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      - EHR Implementation Success Story -

      Leg Up Farm

      Wrangling complex documentation with electronic health records.



      Streamlining Care, Documentation, and Billing for a Special-Needs Therapy Provider

      Leg Up Farm offers a wealth of therapeutic services — including physical therapy, speech-language pathology, occupational therapy, nutrition services, behavioral health, and equine therapy — to thousands of children with special needs.


      A Growing Facility, A Need to Scale

      As the York County, Pa.-based organization grew, documentation became increasingly complex and time-consuming. Organization leaders quickly determined that their existing electronic health record (EHR) lacked the robust functionality needed to align with the current growth trajectory.

      In January 2019, Leg Up Farm implemented InSync Healthcare Solutions’ industry-leading EHR. The organization selected the platform for its nimble, flexible interface and templates, which could be configured to existing workflows while supporting revenue cycle management (RCM) operations.

      Two years later, the EHR has delivered on its promises in a big way by streamlining documentation, enhancing provider-patient communication, and improving bottom-line health.

      18 Acres of Care

      Situated on a bucolic 18-acre campus in Pennsylvania’s York County, Leg Up Farm was founded in 1997 to connect children with special needs to the therapeutic services and recreational outlets that support their development.

      Today, Leg Up Farm offers multiple therapeutic services to patients from birth to age 21 and provides more than 20,000 sessions to approximately 700 children annually, many of whom participate in public health/state Medicaid programs.

      Services range from those covered by health plans, including physical therapy (PT), occupational therapy (OT), speech-language pathology (SP), nutrition, and behavioral health, as well as cash-based ancillary services such as equine-assisted therapy.

      Leg Up Farm also offers recreational and educational services to families along with the Able-Services day program for adults with special needs up to 59 years of age, which allows them to explore community interests and develop skills for independent living.

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      Bursting At The Seams With Growth

      As Leg Up Farm expanded, keeping up with documentation grew harder and more cumbersome.

      “When I started in 2011, the EHR that was in place provided an early foundation for electronic processes,” recalls Tom O’Connor, President, Leg Up Farm. “But as we expanded our caseloads, staff, and service offerings, we realized the existing solution would not support our current path or future goals. We were spending a lot of time onboarding people, and the system lacked the functionality to create the efficiencies we needed.”

      Complex clinical documentation often took therapists several hours, between culling colleagues’ notes with their own care plans and updating goals.

      Cindy McMahon, the practice’s rehab services manager, recalls that processes were very disjointed with the previous EHR.

      “There was no attachment between notes and billing, and no way to tell if treatment plans were signed by the physician,” she said. “It would take about two days for me to orient a new therapist to use the system, and we had so many different rules we needed to consider across our different therapies ranging from school-based settings to occupational and equine therapy.”

      Documentation processes were also error-prone as therapists typed out all their daily notes and then pasted them into the EHR. Also, the wide mix of insurance-covered and cash-based therapies, coupled with these other challenges, led to complicated billing scenarios and delayed claims processing.

      Consequently, the practice began vetting a wide swath of EHR vendors in 2018 to identify an infrastructure that would position Leg Up Farm for future growth. While cost was a factor in the decision-making process, ease of use was king: The new EHR would have to be intuitive, flexible, and built for clinical collaboration.

      A Solution Tailored to Fit

      Leg Up Farm selected InSync Healthcare Solutions’ EHR because it was tailored to the real-life needs of specialty therapy practices, which are different from those of large hospitals and general physician practices. The EHR offered configurable workflows and a streamlined user experience—important factors influencing the final decision.

      “InSync provided flexibility and helped us achieve the right balance between customization and pre-configured templates, which speeds up the documentation process down the line,” says McMahon.

      In early 2019, Leg Up Farm began its implementation process, which lasted six weeks and was “more intense” than McMahon had anticipated. But InSync’s dedicated support team made itself available and patiently answered staff and therapist questions as they got acquainted with the new system.

      We were undergoing a huge transition, and there was a lot of work that needed to be done. Our program is unique, which meant that we were really starting from scratch in terms of how we approached the new system. Our dedicated InSync implementation specialist was really patient, walking us through steps four times and five times if needed, and that level of support continues to this day.
      - Cindy McMahon

      Trimming Down Intake

      Prior to InSync, Leg Up Farm’s intake process was cumbersome and long, and characterized by a lot of paper. This is no longer the case, and the practice is reaping the benefits of more efficient operations.

      “A simple evaluation, or daily note, went from 15 to 20 minutes to write, down to 3 to 5 minutes,” says McMahon. “A complex evaluation that would previously take me two hours to write now takes 30 minutes.”

      The new systems also offers transparent views into patient benefits—when authorizations end and how many visits a patient has left, for example.

      Collaboration between therapists also grew easier.

      Previously, a therapist would have to open up a screen, and figure out from that screen which note went to which service,” says McMahon. “Now, I can just open my notes and quickly identify documentation from PT, SP, and OT to better understand the full picture of care. We’ve reduced five views down to one.”

      An unexpected benefit of the InSync EHR solution is the patient portal, which has improved provider collaboration and communications with parents/guardians of the special-needs children Leg Up Farm serves. The patient portal has expedited other processes too, for example, the turnaround from a client on a waitlist.

      “It’s helped us manage, organize, and truly predict waitlist,” says O’Connor. “We have a better understanding of what it means to optimally manage client flow.”

      InSync’s RCM functionality now ensures a seamless documentation and billing process, which has notably improved cashflow. Previously, Leg Up Farm’s administrative staff would have to collect documentation from multiple therapists via fax or email before submitting claims, which significantly slowed down the revenue cycle.

      “We’re definitely getting paid faster now,” says O’Connor. “Most families utilize Medicaid as the primary payer, so every dollar is critically important. We also have a better understanding of financial health through the solution’s robust reporting, enabling us to track where money is going. From a cashflow standpoint, it’s made our world a little easier, and a little more predictable.”

      Where Are They Now?

      Two years since implementing its EHR, Leg Up Farm’s needs have shifted with new challenges — such as COVID-19, and the transition to virtual care services — impacting clinical and billing departments. Having InSync as a partner has made an enormous difference in this regard.

      “One of the most positive things I can say about InSync is that the organization, and their technology, evolves with us,” says O’Connor. “From a setup and billing standpoint, there were a lot fewer surprises in the system day to day than my previous system, which helps me sleep at night.”


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