Software / Hardware

The Hottest (And Most Useful) Technology for Your Practice

Mark Sanna, DC, ACRB Level II, FICC

Lately, while much attention has been focused on electronic health records (EHRs) and other software solutions, technology innovators have continued to develop new tools and equipment to improve the cost and efficiency of delivering care in your practice. In this tech guide for your practice, I'll profile several new tools available for the chiropractic practice. Unlike EHRs, most of these devices could start paying for themselves right way – without having to wait for a government incentive check and without disruption to the operation of your practice.

Reception Area Patient Tablet Computers

The enormous popularity of the iPad has transformed the use of tablets in all areas of our digital lives, including the chiropractic practice. Reception room touch-screen tablet computers can be used to speed up the check-in process and create a better overall patient experience. Patients can pick up the tablet when they check-in at the front desk and can fill out forms electronically, view educational videos, as well as the internal marketing messages of your choice. Tablets help eliminate data entry errors and improve the efficiency of patient data input. Patients appreciate the idea of making the time they spent waiting more productive and any wait time seems to go by faster. A word of warning: portable devices can go missing if unsupervised. You can load the devices with a "LoJack" theft deterrent system that tracks the device if it is stolen. Another decision you'll need to make is whether you want a tablet that's 3/4G capable or a Wi-Fi only model. The iPad comes in both iterations, and so do many of its competitors. The Wi-Fi only models cost less, but of course the 3/4G models (which can also use Wi-Fi) offer more flexibility. Remember, though, that 3/4G service plan adds to the cost on a monthly basis.

Electronic Signature Pads

You can do away with paper sign-in sheets with an electronic signature pad. Patients sign the electronic pad, which is connected to your computer's USB port, to sign in for their appointment and to sign forms. As the stylus moves when the patient writes, all of the data associated with the signature is captured. Data, such as how fast and in what direction the pen is moving, is captured by the pad. This produces much more than a snap shot of the signature. Security software also compares signatures to prove authenticity. Having a digital signature on file facilitates the third party reimbursement process and reduces claims errors. Signature pads can also serve as a communication tool, connecting the various departments of your clinic. The digitally captured signatures are time and date stamped and can be used to monitor patient flow and wait time. This ensures that patients are cared for in the correct order and that patients waiting to be seen are not overlooked. For paperless practices, digital signatures are more convenient than scanning forms and most EHRs can integrate your practice management system with a signature pad.

Digital Dictation Microphones and Software

In the last several years, the accuracy of voice recognition software has improved by leaps and bounds. Digitally inclined chiropractors who want to dictate their notes but avoid transcription fees can use updated versions of the Dictaphone. Powerful noise-cancelling microphones are available that eliminate background noise for greater accuracy and cleaner transcription. Software applications such as Dragon can integrate with your EHR system and be used to navigate between fields and control the application. Spoken notes are automatically transcribed to the corresponding fields in the EHR. If you do not dictate your notes, you may find that digital dictation requires some alteration in your workflow in order to avoid awkward interruptions during patient encounters.

[pb]Expanded Use of EHR

While many chiropractors have adopted an EHR system for their practice, most are not making use of their systems in a comprehensive way. Digitally savvy chiropractors are expanding use of their EHR systems to access patient charts remotely and also to use functions that make their practice more efficient. If, like most practitioners, you find the most useful parts of your EHR to be the low-tech functions like creating legible notes, you have a way to go. That's not to say that the more basic tasks aren't important. It's that they're not helpful enough to label the technology exceptional. Many practices are successfully moving beyond the basics. Newer EHR features include online scheduling, instant messaging between team members and electronic encounter forms that can generate a searchable summary page for each patient after their visit.

Computed Radiography Systems

Computed radiography (CR) systems replace traditional film cassettes with digital cassettes. Once an image is taken, a cassette is inserted into the CR system to transfer the image to a computer monitor for archiving. Digital images can be imported into your EHR and shared via the Internet with a radiologist or other co-managing physician for consultation. Conversion to a CR system eliminates the need for film, a developer and chemicals. It also frees up valuable space by doing away with the space requirements necessary to store films in your practice. You must already have radiology equipment to convert to CR. However, there are no construction costs associated with converting your existing radiology room to CR, because the systems were designed to work with pre-existing equipment. Practices that take ten or more x-rays a day could find that they will come out ahead by converting to CR.

Smartphones and Personal Digital Assistants (PDAs)

As fully "wired" chiropractors have discovered, there is an "app" (software solution) for practically everything — such as providing fingertip access to a patient's health care information, radiologic imaging studies, and laboratory test results. A smartphone can be used to look up drug interaction and side effects information, to review research references and to e-mail colleagues. Some EHR systems allow remote access to practice management tools, patient lists and other information through encrypted portals. With a smartphone, you can view a summary sheet of the past day's activities on your phone and preview the patient schedule for the upcoming day. Voice-activated dictation features can be used to make a chart entry if a patient calls to consult you after hours and you want to document a note of the encounter in your EHR. When you return to your practice the following day and boot up your computer, the event will appear as a chart entry. As a crucial preventative measure in light of HITECH HIPAA protocols, you may want to limit smartphone use to read-only access to patient information while prohibiting the storage of this information.

Some Older Technologies Are Still Viable

Exceptional practices are also figuring out ways to use older technology, such as the telephone, in fresh ways. One strategy is to use an automated telephone calling system to reach out to patients and remind them of their previously scheduled visits, recall them after missed visits, or to make them aware of special practice events. IT experts agree that technology is never the entire answer. Results depend on how it is used, and there are always limits. While an automated phone system can lighten the outgoing workload of your practice personnel, patients appreciate talking to a person when it comes to their health care. Top practices use technology wisely and foster the personal touch and deliver an exceptional patient experience by having a human being answer all in-coming phone lines.

Surprise and Delight Patients with Technology

The term "technology" can trigger enthusiasm, anxiety or skepticism — possibly all three. Don't let the unknown stop you from taking advantage of the benefits your practice can reap. The practice building lesson here is that you can use technology to deliver a positive patient experience by unexpectedly exceeding expectations. "Business as usual" is unremarkable and nobody thinks twice about the "ordinary." When properly deployed, you can use technology to help create a truly memorable experience for your patients. What are you waiting for? The hottest technology beckons!

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