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Rehab industry insiders point to two key reasons why rehab facilities need to move to electronic documentation and use new technology in other ways. First, electronic documentation will improve the industry’s appeal to young people entering college and deciding on a profession. Second, it will enable the industry to better meet tighter financial constraints.
The first issue, staffing, is now on everyone’s minds as the entire health care industry faces shortages of staff in nursing, pharmacy, and other fields. While it’s a little easier for rehab facilities in some areas to find physical therapists, other regions of the country are experiencing shortages. New trends in occupational therapy school enrollment also indicate that shortages of OTs are not far behind.
A work force supply report issued by the American Hospital Association (AHA) in Chicago on Jan. 23, 2001, cites a number of reasons behind the current staffing problems, but the main reason listed is that hospitals and health care providers are no longer seen as the favored employer. The AHA notes in its report that when the U.S. economy was chiefly a manufacturing economy, health care was seen as high tech, but now that the country is in an information economy, health care is seen as low tech.
"I think to a certain extent, health care is viewed as being somewhat archaic in its use of technology that now defines worker productivity," says Kurt Hoppe, MD, medical director of rehabilitation and post-acute care services for the Iowa Health System and Iowa Methodist Medical Center in Des Moines. Hoppe also is the chair of the American Hospital Association section for long term care and rehabilitation, and he’s the chair of the American Academy of Physical Medicine and Rehabilitation health policy and legislation committee.
"For some reason, the industry has not been able to provide a positive or appealing picture of what it means to work in health care nowadays," Hoppe adds. The Iowa Health System has staff openings on an ongoing basis in the areas of nursing, pharmacy, and medical transcription, Hoppe says.
MaineGeneral Rehabilitation and Nursing Care in Augusta has had a more severe staffing crisis that includes therapists and therapy assistants, and it does not appear to be improving, says Greg Gravel, president. "Our biggest challenge is finding people, particularly for long-term care jobs," Gravel says. "We’re seeing declines in enrollment for physical therapy assistants and occupational therapy assistants at our local vocational tech college," Gravel adds.
Students are gravitating toward gadget-oriented jobs, such as computer technology. Unless rehab facilities start to use bedside computers or Palm Pilots and other high-tech devices to make rehab jobs seem sexier, they’ll continue to lose potential workers, Gravel predicts.
Improved technology also will assist rehab facilities financially as they move into the prospective payment system environment, some rehab experts predict. Rehab facilities will need to do cost-efficiency analyses that will require electronic data and sophisticated computer software.
Computerized cost analyses will help a rehab facility prioritize therapy services and take a close look at which services need to be offered on a less routine basis because they are less beneficial in an analysis that compares costs and outcomes, says Martin Schaeffer, MD, medical director of the department of physical medicine and rehabilitation at DuBois (PA) Regional Medical Center.
Information reporting systems will need to interact with third-party payers and others requesting information, and they’ll need to speak the Medicare terminology, according to J. Scott Gebhard, senior vice president for Solaris Health System and administrator of JFK Johnson Rehabilitation Institute in Edison, NJ. "We have to have those data systems in place both as communication tools and internal management tools for utilization and outcome measurement purposes, and it’s a big challenge," Gebhard says.
In the future, rehab facilities will need to make better use of computer technology for documentation and perhaps even for accreditation surveys, says Peggy Neale, MA, MBA, national director of medical rehabilitation for CARF...The Rehabilitation Accreditation Commission of Tucson, AZ.
Also, rehab facilities may find that the Internet and other uses of computer communication technology are a good way to supplement hands-on health care. Already, consumers are using the Internet to do their own research about their health problems, Neale says. "I think health care has been the slowest to get on the technology bandwagon, but consumers are pushing for it, and there will be more advances in web-based use of health care," Neale says.