Advances in Occupational Therapy Technology: Rehab Week 2017

There is no better place to take in emerging technology in occupation therapy than Rehab Week.

I had the opportunity to attend the 2017 conference in London and I am excited to update you on the technology advances that are coming to rehabilitation.

Whether you are looking to invest in new rehab tech or simply feel inspired, this post is for you.

What is Rehab Week?

What do engineers, researchers, therapists, physicians, neuroscientists and students from all over the world have in common?  

No, this is not a complicated riddle- they all took place in Rehab Week 2017 in London, United Kingdom to share knowledge, new products, research in progress, best practice and collegiality toward the aim of helping restore function for patients with neurological injuries and illness.

As you might imagine, the energy was buzzing with bright minds, new ideas and inquiry as we all took our place as students of the world and of the same craft.  

Four simultaneous conferences were held as part of the 3rd ever Rehab Week conference in the bustling city of London after previous conferences held in 2011 in Zurich and 2015 in Valencia.  

The conferences represented were the IEEE International Conference on Rehabilitation Robotics (ICORR), the International Neurorehabilitation Symposium (INRS), the Annual Meeting of the International Functional Electrical Stimulation Society (IFESS) and the British Society of Rehabilitation Medicine (BSRM).  

In addition, the conference was supported by IISART, the International Industry Society in Advanced Rehabilitation Technology.  The conference kicked off with a challenge by the conference chair, Nick Donaldson, to “make connections, ask questions and not just settle for any answer”.  

How Rehab Week Impacted My Own OT Practice

As an occupational therapist and Clinical Manager of a Rehab Tech company, it was an opportunity to learn from those that asked questions of the mechanics of our products and gave me a chance to engage in dialog about how we’re using technology for good in the world of rehab.  

Some of the major items for discussion;

1. How we make rehab technology more financially accessible and
2. How we can continue to share knowledge across disciplines.  

(I’d love to hear your thoughts in the discussion string.)

For the first time, I was charged with answering “how” the products do what they do as well as “why” and “what” the application of our technology is in the rehabilitation of patients after stroke and brain injury.  

What Companies Were There? (And What They Were Featuring)

The expo allowed over 30 vendors to update the community on new developments in rehabilitation technology; newly improved rehabilitation robots, prosthetics technology and virtual reality solutions for rehabilitation.  

The combination of the four conferences yielded 522 poster presentations by students focused on the development of new assessments, robotics technologies, and algorithms to continue to make the products that we have available in our “toolkit” of items for neuro-rehab, more intuitive, accessible and supportive to the end user.

To learn about the latest in Neuro-Rehabilitation Technologies, visit the RehabWeek Vendor Websites:

Upper Extremity Robotics

• Axinesis:  Robotic upper extremity rehabilitation solution
• Egzotech:  Robotic upper extremity rehabilitation solution with EMG triggered electrical stimulation
• Hasomed:  Arm laboratory for upper extremity rehabilitation and RehaCog for cognitive training
• Hocoma:  Upper extremity robotics and virtual reality options for neuro-rehab through the Armeo line of products
• Rehab Robotics:  Hand of Hope, upper extremity sEMG driven robotic hand rehab
• Shanghai Fourier Intelligence Co.:  M2 upper extremity robotic training device and lower extremity exoskeleton.
• Tyromotion:  Robotics and virtual reality combinations for upper extremity and cognitive training

Upper Extremity Rehab Using Virtual Reality

• Hocoma:  Known best for upper extremity robotics solutions, new virtual reality product Armeo Senseo
• Kinestica:  Bimeo, sensor based upper extremity rehab in a virtual environment
• Mindmaze:  Mind MotionPRO and Mind MotionGO, upper extremity rehabilitation for clinic and home use (not yet available in the US)
• Neofect:  Rapael Smart Board, Glove and Smart Pegboard for upper extremity, hand and fine motor training through biofeedback; available for clinic or home use
• Saebo:  Saebo ReJoyce and SaeboVR for upper extremity rehabilitation in virtual environment.  Other neuro upper extremity devices available including SaeboFlex and SaeboStretch
• Tyromotion:  Robotics and virtual reality combinations for upper extremity and cognitive training
• Virtualware:  Virtual rehabilitation system using online platform for home
• YouRehab LTD:  YouGrabber and YouKicker for interactive upper and lower extremity rehab

Electrical Stimulation

• Bioness:  Best known for their electrical stimulation technology, H200 for the upper extremity and L300 for the lower extremity.  
• Egzotech:  Robotic upper extremity rehabilitation solution with EMG triggered electrical stimulation
• Fesia Technology:  Functional Electrical Stimulation for Gait, Fesia Walk
• Thera-Trainer:  Training devices for FES cycling, standing frames and gait training (body-weight support)

Cognitive Training

• Bioness: Best known for their electrical stimulation technology, check out their BITS system for visual and cognitive training
• Hasomed: Arm laboratory for upper extremity rehabilitation and RehaCog for cognitive training
• Rehab Robotics:  SmarTable, multiplayer cognitive training system
• Tyromotion:  Upper extremity and cognitive training through new Myro system

