Thanks to the collaborative work of several groups committed to making the case for physical therapists (PTs) as qualified providers of electrodiagnostic studies, the landscape for lab accreditation has changed in ways that create opportunities for PTs, all while following standards more rigorous than previously existing systems.
The new lab accreditation is an effort of the Federation of Electrodiagnostic Laboratory Accreditation (FELA). But as the name implies, FELA is a group effort, created when members of the American Academy of Clinical Electrodiagnosis (AACE), the American Congress of Electroneuromyography (ACE), and APTA's Academy of Clinical Electrophysiology and Wound Management (ACEWM) came together around a shared goal—creating a program that allows PT-run labs to achieve accreditation.
According to Greg Ernst, PT, PhD, member of AACE, the idea began 4 years ago. "There was already a lab accreditation process developed by the American Association of Neuromuscular and Electrodiagnostic Medicine [AANEM]," he said. "However, the AANEM accreditation requires that each lab, and all satellite labs, have a physician that performs electrodiagnostic studies—PTs could only function as technicians."
So Ernst, ACE President Elaine Armantrout, PT, DSc, and Rick McKibben, PT, DSc, chair of ACEWM's clinical electrophysiology practice group, set out to create an accreditation program that would not only acknowledge the PT's ability to oversee electrodiagnostic labs, but would be based on standards that exceeded those created by AANEM. Joining the effort were Robert Sellin, PT, DSc, David Greathouse, PT, PhD, and John Palazzo, PT, DSc. Ernst, Armantrout, McKibben, Sellin, Greathouse, and Palazzo are all board-certified specialists in clinical electrophysiologic physical therapy. Greathouse, additionally, is a Catherine Worthingham Fellow of the American Physical Therapy Association.
"We all agreed that FELA should be as inclusive and open as possible while maintaining strict adherence to what is needed to represent quality and integrity in an accreditation process," Armantrout explained. "FELA applicants can be from any discipline as long as their state licensure allows, which sets us apart from AANEM's accreditation, to which only neurologists and physiatrists can apply. We think that by restricting the accreditation in that way, the public and payers are misled, and it implies that there aren't other qualified providers, such as PTs."
Besides the more open qualifications for accreditation, Ernst points to 3 other areas that make FELA distinct from the AANEM path:
- A higher bar for "exemplary accreditation." While both FELA and AANEM offer 2 levels of accreditation—"regular" and "exemplary"—the requirements to achieve exemplary status through FELA are tougher than the ones used by AANEM, Ernst said
- Emphasis on waste, fraud, and abuse training. Ernst said that FELA requires evidence of Centers for Medicare and Medicaid Services training on avoiding waste, fraud, and abuse. The AANEM program doesn't.
- Cost. "The FELA lab accreditation process is less than half the cost of the AANEM accreditation," Ernst said.
