THE POWER OF TECHNOLOGY
How technology helps boost office productivity
By John V. Wood

Chiropractic, much like any other business, feels the day-to-day strain of appointment setting, billing, patient records, visit tracking, and many other forms of organizational bookkeeping.

In the age of computers, some offices are turning to technology to help overcome their recordkeeping workload. Some clinics have found success with software; some have not.

Chiropractic Economics talked with 10 chiropractors around the globe and asked them about their individual situations, and to which technological solutions they turned. We also asked if the solutions were successful, or if they failed to improve their current situation. Here’s what they had to say.

TRACKING PATIENT VISITS

Practice: Union Square Chiropractic (www.UnionSquareChiro.com), owned by Jacalyn Buettner, DC, is a solo practice in San Francisco that sees about 130 patients a week. It provides chiropractic adjustment and therapeutic massage services.

Problem: Timely scheduling of patients during restricted time periods. For example: Some insurance plans allow a specific number of visits within a particular time period, such as four visits between June 1 and June 30.

If the fourth visit were booked and billed on July 1, the practice would not get paid for that date of service.

Solution: Buettner found a computer software package that tracks patient visits by date range, total patient visits within certain time frames, and new conditions. It also stops claim forms from being printed if pre-authorization is required.

Payoff: According to Buettner, the solution she chose is definitely worth its weight in gold.

“It not only saved us lost money from services billed outside of date ranges, but it streamlined our system so we knew how many visits patients had used. I have an extremely large insurance practice, and patients want to use their insurance,” Buettner says.

“They do their best to stay within the parameters of what their insurance plans afford them, be it 20-30 visits or $1,000 max. We now can easily tell patients where they are and they feel we are taking even better care of them.”

LEGIBLE SOAP NOTES

Practice: John H. Riggs III, DC, Alternative Chiropractic Solutions, Midland, Texas, (432-570-8792), runs a multi-doctor practice that sees about 115 patients a week. It provides low-force chiropractic adjustment, soft tissue treatment, nutritional guidance, exercise/rehabilitation therapy, and other wellness services.

Problem: Providing legible and comprehensive SOAP notes for insurance, workers compensation, and personal-injury (PI) cases.

Solution: Riggs found an inexpensive SOAP program that was customizable, had the ability to use templates, and had expandable text.

Payoff: Riggs feels his solution was an “absolute” success. “We purchased the system and hardware for around $2,000 less than most electronic medical record programs. It made charting a lot easier and also provided me with past medical history information on the left side of the page which was always available at each visit,” Riggs says.

“It is easy to update and flexible, allowing me to customize the system to meet my practice needs. It is also fast. I can set up standard protocols for certain conditions and then set up a short keyword such as ‘protocts’ for ‘protocol carpal tunnel syndrome.’ All I have to do is type in the keyword, and my protocol is on the screen. It also serves as a trigger when busy so you don’t forget to do important items.”

TRACKING PATIENT RECORDS

Practice: Estadt Chiropractic Center, Mentor, Ohio, (http://aikidocriggs.chiroweb.com) is a solo practice that treats about 225 patients a week. Owner Gary Estadt, DC, provides chiropractic adjustment, massage therapy, electric stim, nutritional consultation, rehabilitation, and orthodic services.

Problem: Could not find an effective program for keeping track of patient records.

Solution: Found a way to integrate dictation and transcription with a pocket PC handheld device, which created a paperless network.

Payoff: Estadt has three office computers tied directly to a server. From that dedicated server, all of his patients’ medical files, x-rays, and other forms are then transferred onto his pocket PC.

From his handheld or wireless laptop, he can access all files electronically — thus making his office virtually paperless.

“The cost was $299 for a pocket PC, and I am using my existing office computers for record storage. My only real consistent cost is for transcription, and I outsource it (just like the hospitals in my area),” Estadt says.

“While it can be more expensive, there are many other cost savings. I don’t pay for support. My records are more professional. I’m getting more referrals from MDs and attorneys. I’m not having problems with insurers or workers compensation paying my bills. My care gets approved, and I can make sure that my dictation covers the services that I’m billing.”

UNTIMELY REFERRAL REPORTS

Practice: Lake Norman Health and Wellness, Cornelius, N.C., (www.lakenormanspine.com), is a solo practice. Owner Akiba Green, DC, treats about 140 patients a week. He provides chiropractic adjustment, exercise treatment, nutrition, physical therapy, and orthotic services.

Problem: The clinic was having trouble providing local physicians with timely and adequate initial, interim, and final reports for their patient referrals. This was sabotaging future referrals.

Solution: The clinic began utilizing a computer documentation system that eliminated the need for paper records and provided an extremely time-efficient recordkeeping solution.