Gait Training and/or Exoskeleton Walking Support

• Lutz Medical Engineering:  Body weight support device for gait training
• Parker Hannifin Corporation:  Robotic exoskeleton for gait support and training
• Rex Bionics:  Lower extremity robotic exoskeleton for training, walking and standing
• Shanghai Fourier Intelligence Co.:  M2 upper extremity robotic training device and lower extremity exoskeleton
• Tecnalia: ArmAssist assistive robot for upper extremity rehabilitation
• Techno Concept:  Dynafoot and Vibramoov, gait rehabilitation sensor assessment and biofeedback training
• Thera-Trainer:  Training devices for FES cycling, standing frames and gait training (body-weight support)
• Woodway:  Medical treadmills and gait support systems
• Motek:  Virtual reality based gait and balance training

Other

• Reck-Technik:  Motorized upper or lower extremity cycling

How OTs Can Keep Up on Latest Tech Trends

If you have a particular interest in the latest research on neurorehabilitation, hearing from some of the leading industry experts for updates on technology and research, consider attending the next Rehab Week event.  

The next Rehab Week Conference will be held in Toronto in 2019 and promises to be just as invigorating.  

For more information on the groups represented at the Rehab Week conference including the great work that they’re doing in support of the scientific community, visit their corresponding websites.  

Join us in future years to support how occupational therapy is participating in the dialog and development of neuro-rehab technology solutions both on the industry side and more importantly as advocates for the end user.  

What Are Your Thoughts/Questions?

I came away with more questions than answers and would love to hear your thoughts,

1. How we make rehab technology more financially accessible and

2. How we can continue to share knowledge across disciplines?  

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About the Author

Lauren is celebrating her 10th year as an occupational therapist in 2017.  Her dream to join a technology company was realized when dreaming about the possibility of doing something “outside the box” after spending the last decade in outpatient neuro clinical practice and most recently in administration and management roles.  Lauren has served in various roles on her state occupational therapy associations and is a proponent of being an active member, particularly in advocating for occupational therapy through legislation and contact with elected officials.  She has enjoyed planning and organizing Washington state’s “Hike the Hill” event for the last three years.  She is also currently serving as the AOTA Representative Assembly Member for the state of Washington.  

Lauren has published multiple articles with OT Practice and is excited to be back to writing, starting with OT Potential, in this new intersection of neuro-rehab, OT and virtual reality.  Lauren believes that OT professionals are poised to be product designers, user experience experts and consultants as it relates to technology solutions that meet the needs of individuals with disabilities.  

MedBridge Student Discount (Only Pay $100!)

If you are a OT, SLP, PT or AT student, I recommend checking out the MedBridge Student Membership. For $100/year you can have access to teaching from leaders in your field.

Here's the MedBridge Student Discount Promo Code: "OTpotentialStudent"

You can plug it in here to receive the discount: https://www.medbridgeeducation.com/cart#/sign-up

IMPORTANT: You must register with your ".edu" email address for the discount to be applied. 

What You Get with Your Subscription

Students receive everything that is included in the education subscription (700+ courses), except: 

• You do not earn CEUs
• There is a “Student” watermark across all HEP exercises when printed
• You will not be able to send (email or text) the HEP

You can read more about MedBridge in my post, Is MedBridge Right for You?

How to Use the Subscription

A MedBridge Student Subscription is for the achievers. It is for students who want to go deeper into topics than their professors are able to go in the classroom. Our professors are generalists. Many of the presenters on MedBridge are specialists in their areas. 

I think one of the most useful applications will be on fieldwork experiences, as you encounter new diagnoses and complexities for which you would like to find extra guidance. 

Again, here's the promo code: "OTpotentialStudent"

If You Are an OT/PT/SLP Professor....

If you are an OT professor who is interested in connecting your whole classroom with the MedBridge library, send me an email at sarah@otpotential.com and I can connect you with information on group pricing for your students along with additional learning tools.

Best of luck to you! 

-Sarah 

P.S. If you are an occupational therapy student, also check out my post, The Best Student Resources, 2017. 

The Best OT Student Resources (2017)

OT school is hard work. And life outside of school doesn’t exactly stop.

To thrive in OT school, you do need to keep your nose to the grindstone.

But, there is also wisdom in leveraging the best occupational therapy resources out there.

It has been 6 years since I was in OT school. I remember those years as the busiest of my life.

In retrospect, I was entrenched in survival mode and did not invest time in figuring out how to simplify and streamline processes.  

This post is an attempt to gather all of the best occupational therapy resources for OT and COTA students in one place.

How to Stay Organized

Please, don't be like me. 

I paid for my disorganization in school for years afterwards. I found myself hauling boxes of scattered papers and disorganized notebooks each time we moved because I wasn't sure what was important. 

And forget about finding something to reference when I actually needed it! 

