Impacting Chiropractic's Future With Technology

When it comes to electronic health records (EHR), Robert Moberg and Dr. Steven Kraus are two of the leading industry experts on the topic. They recently announced the merger of their respective companies, ChiroTouch and Future Health, a move designed to "continue the drive toward more significant recognition for the chiropractic profession within the health care industry. This recognition will be based on the growing volume of data showing the efficacy of chiropractic care from unified platforms, as well as the cost-savings that are best delivered by chiropractic."

In an exclusive interview with DC, the two industry leaders talk about why this data-driven recognition is so important to the future of the chiropractic profession and the ability of individual DCs to see greater utilization, improved reimbursement and better serve their patients.

Robert Moberg (RM): It's becoming apparent in all of the EHR space that data is going to drive decision-makers, data is going to drive policy; data is going to ultimately drive how care is going to be delivered inside the medical and health care professions. We can get at the data and we can begin to get that information back to the profession.

There are two places where we really need to get the information. One is to the doctors, so they understand what they are delivering in the privacy of their practices; and the other is to administration and policy-makers, so we can begin to demonstrate the value of chiropractic care at a (comparatively) lower cost, and how that can begin to change regulations and policy.

Steven Kraus (SK): It's going to impact three areas. It's going to impact consumer choices. That data is going to impact their decision on the provider they choose and the kind of care they choose, because the outcomes data is going to help steer them to successful types of care and successful practitioners for those kinds of conditions.

Secondly, data is going to drive policy-makers, specifically reimbursement models, so third-party payers are going to now design the case management coverage, as well as the services provided based on that data and the types of providers. Eventually, in the next decade, you will see a drill-down to the specific provider themselves, not just a class of providers.

Thirdly, for doctors of chiropractic [and] the protocols they choose to use in delivering their care, that data is going to change their protocols; it's going to change their decision-making at the point of care because data is now going to impact the kinds of services they employ.

I believe data is not only going to elevate the chiropractic profession in [terms of] their relationship with the public, but also greater recommendations from the other health care communities such as medical doctors referring more people to chiropractors, because the data is going to demonstrate the effectiveness of the majority of what we do.

RM: Bringing our two platforms together gives us a very consistent way of capturing the data, of delivering the data, and a consistent way of reporting on the data. This is going to be critical. That integration is really the first step of our ability to bring a stronger concentration of information and make it available to the profession and key decision-makers as to how they'll allocate health care dollars.

SK: Our combined technologies over the next year are going to give the doctor of chiropractic more functional capabilities to engage with patients, to make better clinical decisions, and to also allow their de-identified data to be aggregated so we can then provide researchers, colleges, and ultimately decision-makers and policy-makers the results of these outcomes that reflect the effectiveness of the care. We see ourselves in a role to really help the profession tell its story not only to the public, but also to the decision-makers. Our aligned vision is really to help the doctor of chiropractic and ultimately the profession.

RM: It's clear that this profession stands for a word that also stands for what our companies are doing, and that word is alignment. When we begin to align ourselves toward the future and toward the real issues that are plaguing chiropractic, it's amazing what we are going to be able to accomplish.

Pooling data and putting it together for the marketplace is not for the faint of heart. We've been at it for about two years and we now have the tooling in place to get that done. We expect to see things flowing out in the next six months. The current administration is moving away from paying for treatments to paying for outcomes. President Obama came out on [Feb. 2, 2015] and indicated there will be legislation put in place before his term is over [that suggests] they will no longer pay for treatment, but instead will be looking for outcomes.

Furthermore, patients are demanding to be involved in their health care. They are demanding to have access to their information. The mobilization of health care information is absolutely underway and it's moving very rapidly into that environment. The reality is that data is becoming more mobilized and EHR systems are going to have to begin to function in an interoperable way with smart devices patients are holding in their hands and with the other systems doctors are functioning in.

There is a very strong mandate for 2017, 2020 and 2024 that says we will begin to move to a place where systems in the medical, dental, chiropractic and osteopathic professions are all going to have to be able to work together with the critical data that outlines the patient's care packages and treatments.

SK: Over the last 10 years, you've seen patient engagement with such tools as patient portals with a rise from 6 percent adoption rate to almost 90 percent in 2014. Consumerism is certainly driving the digital engagement with their health care provider. That is going to involve patient monitoring of certain vital statistics and other health statistics that will feed into those portals so the doctor can look at the data.

We're finally going to see patients have more responsibility for their health care because technology is giving them the tools and making it easier to engage. The EHR is going to be the hub of that ecosystem.

Doctors of chiropractic need to be prepared to embrace the technology adoption so they can be a coach or active leader in their patients' overall health care. As wellness providers, we're going to be engaged in weight loss, smoking cessation and general well-being in addition to the spinal care we deliver. We've got to be looking at this data and using it in our clinical decision-making. If [we] don't have tools to analyze this data quickly in a meaningful manner, doctors of chiropractic are going to be left out, considered un-modern and not an active participant in their local health care community.

RM: The most important thing for us to recognize is that as a company that is beginning to be pretty significantly established in the chiropractic community, we have to take on that responsibility. We see new regulations, we see HIPAA, we see meaningful use, we see ICD-10 and eventually ICD-11. We see the coming mandate for interoperability between all of the EHR systems. This is not going to be easy. We've brought ourselves together to create a more significant company that has the strength to represent the profession.

SK: We've always dreamed of having chiropractors be successful, and we're going to help them achieve that because we're going to enhance patient engagement and "big data" is going to drive more patients to the doors of doctors of chiropractic – because the data doesn't lie. We're going to help the profession get better utilization for chiropractic services, and I truly believe that the quote of Thomas Edison is going to come true. It's going to be technology that delivers on that promise.