A new data acquisition system developed primarily for chiropractors allows the individual physician to compare and assess his treatment within a dynamic outcome assessment database based on return to function, patient satisfaction and cost containment.
The practice of chiropractic, already faced with reimbursement challenges, is increasingly pressured to provide justification of therapy to payors. Irrespective of millions of satisfied patients, the chiropractic physician must now prove to these reimbursement sources that chiropractic therapy works. Results that seem so obvious to the treating professional are being challenged, and in many cases, reimbursement denied. The chiropractic physician, and the profession as a whole, will soon be required to develop biostatistically valid models of therapeutic outcome.
Outcome-directed models are currently being developed to predict patient treatment success. Promoted by managed care, large databases incorporate patient demographics, cost of treatment, and individual physician treatment profiles throughout the country. The failure of health care reform in the early 90’s established an opportunity for managed care and other payors to define payment and accessibility to certain physicians. Relying on these large databases, payors will develop their own healthcare reform within the next few years. Chiropractic physicians should consider this as an opportunity to help develop biostatistically valid treatment plans and be included in payor-preferred models. Based on return to function, patient satisfaction, and cost containment, the physician who incorporates outcome analysis into their practice will likely command a large share of the marketplace.
Multi-level Data Acquisition Systems
A multi-level data acquisition system is now available and has been designed primarily for chiropractic physicians. The system is designed to easily integrate a large amount of statistically valid information into a common database ultimately to be exported to medical university-based biostatisticians. The data is carefully analyzed, and as the database grows, specific outcome projections will be generated. The individual physician retains control over his own data and has a unique opportunity to compare and assess his treatment within a dynamic outcome assessment database.
Emulating the model of insurance companies and other large data collection centers, it was determined that acquisition of data required an inexpensive, user friendly system requiring little maintenance and distraction from the physician’s daily practice. Research also determined that a data acquisition system required a central data collection point. Three systems were designed to obtain this data, and have been thoroughly tested at multiple centers throughout the United States. The content is easily adaptable to any user requirement. Standard validated pain and function assessment tools are used to aid in interdisciplinary objective pain assessment. Data is regularly analyzed and returned to the central service center.
Issues of support, intrastructure obsolescence, and technical training were considered as hindering cross-sectional national data acquisition. Each system is designed to have minimal impact upon the physician and office personnel. To this end, the data acquisition system is primarily patient-driven. A report of patient responses is ready when the physician walks in the room. In fact, productivity items are being added regularly to the initial system. These include a medical record card that links the physician to the patient worldwide.
The data acquisition system was designed in conjunction with some of the most influential medical and technology companies in the world, ensuring this will be the primary outcome assessment tool for practitioners in the country.
Three Systems of Data-Tracking
PC or Laptop Computer
This data acquisition system utilizes patient-generated data that is actively transferred to a central network and exported to medical university-based biostatisticians for ongoing data analysis. For under $500 the chiropractic physician connects his existing PC or laptop to the central database. Regular communication with the service center automatically retrieves practice data. Touch screen technology allows your patient to quickly enter information into a laptop or PC using biostatistically valid content assessment tools. More than 2,500 patients have used this assessment system to date. As a result, the data acquisition system was recently acknowledged by one of the country’s largest medical organizations and results will be presented at their national meeting. Publication will follow in an internationally distributed journal.
A second system for data acquisition requires only the presence of a fax machine in the office. Data is scanned into the central computer automatically and again, exported for data analysis. Anywhere in the world, a patient can fill out the data collection forms and enter data into the central database using a common fax machine. The cost of this system is either transactionally based, or by monthly charge, and the outcome assessment will be faxed to the physician upon request.
Internet World Wide Web
The third and most sophisticated system available to the data tracking system is technology that utilizes the Internet World Wide Web to input, transfer, and retrieve medical records in a highly secured and proprietary environment. The physician retains complete and confidential control of his data and biostatistical analysis is ongoing. This system is inexpensive and easy to use. The “”Intranet”” application allows for online training and testing as well. The intent is to bring online learning and processing to the marketplace.
The power of this technology should not be understated. The reimbursement community, attorneys, and professional colleagues will respect any physician who has a clear understanding of his patients within the context of an expected outcome and cost. Direct transfer of records immediately verifies your involvement with the patient. This high level of sophistication lends instant credibility to the chiropractic physician’s practice.
Outcome-Based Treatment Referrals Future Requirement for Gatekeepers
To remain viable in the marketplace, the chiropractic physician must understand that gatekeepers will be mandated to follow specific outcome-based treatment referrals. It is clear that the chiropractic physician will need an outcome-based practice profile to obtain these referrals. The practitioner will continue to receive the highest level of technology to enhance practice development. The interdisciplinary care team will migrate toward the physician who understands patient management within this cost-conscious environment of managed care and shrinking health care dollar. The attorney who refers a patient for chiropractic therapy is naturally drawn to this high level of sophistication.
Consider the utility of a system that can assess if a patient will have a protracted course or rapid return to function. Integration of the chiropractor to the medical hospital environment is defensible within the context of outcome-based practice data. Hospitals and referral sources will understand the cost-effectiveness and utility of chiropractic therapy, and increased patient visits reflect an enhanced level of respect and credibility. Researchers will have a large data pool from which to develop studies and publish in the literature. The possibilities are endless and await chiropractic practitioners to explore. Don’t allow managed care to determine the course of your practice. A proactive protective approach to your practice will benefit you and your patient.
Hansen Medical Systems designed the HippocratesTM data acquisition system, which was researched and designed primarily for chiropractors as an outcome database for chiropractic therapy. HMS is a strategic partner with Smart Communications, Inc.TM in efforts for HMS to be the primary outcome assessment tool for health care practitioners. For more information on the multi-level Hippocrates data acquisition systems, please call 704-871-0620. Hans C. Hansen, M.D.
Cathleen C. Curry, BA, RN” “Hans C. Hansen, MD, received his Doctorate in Medicine in 1986 from the University of Colorado Health Sciences Center in Denver. Dr. Hansen’s post graduate training includes his residency in anesthesiology and chronic pain management at Yale University School of Medicine, and principles of manual medicine and manipulation therapy from Michigan State’s Department of Osteopathy.
Dr. Hansen is co-founder and director of the Medical Chiropractic MUA Centers of the Carolinas and Director of the Center for Chronic and Cancer Pain Management at Columbia Davis Medical Center in Statesville, North Carolina. Dr. Hansen is Founder and Medical Director of The Open Door Clinic, a free medical clinic for the homeless and working poor in Iredell County, North Carolina, and has received numerous awards for his volunteer work, including the Governor’s Award for Outstanding Volunteer Service, Salvation Army Volunteer award, J. C. Penney’s Golden Rule Award and the AMA’s Three Year Physician’s Recognition Award.