Here are some practical organizational strategies I have collected from forums over the years: 

• Buy 3 inch binders for each course to organize all of you papers, handouts, Powerpoints, etc.
• Tab out your Power Points using the dividers with reinforced holes and erasable tabs. (This can be done the night before the class so you can hit the ground running)
• Also buy a  folder for each class to keep returned work/tests/other important documents to refer back to.
• Get Google Drive and keep all digital documents organized. 
• Buy lots of notecards and highlighters! 
• Buy a daily planner. (Now in my professional life, I love the Get to Work Book. If only I had found it sooner!)

How to Improve Your Studying

This is the nose to the grind stone part.

But, you can also leverage these practical strategies to set yourself up to study well.

Here are some tips, I've gathered from fellow practitioners: 

• Do your notes for anatomy on graph paper as drawing the material can help tremendously.
• Take handwritten notes as often as possible vs typing. Helps to learn and maintain the info.
• Record every class and I mean every single class. Then listen to them constantly esp while driving (This must be done with permission from professor.)
• Take the VARK Assessment to determine your learning style and study strategies.
• START STUDYING THE NBCOT EXAM NOW! Make flash cards and as each course is taught, pay attention to HOW particular questions are worded

Here are some other resources I have found:

• OT Flashcards- Quizlet
• Tips for Surviving Anatomy Lab- OT in Motion
• Learn How to Work in a Group- Gotta Be OT
• The OT Practice Framework Abbreviated- Miss Awesomeness

How to Improve Your Writing

In OT school, you will find yourself undertaking much more technical writing than you did in your BA program. The amount of writing only increases when you become a practitioner. You will have to write efficiently and accurately.

I cannot imagine life without my Grammarly subscription. For $11 a month, it checks all of my writing, including emails, Facebook posts, and blog articles.

Citation Machine has come in handy to give a starting point in creating references. 

If you haven’t read the book “On Writing Well,” I highly recommend it for general writing style guidance. 

How to Connect with Fellow Students and  OT Practitioners

The OT network you establish in school will be one of your biggest assets as you head into practice. 

6 years after graduation, my classmates are often still my first phone call if I need to talk through something. 

If there isn't a Facebook Group (or some other group communication option) set up for your class already, take the initiative to do it! 

I also recommend joining the Occupational Therapy Students: Get Connected Facebook group, which is an international group.

As far as connecting with, current practitioners, I outlined some of the most popular groups in this post: Social Networking with a Purpose: A Guide for OTs.  

How to Stay Abreast of Therapy and General Healthcare Trends

Your success as an OT will depend on your ability to navigate the larger health care system and to stay abreast of its constant evolution.

Don't get OT tunnel vision.

Start habits now of keeping up with general health care trends. 

Here are some of my favorites avenues to do so:

• New York Times-Well
• The WebPT Blog
• AOTA’s Advocacy and Policy 

How to Deal with Frustrations

After my first year of OT school, I was ready to quit. 

I was frustrated and really didn’t find a good outlet other than talking to my parents. If you are dealing with frustrations, talk to fellow students and professors. And again, don't underestimate the value of looking for online support. 

Whatever you are frustrated about there is a likely an online conversation happening about the topic.  

Here are some examples of bloggers tackling tough issues:

• Speech to Occupational Therapy Students and Parents: Ways You Will Be Paid- ABC Therapuetics
• 5 Signs You’re Burnt Out on OT School and How to Get Back into the Groove- OT in Motion
• What Needs to Change About OT School?- OT Potential

How To Thrive in Fieldwork

After helping supervise students, I now have a new appreciation for the challenge of quickly learning the ropes to a new place and navigating the supervisory relationships.

Lean in on your aforementioned support networks. 

Here are some FW Resources to help you along the way: 

• Articles on Fieldwork- Student Pulse
• Answers to Your Fieldwork Questions- AOTA
• 10 Tips for Navigating a Non-Traditional Fieldwork

Side note: I recently made this OT Fieldwork Manual if you show up at your site and realize they don't have one!

How to Prepare for the NBCOT Exam

Ultimately, school is  preparing you for the NBCOT exam. NBCOT has an awesome suite of resources to assist you when that time does come. 

I also highly recommend checking out OT Miri, who hosts the OT Miri Facebook Group and makes You Tube videos to help students studying for the NBCOT! 

OT Miri will help you arrive to this point: 

Managing Your Finances

Managing your debt should technically start before OT/COTA school even begins, and it certainly should trail off while you are in school. 

Gotta Be OT has a good list of steps you can be take while you are in school to secure funding. 

To keep your eye on the big picture, here is my post on occupational therapy and student debt. 

Start Thinking Ahead to the Job Hunt

I had my first job lined up before I even headed into to my second fieldwork placement.

This is a unique circumstance, but honestly it is never too early to get a pulse on the job market! 

Check out my resource: 6 Steps to the Right OT Job. 

Discounts for OT Students! 

