | Cloud based, one login for documentation, scheduling, and HEP; cost and ease of use; Documentation flow is fair; Ease of writing a daily note; Free text boxes; I like that it’s web based. It’s aesthetically pleasing.; It is laid out mostly intuitively for a PT | Don’t get notifications of patients being checked in, connectivity problems, order of tabs (plan is last when you open a new note and should be first since that is what you said you were going to work on this visit; down time, slow at times; Lack of willingness to progress make changes for the small clinic.; The exercise flow sheet builds backwards. The first exercise I enter ends up at the bottom of the list, but it is the first exercise I want to see when I open the list; Not enough pre-loaded formats, slow, have to manually enter outcome measurements; In ability to search in messages. In ability to add new outcome measures to match presets. Inability to open new tabs from messages. In ability to generate frequency from schedule without manually counting. Maintenance performed during worker hours.; Loses data, is unavailable, just doesn’t work sometimes | On screen notifications of when patients are checked in; being able to customize documentation more freely; All electronic intake process, when a patient fills out intake paperwork, it is automatically sent to the EMR and all data is pre-loaded into the Therapist Eval preventing the need for extra documentation time; build in customizable text systems (text for when a patient needs to get scheduled and currently isn’t, reminders, follow up texts for new patients we are trying to get a hold of; call tracking system with a Built in template for office staff.; I would like to write one note and have that data mined that generates external communication to different parties containing different levels of information. Referral sources, case managers, employers, etc all want different parts of my note and I’d rather not write several documents.; auto-text, pop up blocks when pt is checked in/arrives; More customizability, add more drop down menus; All in one metrics reports across documentation, internal business metrics, and marketing/ outcomes/ satisfaction metrics, all in one silo, vs having to go to different silos to find info |
IV. Brand Loyalty
It’s worth noting that TheraOffice and WebPT had the most narrative notes that the user was satisfied and not intending to switch platforms. However, they also had the most users volunteering ideas of switching. Please keep in mind these two platforms had the most respondents as well. Below are some named “alternates.”
| Which EMR are you using? | What would you rather be using? |
| Epic | WebPT |
| Google Suite | PT Everywhere, Something that has yet to be created. |
| IntakeQ | None |
| RevFlow | OptimisPT |
| TheraOffice | Epic, OptimisPT, None. |
| WebPT | Heno, searching for a new platform, none. |
It’s also worth noting that these were “wish list” responses — not a declaration by the user they intend to switch per se… save for the one user who declared they were indeed actively searching for a new EMR. It’s also interesting that some of the lower scored EMR platforms did not warrant a narrative response or declaration of intention to switch.
V. “Can we get rid of this? / I’d like to tell you something…”
Again, the table below comes in no particular order or volume; and, as with the majority of this report, we are looking primarily at narrative and sentiment analysis through merging of responses and/or honing in on a centralize phrase of response.
| EMR Being Used | The feature or function I wish I COULD GET RID OF in my current EMR platform would be: | Is there anything you wish you could tell your CURRENT EMR platform? |
| Casamba | needing to account for all productive time before clocking out | |
| G- Suite | Cells- user interface is poor | No – it’s free and now maintenance and not really built for an EMR |
| IntakeQ | Extra costs with integrations | Provide clients with walk through of basic set-up to reduce the learning curve |
| Meditech | need to toggle screens to find information | |
| Raintree | N/A | |
| RevFlow | Internet Explorer. (no context given) | N/A |
| TheraOffice | Inability to jump back and forth from exercise selection box to note and having to re-open the window each time; Having to click so many times just to input information or get rid of a pop up text box that doesn’t even work; Would like to streamline security features | I appreciate that you are sending out emails with updates consistently. I appreciate that you haven’t had a server go down mid-day. For a small practice, you help me get the job done in a timely manner and not take too much work home with me. I do appreciate the web server as well, that way when I do have to complete a few notes at the end of the day I can do so from the comfort ; It would be great to be able to be concise without being redundant and have the ability to do that efficiently. There is SO much unnecessary clicking required to input information that it makes it incredibly difficult to be efficient and productive without doing a ton of paperwork at home outside of work hours that I don’t even get compensated for in my home. |
| WebPT | Ridiculous pricing.; manually entering outcomes measurements; awkward billing mechanics in Kareo/ WebPT; non PT related items built in to documentation software (OT and SLP items) | I don’t like them; Add notifications for patient check ins, improve the HEP database (and fix the messaging system for it), overhaul the GUI to be more user friendly; Pop-up boxes that translate across screens when a pt is checked in, so you are alerted.; I have heard WebPT is pivoting to focus on billing and deprioritizing documentation. I like them enough to stay with them if I didn’t lose data and run into problems with it just not working, but I may have to switch; being able to customize current documentation for quicker/easier use; Allow more customization to allow EMR to meet clinicians needs |
VI. “If I Had To Start All Over Again…”
For this section, we again merged or simplified narrative responses to give a general listing of sentiments per each question of the survey. We organized this randomly as to give no specific order or ranking for each style or type of response. This was done with a purpose of delivering a raw feel, gut response read-through for the major collections of each valence and/or leaning of responses.
