This is in reference to Melissa Heyboer’s article, “The $44,000 question,” which appeared in Issue 13, 2010. The following are Alex Niswander’s responses in their entirety.

Question 1: How will this affect the chiropractic office? i.e., do you think this program is beneficial

A: After we put aside the pipe dream of being handed a check for $44,000 the impact of global (or at least national Electronic Health Records) will be tremendously positive. The core benefit is speed of accessing patient charts. Currently with a paper model it could take months to get a full patient chart from past offices and there is no way to know what is missing from their history. The program is beneficial because it brings to light the issue that record keeping in general has been sub-standard a long time - consider almost all other industries have been electronic for years. Overall healthcare technology has advanced light years and many doctors are still writing patient charts with pen and paper. 

Another thing to consider with general impact is that if your practice finds it difficult or impossibly to afford a software for EMR, it may be time to evaluate your entire practice's ability to succeed.

Question 2: What do chiropractor’s need to take advantage of this incentive? How much will it cost, as far as time and money, to implement?

A: My greatest point on this one is that if someone is only looking for EMR to aquire the incentive, they should save their time and money and stay with paper notes. There is more to this than just buying a software and receiving a large check. There is software, hardware, office changes, design changes, implementation, learning curve, frustration and time, time time. If a doctor is doing this to become more efficient and have better documentation, then this will be highly successful. If they are doing this to cash in on a reimbursement, it is a very painful process and honestly is probably not worth the effort this will take.

They need to:
1. Implement a software that is willing to become certified.
2. Review & meet guidelines for meeting the 'meaningful use' process. I would encourage them to look to their state association for how to do this for office procedure changes needed (similar to Hipaa 10 years ago- some changes may be needed). If their state association shy's away from this responsibility, they need to push them to step up and become the expert on this.
3. Ensure they meet some sort of medicare amounts in order to qualify. Recently someone said to me: "My medicare volume is not enough and I wish they could use my insurance volume for this