Oh how I miss the days of student discounts! Please enjoy these discounts on my behalf! 

MedBridge Student Discount (You pay $100)

MedBridge is a continuing education resource that many practitioners use. I wish that I had signed up for continuing ed. courses right away as a new practitioner so I could have referenced them during fieldwork and my first year as a new practitioner. (I love MedbBridge and am an affiliate.)

Learn about the MedBridge Student Discount here. 

Fusion Web Clinic 

Ok. This is something your professor needs to sign up for, but it is a way to practice documentation in an actual EMR. If you think your program would benefit from this, definitely pass it along. (Not an affiliate, just a fan :-)

Learn more here: https://www.fusionwebclinic.com/educator-program/

Last but not least here are some general student discounts you can take advantage of: 

The Ultimate List of Discounts for Students

What about you? What OT resources would you share with fellow students? I would love to make this post stronger with your input! 

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MedBridge Go App: Using Research to Improve Your Therapy HEPs

If you haven’t taken some time recently to re-evaluate the role that home exercise programs (HEPs) play in in your OT/PT or SLP practice, it’s time to sit down and do some thinking.

New tools are on the market. (Hello, MedBridge GO!)

Research is telling us that what we’ve done in the past isn’t working spectacularly..

But, these 5 changes informed by research (and made easy with MedBridge GO) can boost your client’s satisfaction with the therapy experience, their engagement, and ultimately outcomes.

Note: I am a MedBridge affiliate. However, my intention is always to enable to therapists to provide the best care possible. Below I will also share other resources that help you achieve best practices.

Where We Were. (AKA what didn’t work.)

I remember being a new grad and gleefully scrolling through the exercise software at my work and checking every exercise vaguely related to my patient’s condition.

My thinking:

“The more exercises, the more value!”

“How cool that I can just check some boxes and the program generates this professional looking HEP. Neat!”

Reality:

I had no idea how long the HEP was going to take.

+

I did not formulate a plan about how this would fit into my patient’s life.

+

I did not provide reminders.

+

I maybe went through it once with them…but definitely did not seek feedback on how it was going at home.

+

I usually did this toward the end of episode of care.

=  

The Results: My patients probably did not do the home exercise program.

I’m not alone in this low patient adherence. From looking at the research, it seems that 30-50% of patient’s participating in HEP is about what can be expected.  

So how can we do better?

5 Research-Based Changes to Make to Your HEP Offerings

After reading several studies on what makes patients more likely to participate in home exercise programs, I saw these 5 themes emerging.

Check out the research articles linked with each change and at the very bottom of this article for a fuller explanation of the research. 

1.) Go Digital

I live in rural Nebraska and through my gym I get this snazzy app that allows me to track every work out, watch videos of proper form, and even message the gym owner with any questions.

I believe that our therapy patients will start expecting interactive technology like this.

And for good reason.

Studies are showing increased patient satisfaction when interactive technology is provided with education materials. (The article HEP: The Secret Weapon for Better Patient Retention and Satisfaction does a great job of summarizing this.)

2.) Make a Plan for How Much Time It Will Take

The first thing I did with my MedBridge Go app was to plug in what I thought to be a typical home exercise program.

I was shocked to see that the amount of estimated time it would take.

It added up to almost TWO HOURS.

What? I had no idea I was asking so much of my patients.

The lesson:

Talk with your patients about how much time they can see dedicating to a home exercise program. If they are not accustomed to regular exercise, 15 min. might be a realistic starting point.

Or maybe you are working with someone who actually does work out for 3 hours everyday so my initial 2-hour plan might be completely plausible.

(Not convinced by my anecdote? In this study 1/3 of the participants said “if the home-based program requires a lot of time, they tend to prefer drugs by pragmatic reflection.”)

3.) Recommend Fewer Exercises

This is in the same vein as being aware of time.

You should consider limiting the number of exercises.

Why?

Because multiple studies have shown that adherence starts to drop once you get into the range of 6-8 exercises. Here’s what one 2009 study found:

“Total number of exercises per session in the HEP is a specific predictive factor for frequency adherence. Subjects who received an HEP including more than 6 exercises have lower odds of frequency adherence (OR = 0.2; CI = 0.1-0.9; p < 0.05) than those with three or less exercises.”

After taking in the research, I would say that 2-3 exercises is a good number to shoot for. Any more than 8 exercises should throw up a red flag. 

4.) Send Reminders

Let’s be honest it is hard work to incorporate a new routine into your schedule.

I know that I need all of the reminders I can get.

This 2010 study indicates that HEP can be helpful, but the research is just referring to having a handout to refer to. At the time they hadn’t even conceived of secure texting/push notifications.

Today, the research still has not yet caught up with how text message or push notification reminders specifically impact adherence to HEPs.

But, I think a helpful parallel to look at is how the technology is impacting medication compliance.

Here’s a telling quote from this summary of the research:

“We found that text messaging doubled the odds of patients with chronic diseases sticking to their medication program.”

Yowza.