If I had to start all over again, I see ____ as a DEAL MAKER in an EMR platform:
- Ease of use for the end user. Compliance and security should be antes at this point.
- I want to pay for the channels I use. Breaking up cable 🙂 Price structure for single therapists working part time and customized based on EBP.
- Text reminders to patients for free or lower cost.
- Better User Interface
- User-friendly, simplicity
- Able to customize documentation to keep things I always want to quickly look at in each note/ carry over from note to note, easily add functional outcome forms not already included, smooth interaction with doc and billing
- Regulatory updates for payers
- Free typing and free-form code selection
- Ease of billing and overall simplicity.
- Customization
- Scheduling and ease for patients to send me their paperwork
- Customization and customer service
- Efficiency
- Intuitive notes
If I had to start all over again, I view ____ as a DEAL BREAKER in an EMR platform:
- Any rigidity at all in the document. If I can’t customize, I’m not interested.
- Pricing, contracts.
- Too expensive for features that I do not use.
- Too much customization.
- Complexity
- Stodgy, inflexible documentation formatting, no easy metrics reports
- Ease and clarity of documentation
- Exorbitant pricing for simple features/non-innovative features
- Unable to simply and efficiently do billing.
- Price
- Lack of customization or poor service
- Not customizable
- Too focused on billing platform and notes take a back seat
If I had to start all over again, I consider ____ as a MUST HAVE QUALIFIER in an EMR platform:
- Connected to billing
- EBP- norms
- Changing note type mid note, ie if someone chooses to DC
- Cloud based
- Built in billing
- Teamed billing with documentation
- Customization of documentation
- Unsure
- Ease of billing, intake, and documentation. There’s no need for any of it to be tedious.
- Synchronization with info input from clients to my notes
- Access on any device
- Web-based with good customer service/tech support
- Main interface with minimal tabs to open to in order to use the system.
VII. A Message from Industry Users to EMR Companies
This final section of the EMR Wish List Survey from 2020 details, once again a narrative analysis with a focus on sentiment — asking users to convey what they will to EMR companies. Here are the major valences of thought:
- Do better, think progressive into the electronic era and how to reduce redundancies for a smoother, less burdensome documentation to improve for both consumer and rehab professionals.
- Too expensive, work with the solo mobile PT.
- Combine your products to make one actually decent product that is an industry standard.
- Build a better system and we will buy it.
- “I have to go to EMR for productivity, Cx/NS rates, etc. I have to go to Billing site for units/visit, $/visit, units/visit/ therapist, etc. I have to go to quickbooks for PnL last month, compare last month to the same month last year, etc. PT needs EMR that includes all this info in one silo. I want to open one thing and see every metrics and compare them across platforms. How many support staff does it take to produce max units/visit? Are they related at all?”
- “I believe a majority of us are concerned with being able to provide quality services to our patients, and being able to perform both fast and high quality POS documentation is integral to that and helping us to stay in patient care longer.”
- Talk to the people who use your EMR! TheraOffice is great about taking their users feedback and making their product better. Documentation should be as simplified as possible.
- Don’t charge too much for something so simple.
- Make the experience (clinician’s and patient’s) easier.
- “Please employ therapists of all generations, practice settings and sizes, and experience to gain feedback from different perspectives to find a good middle ground that works for the majority.”
- Keep it simple.
VIII. Thanks and Acknowledgements.
The UpDoc team would like to thank all of our survey respondents, all of you for taking part in the reading and sharing of this industry reporting; and, we’d like to thank in advance the EMR companies who take these narrative and sentiment analyses to heart — adopting solutions that address the heart of what users are looking for in the jobs, gain makers, and pain alleviators they are bound to in the daily clinical work.
Don’t Forget about the Physical Therapy Productivity Survey 2020
Throughout the last decade, the pressure of productivity in healthcare have only increased. Anecdotally, clinicians have been wary about the progression and have voiced that things are getting worse…. but, how much worse? It’s always nice to have numbers to give context to what we feel is going on in the profession.
So! Today, we’re pleased to release this year’s productivity survey to gauge for rehab therapy what is actually going on in the frontlines of the field. How good or bad is the pressure of production in the healthcare landscapes of 2020?
Until next time, I remain humbly your colleague in service,
Ben Fung, PT, DPT, MBA
COO/Co-Founder, UpDoc Media
CFO/Co-Founder, Recharge
Mobile: 470-BEN-FUNG | Twitter: @DrBenFung
Snapchat ID: DrBenFung | Instagram: @DrBenFung | Linked In: DrBenFung