San Diego, CA – October 13th, 2010 – ChiroTouch™, the nation's leader in chiropractic software, recently posted its latest article in its educational series entitled "Building Your Chiropractic Toolbox."
As with any job, the right tools will produce a quicker, more precise, and more desirable result. Proper tools can get the job done and measure the success of the outcome. The field of medicine has advanced greatly with technology, and chiropractic medicine is no exception. Proper digital clinical tools can help you manage a larger and more variable case load in less time.
Historically, the tools of a DC were relatively simple. In the 80's, all we needed were a blood pressure cuff, stethoscope, thermocoupler or rudimentary spinal scanner, and weight and height scales. The rest of the work was performed with our hands and our minds. Back then, there was no way to present x-rays or bloodwork to a patient. Most DCs had no access to diagnostic scans because they were not granted hospital privileges. Diagnoses and treatment were based on visual inspection, which was sufficient at the time. However, there is a big difference between being effective and demonstrating your effectiveness.
With the advances in medical technology, our field has now been criticized for going in the opposite direction - DCs have been accused of (and we have accused ourselves and each other) of relying too much on tests and losing many of our "hands-on" skills. To achieve the desired outcome, we must have an equal balance between the best tools: our minds, hands, diagnostic reports, and technology.
Devices today are incredibly advanced. Now we can see inside of the patient. Our measuring tools are ultra-sensitive and much more accurate. Many of these technologies cost a pretty penny, but can save long-run costs by quickly alerting us to an accurate diagnosis so that we may render more effective treatment. Even without these tools, we would probably come to most of the same conclusions. However, these technologies are more precise than any visual inspection and are not reliant upon instinct. For both the patient and DC, it may be difficult to justify several weeks of treatment without accurate demonstration of progress and favorable outcomes. Technology can give us a clear and accurate visual representation of this.
Since we often rely on third-party reimbursement, it is our responsibility to show that the patient is improving with the treatment we are giving. It is even more important to have an accurate, detailed analysis to prove it. With the correct tools, this job can be done quickly. Measurements taken prior to treatment can be compared with measurements taken after treatment. Many digital clinical tools that can be used in your office are evolving. Some of these tools include:
· Mechanical adjustment devices: indicating tissue resistance and delivered force
· Digital X-ray: much clearer than plastic film, develops quickly
· Thermoscanner: new models detect even the slightest temperature differences on the skin
· Inclinometer: wireless models can more easily measure range of motion
· Posture analyzers: better software can give more accurate readings of posture asymmetry
· Balance and gait analysis software: detailed assessments can clearly demonstrate abnormalities
· Foot scans: used in orthotics, based on thermography, or pressure, to properly analyze weight-bearing
· Computerized algometer: digitally determines pressure sensitivities anywhere on the body
· Functional capacity equipment: tests strength and endurance of target isolated muscle groups
· sEMG: this scanner can measure paraspinal muscle activity, but still has some reliability issues
Do most DCs have all of these tools? Do most DCs even need them? Yes, there are other ways to diagnose patients and demonstrate progress than with machinery. However, the purpose of this article is to show how technology can be an additional step in this process. While all of these steps can be performed without using these technologies, these tools lack the subjectivity that we have. Objectivity translates to better accountability. This leads to better third-party reimbursement in addition to better quality treatment for our patients.
For years, we have used paper surveys and questionnaires, many of which are still reliable. These require the doctor or staff to grade and calculate scores based on the outcome and methodology of the assessment tools. Technology can aid in this instance as well; digital outcome assessments and SOAP notes can be used to quickly calculate the scoring and even comparatively analyze the outcome to prior scores. You can very easily print these reports to show the patient or include them in your digital documentation.
Practice management software can allow you to better manage day-to-day operations within your clinic. These programs include chiropractic billing, electronic health records, appointment scheduling, insurance and client lists, and other everyday necessities and allow you to keep all of this information organized and accessible.
By using technology, you can quickly and more accurately come up with the correct diagnosis, prove that your treatment plan is on course, modify care if necessary, and demonstrate progress. Technological data is an additional source of documentation. These tools are not meant to replace your skill, but act as a confirmation that the patient is progressing and that the correct treatment is being administered. These tools will improve your quality of care and increase your potential for reimbursement. Technology serves as hard evidence for Medicare audits, insurers, and your own benefit.
These digital devices and chiropractic software can be beneficial for your patients. For example, a patient may live with a condition every day. The treatment process may be slow and he or she may not feel that any improvement has been made. Many factors, including pain and the natural passing of time, can cloud the memory. Technology can demonstrate quantitatively how they felt prior to treatment and where they are now. While he or she may not feel much progress, visual results can show a great deal of progress. Naturally, a patient will be more focused on pain. The patient may feel that pain has only improved by 25 percent even though his or her range of motion has improved by 75 percent. Technology can give an objective analysis of progress.
On the other hand, a patient may say that his or her pain has improved by 90 percent. They may want to halt treatment sooner than planned. In actuality, only 25 percent of his or her function has improved. Technological representations can show that care must be continued.
Ultimately, we need a qualitative method to measure and gauge our success. All of these tools can help do that for us and therefore enhance our credibility. These tools can help you create reliable outcomes for a treatment plan. Clinical tools are becoming standard for decision-making, compliance, and quality of care. They can help patients quickly return to a functioning level, all with great precision and without the unnecessary work which often befalls gut-instinct guesses. The only gut instinct you must serve is that of the patient— so arm yourself with the proper tools to get the job done.