Imagine the impact on the effectiveness of HEP if we could see those kinds of results. 

(Thanks to Dave Kittle of Vinitial, for answering my questions about available research for this section.)

5.) Provide a Feedback Loop

As one might guess, clarifying doubts and questions from patient increased the likelihood that they would initiate their HEP according to this study.

Currently the best way to answer questions is to do so in person, when you introduce the plan and in subsequent sessions. Within the MedBridge GO system, patients can also ask questions within the patient portal. 

If you have secure texting with your patients this could be another option for them to ask questions as they are going through the process.

Look for the technology to improve on this over the next few years. Just like is possible in my aforementioned fitness app, I anticipate people will be able to send messages directly from the app itself. 

Overview of MedBridge GO and Other Digital HEP Tools

Luckily, some of the resources you are already using are investing in HEPs.

MedBridge GO

The MedBridge GO app comes with their Premium Plan (save $175). Therapists can craft a home exercise program that is then sent to the client-facing app.

The set up is really simple for the client. When they open the app they see how much time today’s exercises will take. When they are ready, a video will walk them through exercises that are paced so they receive maximum benefit from each movement.

The app then tracks the progress for both the therapist and client can see.

The app was developed with research in mind and therefore helps you achieve all 5 of the aforementioned ways to improve your HEP offerings. (I'm hoping to see even more developments though on #5, "provide a feedback loop."

WebPT Home Exercise Software

WebPT has home exercise program software that allows you to email exercises to patients. This system also has peer-reviewed exercises.

Are there other digital HEP tools that people are using (and enjoying)? Let me know!

Conclusion

Many of these changes are relatively simple. And even if you are using one of the free HEP resources out there, you can incorporate some of the research into your offerings.

But, I’m excited for the advances in technology, like MedBridge Go, that are now allowing us interact with patients on a whole new level and incorporate all of the above best practices.

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Helpful research articles on HEPs and therapy:

• The effectiveness of home-based exercise programs for low back pain patients (2016)
• How do care-provider and home exercise program characteristics affect patient adherence in chronic neck and back pain: a qualitative study (2010)
• Predictive factors of adherence to frequency and duration components in home exercise programs for neck and low back pain: an observational study (2009)

20 Occupational Therapy Quotes

Looking for an occupational therapy quote to share on social media, pin-up in your office, or just refresh your OT spirit? 

These quotes are for you. 

I believe quotes are vital to our profession. We currently have difficulty defining ourselves. We shrink from the bold statements about the core of our practice—that daily tasks are vital to healing.

This is where quotes come in. They give us the language to articulate what we intuit and build our practices on. You can bet that we are not the only ones to have found meaning in daily activities. 

Enjoy! (And feel free to share the images.) 

The Value of Daily Activities

From Laura Ingalls to Ana Tijoux (a French-Chilean hip-hop artist), assertions of the value of daily activities pop-up across literature and art.

Here's some of my favorites:

“It is neither wealth nor splendor; but tranquility and occupation which give you happiness.”

— Thomas Jefferson, Personal letter to his sister

“As the years pass, I am coming more and more to understand that it is the common, everyday blessings of our common everyday lives for which we should be particularly grateful. They are the things that fill our lives with comfort and our hearts with gladness — just the pure air to breathe and the strength to breathe it; just warmth and shelter and home folks; just plain food that gives us strength; the bright sunshine on a cold day; and a cool breeze when the day is warm.”

— Laura Ingalls Wilder, Writings to Young Women from Laura Ingalls Wilder

“I think we live in a world where the most important thing is daily life: sharing a space with your family, making meals, being with your people. It’s not only the idea of privacy, it’s the beauty of the moment, at a time in the world when everything goes really fast - too fast.”

— Ana Tijoux

“A man’s motive in the small actions of daily life, like resting a moment on his pitchfork in the sun and listening intently, may be the most important thing about that man.”

— Haniel Long

This next quote from Joan Didion might need some context. It comes from her memoir about the sudden death of her husband and concurrent illness of her daughter. It is the best articulation I could find of a sentiment that I have encountered from both clients and friends – that daily tasks can serve as anchors in times of grieving and loss.  

“I learned to find equal meaning in the repeated rituals of domestic life. Setting the table. Lighting the candles. Building the fire. Cooking. All those soufflés, all that crème caramel, all those daubes and albóndigas and gumbos. Clean sheets, stacks of clean towels, hurricane lamps for storms, enough water and food to see us through whatever geological event came our way. These fragments I have shored against my ruins, were the words that came to mind then. These fragments mattered to me. I believed in them. That I could find meaning in the intensely personal nature of life as a wife and mother did not seem inconsistent with finding meaning in the vast indifference of geology and the test shots.”

— Joan Didion, The Year of Magical Thinking

“Care asserts that as difficult and painful as life can be, it is worth something to be in the present, alive, and doing one’s daily bit. ”

— Kathleen Norris, The Quotidian Mysteries

“How we spend our days is, of course, how we spend our lives.”

