Published: 2009-12-01 16:38:29
Author: Steven Kraus | Dynamic Chiropractic | December 2, 2009
What was controversial four years ago, but not anymore? How about the following three statements: (1) More chiropractors will adopt electronic documentation in the near future. (2) Medicare will increase audits of chiropractors. (3) Electronic health records (EHR) will be mandated. These are predictions made by me and several others in the profession dating as far back as 2005. To some degree, all three have come true. On the eve of a health care overhaul, there is no better time to look back, see how we got here and realize that the times really are changing.
I believe it's up to us to decide whether we change with the times or face the possibility of being left behind. Let's go through each of the above-mentioned formerly controversial statements one at time, and see how they've come true. To set the scene, I want to start in a place that seems as far away from your practice as you can get: the criminal forensics lab.
Crime Scene Investigation and the Chiropractic Practice
Ever watch the TV show "CSI" and get caught up in the story by the production alone? The gadgets, the science and the music can mesmerize us and hold our attention. Now imagine the show, but not with million-dollar labs and walls of computers, but with walls of filing cabinets. Not very exciting, is it? Somehow, it just isn't the same.
Today, it's hard to imagine a forensics lab without any high-tech wizardry; the thought of doing science without a computer seems impossible. But if "CSI" had been on 20 years ago, you would have seen filing cabinets, fingerprint dust, and the occasional microscope - much more reminiscent of a show like "Diagnosis Murder" or even "Quincy, M.E." (remember them?). What has made the "CSI" franchise so successful is the way they take the classic "who-dunnit" mystery and anchor it to technology that pushes the limits of science.
Now imagine a scene from a show about your practice. Is the background more suitable for the "CSI" detectives or the county coroner on "Quincy, M.E.," a show that went off the air in 1983? If you look around and you see more filing cabinets than anything else, then it's only a matter of time before you lose prime-time position - in chiropractic specifically and in health care in general. Let's see why.
Prediction #1: More DCs Will Adopt Electronic Documentation
I started this column in the spring of 2006 when the dust over the 2005 Office of the Inspector General (OIG) report was starting to settle. I am active in both my state association and the ACA; I also happen to be the president of a company that has developed chiropractic management software. I say that in order to say this: I am acutely aware of the pulse of chiropractors' opinions when it comes to electronic health records because it's my job and because my service in our state and national associations means I get to talk to a lot of our colleagues.
I don't have peer-reviewed research that covers chiropractic opinion on EHRs, but I have seen surveys, as well as my own first-hand observation indicating a growing openness to adopting electronic documentation. First, there's the evidence of our chiropractic colleges; many of them have already switched to digital clinic management or have started the process. Second, there's our company research. We have internal data showing that back in 2005, less than half of the profession we surveyed believed that adoption of EHRs was going to be necessary in the next five years. Today, about 80 percent believe adoption will be mandatory within three years. That's quite a leap.