The dictates of a managed care environment have forced the health care industry to take a close look at how services may be provided in a more timely, cost-efficient way. Some of the more obvious manifestations of this phenomenon include releasing patients from the hospital sooner, reducing the number of diagnostic tests, and providing more care in the home.
One of he less obvious changes involves finding ways to document patient care more efficiently. It is this need -- to provide more timely documentation to managed care companies -- that is the foundation of West Springfield-based Progressive Concepts Inc. (PCI).
Founded in 1994 by Frederick Kadushin, the company offers information and management services to health care providers. A neuropsychologist who originally managed the Colorado Neuro-Behavioral center in Denver, Kadushin came up with the idea for PCI after meeting Todd Bergstrom, who was then director of Clinical Operations with The Frontier Group, a provider of rehabilitation services based in Boston. Bergstrom is now vice president of Progressive Health Care Solutions at PCI.
Although the software program is currently available only for rehabilitation facilities, Kadushin says PCI will be developing programs for other health care providers, including physicians' offices, in the near future.
As information technology continues to improve, and the health care industry becomes ever more bottom-line focused, opportunities in this field will multiply, he predicts.
In a sign of its already impressive growth, the company moved in August from its original location in Kadushin's home in Longmeadow to 380 Union St. in West Springfield.
Off the Charts
Because of their work in the field of rehabilitation, Kadushin and Bergstrom realized the need for a system that would allow clinicians to document their treatment plans and track their patients' care more effectively. Such a system, says Kadushin, was needed not only to provide the best quality health care possible, but also to ensure timely reimbursements from managed care companies which require detailed documentation of treatment plans and their outcomes. Kadushin's work in college in computer science gave him the tools necessary for he and Bergstrom to develop a software package to meet those needs.
The Comprehensive Rehabilitation Evaluation and Management System (CREMS) that Progressive has developed allows clinicians to completely automate patient records and compile valuable data related to the care and outcome of services. Customized for each facility that uses it, the software enables each health care professional involved with a patient's care to enter the type of treatment provided to that patient at any given time.
The physician or person in charge of that patient's care can then easily access that information and evaluate the treatment plan to determine where changes may be made to accelerate or improve progress toward goals for recovery. In a non-automated system, each clinician must take the time to write their notes on the patient's chart, and the case manager must continually flip through pages of documentation to track the patient's treatment.
By computerizing this process, the case manager can easily determine if a treatment plan is being followed or if changes are needed. When several people are involved with the care of one patient, notes Kadushin, it is often easy to duplicate some treatments while ignoring others. For instance, if a person is being treated for a broken leg, it is necessary for the treatment to include help with walking, balancing and performing the tasks of daily living such as dressing. If one of these areas of treatment is neglected, the patient's rehabilitation will not progress as it should.
The program also enables health care providers to track the treatment plans that work best and apply them to other patients. "The manner in which this program is most effective in saving time is in collecting data and using it in an effective manner," says Bergstrom. "Clinicians can get the information quickly about what's effective and what is not."
The software also performs chart auditing to ensure that all the documentation is correct, a requirement of state accreditation agencies.
Logging On
Joshua Schenkman, chief operating officer of PCI and formerly Northeast regional manager for Apria Health Care of California, notes that maintaining accurate and concise documentation also helps health care facilities when it comes time for accreditation. "We talk to accreditation agencies to see what standards must be met, and we update our packages as needed."
The ability to compile and access information also helps health care providers with record keeping. Nancy Paquette, program manager at Linda Manor, a skilled nursing facility in Northampton, says that since that facility began using CREMS two years ago, her job has become much easier.
"The program enables me to do end-of-the-month billing, keep track of employees' hours, audit charts, all of that," she said. "It really gathers the data I need. It's something I don't have to write on paper ... the computer prints it all out."
The system also allows her to project the length of patient stays and the cost of treatment, which is valuable when dealing with managed care companies. It also enables clinicians to provide better care to their patients by monitoring treatment goals such as walking, balancing and performing daily tasks. "It helps the overall therapy progress," she says. "I'm very satisfied with it."
Paquette says the program is also easy to use. "Most of the therapists have mastered the program and are now finding that the computer can do a wide variety of functions, and are anxious to add on. We just haven't taken that initiative yet."
Because their system is sold in modules, an organization can utilize as much as it initially feels comfortable with. PCI will provide upgrades and additional training as part of its package of services.
In addition to its software program, PCI offers Progressive Health Seminars, an educational series which provides clinicians and administrators with the critical information necessary for professional advancement and organizational success. It also provides consultation to assist health care administrators in understanding an increasingly competitive health care market.
To the Future
Five years ago, says Kadushin, he never dreamed he'd be doing what he is today. But with the changes he saw in technology and health care, he seized an opportunity.
"We have to look ahead to what changes are occurring in the health care field and in technology. It's very exciting where the future is going to be. I think we'll be growing very quickly."
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