— Annie Dillard, The Writing Life

Occupational Therapy Treatment

The Mary Reily quote is the most famous quote I could find from an occupational therapist. It is derived from the 1961 Eleanor Clarke Slagle Lecture, titled "Occupational Therapy Can Be One of The Great Ideas of 20th Century Medicine." The title in itself is an inspiration.

“Man, through the use of his hands, as they are energized by mind and will, can influence the state of his own health”

— Mary Reily, OTR, EdD

“Tell me and I forget.
Teach me and I remember.
Involve me and I learn. ”

— Chinese Proverb

“You treat a disease: you win, you lose.
You treat a person, I guarantee you win-no matter what the outcome.”

— Patch Adams

The Art of Being an Occupational Therapist

I tend to overanalyze the exact language I use in difficult situations. Daily, I wish I had chosen my words differently. The Maya Angelou quote was introduced to me back in college and helps me focus on making people feel cared for. The Eleanor Brownn quotes reminds me to also take time to care for myself.

“I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”

— Maya Angelou

“Rest and self-care are so important. When you take time to replenish your spirit, it allows you to serve others from the overflow. You cannot serve from an empty vessel.”

— Eleanor Brownn

Making Progress

All three quotes emphasize the importance of breaking tasks down into small steps--and then taking things one step at a time. 

“The secret of getting ahead is getting started. The secret of getting started is breaking down complex overwhelming tasks into small manageable tasks, and then starting on the first one.”

— Mark Twain

“You need to be content with small steps. That’s all life is. Small steps that you take every day so when you look back down the road it all adds up and you know you covered some distance.”

— Katie Kacvinsky

“I long to accomplish a great and noble task; but it is my chief duty to accomplish small tasks as if they were great and noble.”

— Helen Keller

The Art of Play

I had to add in this little section on play. Our training gives us a unique perspective into the holistic value of play across the lifespan. I love seeing OTs advocate for play opportunities from infancy through old age. 

“Watching a child makes it obvious that the development of his mind comes through his movements. ”

— Maria Montessori

“You can discover more about a person in a hour of play than a year of conversation. ”

— Plato

Quotes from the Early Years of OT

These gems were found during my research for my post "10 Amazing Moments in the History of OT." 

“The association is a responsible, incorporated body with officers of large experience, and active committees encouraging research, collecting data and recommending standards. It seems reasonable to assert that here is a work of national importance, a human reclamation service touching vitally on matters of vast social and economic consequence. Mere encouragement, even placement in industry cannot restore men and women who have not learned through careful bedside training how to use their disabled bodies. The association is literally helping the helpless to help themselves.”

— Herbert Hall, From a 1922 editorial on the purpose of the AOTA

“In your chosen field, a part of the noblest work of man– the care and relief of weak and suffering humanity– may you realize in increasing measure the value of certain spiritual things which are the making of life, but which we call by many common names. Kindness, humanity, decency, honor, good faith– to give these up under any circumstances would be a greater loss than any defeat, or even death itself.”

— Thomas Bessell Kidner, from a 1929 OT graduation speech

“Reverently and earnestly do I pledge my whole-hearted services in aiding those in my care.

To this end that my work for the sick may be successful, I will strive for greater knowledge, skill, and understanding in the discharge of my duties in whatsoever position I may find myself.

I solemnly declare I will hold and keep whatever I may learn of the lives of sick.

I acknowledge the dignity of the cure of disease and the safe-guarding of human health, in which no act is menial or inglorious.

I will walk in up-right faithfulness and obedience to those under whose guidance I am to work, and I ask for patience, kindliness and strength in the holy ministry to broken minds and bodies.”

— AOTA Pledge, adopted 1926

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I would love to keep adding to this compilation over time! If you have any quotes that you have inspired your occupational therapy practice, please share! 

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Is WebPT Right for You? ($100 Discount, If It Is!)

No EMR system is right for every therapy practice. 

This post is to help you discern which documentation and billing software system is right for your occupational therapy, physical therapy, and/or speech therapy business. 

In the end, WebPT may be right for you – or perhaps you'll find another option. 

We'll begin by comparing the cost of WebPT to other EMR/billing prices. (You should definitely look into multiple EMR companies.) 

Then, we'll look at crowd-sourced questions that you can ask during demos. WebPT has already provided the answers to accelerate your research.

If you end up requesting a demo with WebPT, you can use my custom link to receive a $100 discount on WebPT if you then decide to subscribe.

Disclaimer: I have a partnership with WebPT, but, please know that being helpful to my readers is my first priority.

Overview of EMRs for OT, PT, and SLP (Includes Pricing!)

When searching for a software solution, I know for many of you the first question is this:

"How much does it cost?"

The table below gives you a starting point to finding those answers for your practice. It will help you filter which systems are designed for your type of practice AND which ones are in your financial wheelhouse.

I wanted to make the table simple to navigate, and to do so, I did not include all of the specific features included in each system. 

