Today’s guest article comes from Michael Dwyer and the Prompt EMR team with an “outsider’s perspective” on a common frustration in clinical care: Documentation.
At Prompt, we are a team with ZERO clinical experience. And we know, that sounds crazy! However, we believe that it has been our greatest strength. It has enabled us to tackle problems with a unique approach and is the reason we have built a product that is so drastically different, yet, at the same time, so improved, simple, and intuitive. Understanding the workflow of our target audience was an absolute necessity. This meant teaming up with physical therapists, billers, front-desk administrators, office managers, and of course the owners.
We believe that the statement “Built by therapists for therapists,” is fundamentally flawed because it fails to consider the other key individuals within a clinic. In order to truly increase efficiencies, the software must be built to improve the workflows of every stakeholder at a clinic, not just the therapists. When Prompt was just an “idea on a napkin,” we noticed that was certainly not the case.
After multiple injuries resulting in lots of PT visits, it became clear that there were massive inefficiencies in therapist workflows with plenty of room for improvement. This led to the first phase of Prompt’s development in March of 2017: Product Discovery.
Before writing a line of code, we wanted to verify that there actually was a problem with the way centers run and the way current EMR and billing software operate. After almost a year of discovery, we started to feel like we had a grasp of the problems at hand. The research we performed included in-person observation of clinic employees operating on their existing software, in-depth interviews, analysis of edge cases, and understanding the journey of one of our customer’s patients from the time they first contact a center to the time their case is closed. We then spent another few months performing follow-up research, competitive analysis, more follow-up research, and finally began mapping out our solution – we knew there was a real opportunity.
Key Problem Areas
It was not too challenging to identify the key problem areas. Asking questions like, “What is your least favorite part of your job?” made the problems pretty clear. We learned that:
- PT Burnout is a very real thing. Most therapists take their documentation home with them.
- Supporting / admin staff have to transcribe data across multiple platforms leading to data loss and other errors.
- Existing systems were antiquated and failed to automate manual processes that in the current time could be solved through technology.
It became obvious that the two most important areas for improvement were in documentation and billing. As an example: Many systems can transfer over CPT and ICD-10 codes from the EMR into the billing software. That is only a one-way communication and requires the user to sign into the billing software to submit claims. In addition, the one-way communication causes issues if the biller notices an issue and needs to get additional information out of the EMR. This one-way communication causes increased data entry and loss, frustration, and ultimately, errors. In order to solve that problem, billing had to be built into the same exact platform as the clinic EMR, not part of a one-way integration.
The Solution – A User Experience Focused Platform
Continuously throwing features at a product is an easy way of creating too many options which can be frustrating for the user — it can quickly create a product that grows into something that nobody wants to use. Yes, it is capable of doing a lot of things, however, it does none of them well and the integrations only compound the issue of clinics having to pay for 2-5 pieces of software to run their practice. We knew from the beginning that we wanted to avoid prioritizing things that could lead to bloat but rather find the most important pieces of functionality and build as much efficiency and ease-of-use into those as possible.
We started off by asking questions about everyone’s problems and then started asking questions that encouraged people to think outside of the box. Questions like, “If you could click a button and automatically have your dream EMR software, what would documentation look like?” No idea was too extraordinary – the crazier the better.
Some of the ideas ranged from “I don’t want to have to type anymore” all the way up to “I want to use Elon Musk’s Neuralink to just think and then have my thoughts convert to documentation.” We wanted these kinds of responses so that we could come as close as possible to their desires, using the technology and resources we have available to us today.
OBVIOUSLY, we weren’t going to be able to translate someone’s thoughts into defensible documentation. But what about their simple clicks or taps on a tablet? The overarching theme is that slow documentation had to be solved. This led to our creation of click-based-documentation that can be done from any device. In the process, we had to totally rethink the way the documentation process works.
For example, SOAP is an inefficient way to document. SOAP was designed as a reporting tool for insurance purposes, not therapist workflow. Going back and forth from Subjective or Objective to Assessment and Plan created a horrible user-experience. We made it possible to generate goals and assessments for a measure all in one screen. Although therapists do not have to document in SOAP, they still have to report to SOAP in order to be paid.
This lead us down the road of designing a user experience that allows for easy data input and one which automatically converts documentation to SOAP to keep documentation bulletproof. Our goal was to create a digital experience that seamlessly converts user input into defensible documentation. If you’d like to learn more, you can explore 8-Minute Evals || 1-Minute Daily Notes. We have additional articles which may be of interest in the world of billing titled 5 Physical Therapy Billing Tips to Increase Revenue, Automate Manual Billing Processes, Drive Down Accounts Receivable.
Prompt’s user-experience team is at the core of our platform, as it should be with any software experience that seeks to make the rest of the day more operationally efficient. Our early users see what the expected version of the finished product is before a single line of code is written for any given feature. That has helped to ensure that our product has been built from the ground up with each and every user’s needs in mind. As we have grown and built out the product, our users have remained an integral part in the future of the platform. A relentless focus on user-experience is what got us to the point we are at today and will remain at the center of Prompt going forward.
This article is not a sponsored post, nor is it an endorsement by PhysicalTherapist.com. The purpose of this post was to shed light onto a design and development process and philosophy that could be helpful for EMRs, app developers, software engineers, and other technology companies which serve within the space of Physical Therapy.