Going “Paperless” or “Fully Automated Paperless”?

by Claude Cote


There is no doubt that one of the most popular trends in chiropractic is going paperless.  Software companies have never been so active at programming all kinds of paperless office systems.  Most chiropractic offices are already using computers for front desk tasks such as billing, appointments, etc. For most chiropractors, going paperless is the elimination of the health record paper file or travel-card.  The chiropractor would use a keyboard instead of a pen to take notes.  This is all nice, but not that big of an improvement for the overall practice.  Although doctors will not have to search for a lost file, the benefits are very limited and the productivity and efficiency will remain basically the same.  Fortunately for the chiropractic profession, the growing trend of going paperless has made Health IT companies surpass themselves with automated systems that, 10 years ago, none would have thought possible.  The key word in these systems is “Automation.”  Going paperless is great, but going fully automated paperless is impressive.  Lets say you are in a situation where your CA is wanting to go on vacation next week because of a family emergency.   You want to do everything you can for them and let them off, but you are expecting 250 patients next week.  Then you start to think, “I can’t do everything by myself.”
Instead, what if your answer to your CA would be:  “No problem, take next week, and then take an extra week to take care of your family.”  Believe it or not, a new fully automated system will let you do this very easily, and with no stress at all.  Many doctors that I know are handling these kinds of situations regularly.  

The concept, a very logic one:
This fully automated concept was invented in 2001, and was available for all chiropractors in March 2003.  Basically, you need three computers in your office.  One installed for patients to signin electronically.  This Sign-in computer will be installed near the entrance door or near the waiting room area.  The patients sign in by themselves and then sit in the waiting area.  This eliminates the need for the patient to go and see the busy CA to tell her “I am here….” By signing in, the entire system is aware that the patient is in and is presently sitting in the waiting area.  Another computer is in the treatment room for the doctor.  At a glance, the doctor sees who is in already and who will come during the day.  When the doctor is ready, he presses one key to release the room for the  patient to come in.  This single key press will activate a calling system where speakers in the waiting area will call the next patient and invite them into the room number one,  as an example.  You could have two or multiple rooms with a computer in each and just do the same thing.  What is really impressive is that the system will use the CA’s (or doctor’s) voice to call the patient.  At the first visit, the CA will record the patient’s name and everything is done for all subsequent visits.  Having been witness to thousands of patients being called this way, I can tell you they are very impressed and excited.  Then, the patient shows up in the treatment room.  The Health Record file comes up on the screen instantly, including X-Rays, posture images, and everything the doctor needs to know about the patient.  You may also want the patients to answer a few questions on the Touch Screen to build the subjective note themselves before the treatment.  As the normal routine goes, the doctor will build the SOAP note on a Touch Screen or electronic Touch Pad (no keyboard needed) and the system will automatically generate all the billing required for this patient.  When the treatment is finished and the patient leaves the room, the doctor will close the Electronic Health Record by pressing one key again. This final action will close the file and, believe it or not, the system will call the next patient in line and direct him to this new available room without any human action needed.  In fact, if the patients have prepaid for a few treatments and have a few appointments already scheduled, they can leave the clinic without stopping at the front desk at all—unless they want to ask your CA how her last vacation was?  
The reactions of patients using these automated processes are incredible. You need to go and visit an automated clinic for yourself to realize how impressed the patients are. Also these systems give your CA a lot of free time so, instead of managing an arrival sheet and entering data for billing, they can walk around educating your patients, reminding people about marketing promotions or can actually be a Chiropractic Assistant instead of a Chiropractic Administrator.  
So, if your CA needs a week or two of vacation, tell her to “Have fun….”


M. Claude Cote  is an expert in EHR systems, insurance billing and chiropractic clinic management for 22 years.  He has installed EHR system in 17 countries over 5 continents and nationwide in USA.  He is the President and Founder of Platinum System C.R. Corp (www.platinumsystem.com).  For comments or questions please email to [email protected].

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