A huge thanks to the OT Entrepreneurs FB Group for their input into this list! All of the EMR companies were highly recommended in this group or on Capterra, with the exception of Planet Rehab, which I found through my own research; I wanted to show you the cost to license software outright versus the subscription model.

EMR/Billing Cost for 1 Practitioner at 1 Location

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Basic EMR: "About $30/Therapist for 1-5 Employees" (You will need to request a quote.)

Additional Costs: A La Carte Options

Designed for: ABA Practices (Behavioral Health, Speech, Multi-Speciality, School)

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EMR: $59.95/Month

Integrated Billing: Additional $49.45 - $79.95/Month

Additional Costs: Optional Add-ons

Designed for: SLP, OT, PT, Mental Health, ABA, Pediatric Therapy

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EMR: $89/Month

Integrated Billing: Additional $70/Month

Additional Costs: No Set-up Fees

Designed for: Pediatric OT, PT, and SLP

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Professional Plan (EMR, Billing & More): $150/Month

Additional Costs: $200-$1000 On-boarding fee, Optional Add-ons

Designed for: OT, PT, SLP

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EMR: $49/Month (For up to 10 patients)

Integrated Billing: Not Available

Designed for: OT

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EMR: $500 - $150,000 Stand-alone Software Purchase

EMR with Billing: 7% of Collections

Additional Costs: 

• $1,500 Billing Set-up
• Support: $100-150/hour (Basic EMR Plan only)
• Training: "Varies" (Basic EMR Plan only)
• Yearly Maintenance Fee: "Varies" (Basic EMR Plan only)
• Upgrades: "Discounted Price" (Basic EMR Plan only)

Designed for: OT, PT, SLP

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EMR, Billing & More: $170/Month (Up to 4 users) 

Additional Costs: Possible Add-ons

Designed for: OT, PT, SLP, Chiropractors, Neuropaths, Psychologists

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EMR, Billing & More: $0.79/Visit

Designed for: Home-based Care and/or EI (OT, PT, SLP, RN, SW)

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EMR & Scheduling: $3/day (about $89/Month)

Integrated Billing: An Additional $99/Month ($188/Month Total)

Additional Costs: $199 One-Time Billing Set-up Fee

Designed for: OT, PT and SLP

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Questions for WebPT (These Are Also Good Questions to Ask Any EMR Company)

After finding 3-4 EMR options you want to explore further, I suggest compiling questions you want answered about each system. 

Ask a lot of questions!

Of course, ask them during the demo. But, also don't forget to reach out to fellow therapists who are using the systems. 

These questions were collected from the OT Entrepreneurs FB Group. Paul Potter, a private practice startup coach, also helped me fill in some gaps! 

The questions are divided into 5 categories for your navigation enjoyment:

1. Saving Time
2. Saving Money
3. Improving the Patient Experience
4. Accommodating Different Practice Areas
5. Accessing a Private Practice Community

The WebPT marketing team answers your questions! (Photo Credit: WebPT) 

EMR Questions from Fellow Therapists:

1. SAVING TIME

"Are you tracking the average time therapists spend on each note? I’m curious how long it will take me to document and bill with this system."

WebPT: Yes, we do track this data. Therapists typically keep their evaluative notes open during patient exams, which is why we see an average open time of around 40 minutes.

Daily notes, on the other hand, are typically open for around 5 minutes, as most data carries forward from one note to the next. So, therapists are simply accounting for visit-to-visit updates.

"I’ve been seeing 10 private pay patients and am currently using paper-based notes and giving my patients a superbill. Can you walk me through (an approximate) step-by-step time investment for getting set-up with WebPT/Therabill?"

WebPT: The amount of time it takes to get totally set up varies by practice, but we do have a clear step-by-step checklist for new members to follow. And we offer tons of support along the way. Most clinics are up and running in a few weeks.

"Figuring out HIPAA compliant email/fax/texting has been a huge time-suck for me! Does WebPT offer a solutions/support in communicating with patients, payers and physicians?"

WebPT: We offer secure electronic faxing directly from the application, and we also have a document portal that allows Members to securely share files via email. This gives the clinic total control over who is allowed to view any particular document, and the clinic can revoke access to that document at any time.

"My EMR and billing company are currently not integrated. How would switching to WebPT save me time?"

WebPT: When your EMR and your billing software are not integrated, you’re forced to perform double data-entry.

Talk about a waste of time and money—not to mention a much higher likelihood of making a transcription error that could lead to a claim denial.

With WebPT, you have numerous integrated billing options, including our robust Therabill integration. With integrated billing, all of the patient and visit information you enter into the EMR automatically flows into your billing system—which means you can get claims out the door faster—and with fewer errors.

2. SAVING MONEY

"My therapy practice startup has been utilizing the HIPAA Compliant Google Suite to meet many of our needs. What are some signifiers that could indicate we are ready to invest in an EMR?"

WebPT: Google is no match for the compliance power of WebPT.

