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Physical Therapy Patient Success: Institute EMR Enabled Care Journey

Applied Behavior Analysis (ABA) is clearly all about learning and behavior. After initial intake and eval, a list of goals to work on during therapy is developed that are individualized for each child. So, goals are certainly key. When a child reaches a goal, positive reinforcement is provided. Likewise, when a goal is missed, the intervention could be negative, to nudge the patient to meet goals. ABA strategies target behavior goals and seek to modify behaviors to be more functional and appropriate in the daily living environment. When it comes to defining and managing goals for ABA, the EMR can play a significant role. A multi-specialty EMR will carry out goal data capture for ABA along with managing other rehab therapies like PT, OT, and Speech. Entering appointments, notes, and charges would be functionality that would be common to all specialties. A daily note template for ABA would come in handy. Goals would play a key role in ABA and need to tie into the documentation workflow.

Getting Goals Squared Away

An automated sequence of steps in the EMR workflow would ensure that the practice is ready to assign and manage goals and efficiently track patient progress.
  • Setting up goals would likely begin in the EMR administration area. Ensuring that the right permissions for setting up goals and mastery criteria have been included would help take care of goal setup.
  • Then it would be over to the typical documentation workflow in terms of starting the workflow and accessing notes.
  • Goals would get added to notes as a new category — ABA goals — as part of an overall categorization structure in the EMR. A goals bank would provide a useful starting point to add more.
  • Goals that are created could be added to a template for easy access in the future and thereby boosting productivity.
  • Goal settings could be added including goal data types like percentage correct and task analysis based on how complex goals are broken into independent steps.
  • Also, mastery criteria would be added. When the patient meets certain goal criteria, the status of the goal would be automatically changed to ?mastered? and this update would also be pushed into the progress chart.
  • Phases would also be added. Sub goals would introduce a hierarchy of goals comprised of parent and child goals belonging to the same data type.
  • That would make it easier to track progress over multiple patient visits. Also, goals could be added to favorites, they could be hidden or even deleted.
  • All captured data points would be automatically included in the note. A session view would provide a more streamlined view of goals.
  • Rate/time-based goals could be linked with a global timer so that the timing aspect of goal completion could be tracked for example the rate of completing a goal. A minimum number of trials for calculating the rate would ensure that the calculated rate is meaningful.
  • Next would be generating progress graphs, exporting them, and including them in the note. Graphs could be created at the individual goal level for example a line graph over time of how a particular patient is progressing.
  • Phase events could be added to the graph and events like goal mastery will be automatically detected and added to the graph. Included goals would be added to the note output along with charts.

Moving Forward on the ABA Journey

When getting started on the ABA journey, a typical jumping-off point could be building categories of ABA goals, then a bank of goals based on categories, and followed by documentation templates that include goals. Tracking goals correctly would make a big difference to making progress on ABA cases and improving outcomes. When it comes to goals, it could be easy to get lost in the data and lose track, which could present a huge challenge to ABA practices. The EMR offers a way out by taking care of goal data management and tracking and thereby offers a strong fillip to the ABA practice.