Payoff: The cost for full integration included the documentation system, the hardware, and a compatible practice-management system. Green says, “In the long run, we are able to provide reports to referring physicians the same or next day after seeing the patient, with less than five minutes of time spent generating the reports.

“The cost of the technology and time involved was absolutely worth it as increased referrals have already been shown effective as a direct result of the reports I’m able to provide.”

TEDIOUS PAPER FILES

Practice: Global Wellness Centres is a high-volume practice located in Portugal. Andrew P. Hatch, DC, is the owner.

Problem: Staff was spending too much time pulling files, then refiling. Patient scheduling and punctuality were problems as well.

Solution: Hatch discovered a computerized office-management product that issues each patient a card. Patients swipe their cards on a scanner, and the program calls them in order of their arrival, taking into consideration if they are late, punctual, or early.

Payoff: Hatch’s new system also provides statistics for missed appointments, doctors’ performance, financial management, etc.

“All patient x-rays, exams, posture photos, EMGs, thermal scans, history, and SOAP notes are on one easy-to-use screen. All SOAP note data is entered with a simple and fast touch pad. It’s an amazing boost to the image of the practice,” says Hatch.

“There are not enough words to express how this product has revolutionized my practice. It truly brings chiropractic to a higher level of professionalism. I am opening a satellite clinic this month and am having this software package installed ASAP. I would never consider returning to the old-fashioned way of practicing. My practice has become streamlined, efficient, and virtually paper-free. I tell every DC I know about this product.”

OVERWHELMING TRAVEL CARDS

Practice: Hands On Health Chiropractic in Colleyville, Ala., is a multi-doctor practice that treats between 175 and 200 patients a week. Owner Meredith Van Horn, DC, provides chiropractic adjustment, spinal decompression, and kinesio-taping services.

Problem: The clinic was using old-style travel cards and filing systems. With one staff member doing all of the clerical work, the clinic was overwhelmed.

Solution: Van Horn converted all files to electronic files, implemented a swipe card check-in system, and placed flat-panel monitors at the adjusting stations on which patient x-rays can be pulled up when their card is swiped.

Payoff: Van Horn feels her solution was “definitely worth it.”

“The computer systems have saved me the cost of one staff member, and the other additions have stimulated enough referrals to pay for itself!” says Van Horn.

“Converting files over in the beginning was very time-consuming, but luckily you only have to do that once! Creating change in a practice seems scary and most people avoid change, but I am definitely excited about the momentum in my office.”

POOR COLLECTIONS

Practice: Robert Whetstone, DC, is the proprietor of Wellness One of Auburn, Inc., in Auburn, Ind., (440-263-3915), a multi-doctor practice that treats about 160 patients a week. The practice offers chiropractic adjustment, massage therapy, decompression, orthotics, and cervical traction, as well as nutritional therapy.

Problem: Deplorable patient visit to collection ratio. Clinic collected, on average, about $15 per patient visit.

Solution: Implemented an actual accounts receivable program that shows after-insurance write-downs. This showed the clinic exactly what to garnish for each visit.

Payoff: Whetstone has definitely seen an improvement in his practice since the upgrade. “Upon imple-menting the technology, we have seen a dramatic change. We have increased our average visit income five-fold!

“The new software package also allows us to know exactly what to expect for each patient visit for all of our carriers. It also creates amazing reports that are easy to understand such as charge and collection summaries and statistics, practice projection analysis, visit summary form claims and schedules, and also monitors how each doctor is performing,” says Whetstone.

“This leading technology allows me to manage my offices from the comforts of my home, while I’m away at roundtables, or just on vacation. Although I’m not physically in the office, I am able to watch real time performance! That is priceless.”

NO EASY ACCESS TO RECORDS

Practice: Family and Specialty Medical Center, P.C. (www.familymedcenter.com) is a multi-doctor practice that sees about 225 patients a week. According to owner Steven J. Kraus, DC, CCSP, CCRD, FASA, the Carroll, Iowa, clinic provides chiropractic adjustment, rehabilitation, physical therapy, massage therapy, acupuncture, athletic training, and other general services.

Problem: No connection between electronic records and billing, nor was there a connection to access x-rays, laboratory results, and patient records immediately when they arrived in the office.

The staff had to re-enter data several times, and doctors had to repeat the same instructions over and again to patients.

Solution: Implemented software that allows electronic health records, documentation, patient education, data storage, and billing systems to communicate. The solution also required new video monitors and computer work stations.

Payoff: Kraus says, “I have saved hundreds of hours of my time and my staff’s time, as a result of the efficiencies created from the system. It also created another reason for my patients to refer others to our clinic because of the high-tech nature of our practice. We estimate the system has saved or earned us an additional $60,000 in the last year.”

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John V. Wood is a freelance writer from Willow Spring, N.C. He can be contacted through his Web site (www.johnvwood.com) or by email at john@johnvwood.com.