Our built-in HIPAA and Medicare compliance safeguards ensure your claims meet every regulation—and as rehab therapists know all too well, there are quite a few of them!

Plus, our system is tailored to rehab therapy workflows, which means intuitive documentation, integrated scheduling, and easy-to-use clinical and business performance reporting.

So, if you’re tired of receiving compliance-related claim denials or payment reductions—or if you’re looking to streamline all functions of your clinic, from appointment-scheduling to treatment to billing—then it’s definitely time for you to look into a therapy-specific software platform.

"My practice is currently cash-based, but I am thinking of expanding.  How would WebPT help me stay compliant with Medicare?"

WebPT: We’re constantly updating our system to ensure total compliance with complex Medicare rules like functional limitation reporting, the 8-minute rule, and the soon-to-be-introduced MIPS and MACRA requirements.

Plus, we build all of those compliance features directly into the normal documentation workflow to ensure minimal disruption to your documentation and treatment processes.

"My unpaid claims are piling up. How would WebPT help prevent this?"

WebPT: When you use our documentation and billing software together, you can easily create and send claims. In fact, you can release entire batches of claims with just a few clicks. Plus, claims undergo multiple rounds of scrubbing, resulting in cleaner claims and faster payments.

3. IMPROVING THE PATIENT EXPERIENCE

"Are there any features to ease out of network submission on the client’s behalf?"

WebPT: Providers can verify benefits for some insurances directly within Therabill, which can help expedite the cost estimation and claim submission process.

"What patient engagement features does WebPT have?"

WebPT: WebPT allows providers to send automated appointment reminders; distribute patient satisfaction and patient-reported outcomes questionnaires (both of which can be filled out via email); and create and send customized home exercise programs. Additionally, our billing software, Therabill, includes a patient portal where patients can log in and pay their bills.

4. ACCOMMODATING DIFFERENT PRACTICE AREAS/MODELS

"When I think WebPT, I think adult outpatient ortho. Could you give any insight into how therapists from more niche practice areas are using the service? (I’m thinking: pediatrics, lymphedema, pelvic health, hand therapy, OP mental health, EI, low vision). Are there any OP therapy practice areas WebPT simply is not built for at this time?"

WebPT: We know there are a lot of niches in the world of therapy. That’s why we offer specialty-specific documentation modules, including speech-language pathology, pediatrics, occupational therapy, vestibular, and pelvic health. We also serve some chiropractic practices. While WebPT isn't tailored to mental/behavioral health practice, the Therabill standalone product can accommodate these specialties.

"I own a hand-clinic and want to expand to include additional revenue streams (such as wellness visits and UE massage). I still want to document and schedule these visits, just not as extensively as my traditional therapy services. How does WebPT accommodate hybrid practice models such as this?"

WebPT: Our SOAP notes are pretty flexible—meaning users can pick and choose which fields they'd like to complete. Alternatively, therapists can simply create case notes, which are essentially free-form text notes.

5. ACCESSING A PRIVATE PRACTICE COMMUNITY

"I have questions on other parts of setting up my private practice . What support and community does your platform have to assist me with this? "

WebPT: For compliance and WebPT app-related questions, we have a searchable online community as well as the WebPT University, which is our on-demand training module. We also provide a public-facing, regularly updated blog with information on business best practices, compliance and billing, and industry news. 

"Ok. Let me get even more specific. Here are 4 private practice questions I have. How can WebPT help me find the the answers?"

1.) "Where can I get help with the process of obtaining a business NPI?"

WebPT: We’ve published an entire blog post dedicated to frequently asked questions about NPIs. You can check it out here.

2.) "Can anyone help me with Medicaid enrollment?"

WebPT: WebPT does not assist with Medicare and Medicaid enrollment. Because each state oversees its own Medicaid program, we recommend reviewing your state’s Medicaid website for more information.

 3.) "Any advice on the application process to be in network for insurances?"

WebPT: We’ve published several resources dedicated to helping therapy providers better understand the private insurance enrollment and billing process, including the following:

• How Does Insurance Work from a Private Practice Perspective?
• The Startup Clinic's Guide to Private Practice Billing
• In-Network, Out-of-Network, or Cash Based: Which Model is Right for Your Practice? 
• Conquering Credentialing: What PTs, OTs, and SLPs Need to Know About Insurance Enrollment

4.) "What support could I get for negotiating insurance reimbursement?"

WebPT: We recommend downloading our guide to insurance contract negotiation. You may also find this blog post and this webinar valuable. 

The Bottom Line

There is much to consider when searching for the right therapy practice management software, but  research and support from fellow practice owners will go a long way in helping you decide which EMR is right for your therapy practice. 

Again, if you decide to explore WebPT, you can sign up with my link for a demo and then receive a $100 discount on WebPT if you decide to purchase.

I have a partnership with WebPT. However, this post was fully initiated by myself and the opinions are my own. 

Please let me know in the comments what updates you would like to see to this post or any thoughts you have on choosing the right EMR.