Southern California Solo Practitioner Finds RAPID EMR

Dr. Michelle Zarzana came to chiropractic later in life than many of her peers, having previously established herself as a marine biologist and researcher and as a teacher. An injury had placed her in extended chiropractic treatment and it was so effective that she enrolled in the Southern California University of Health Sciences, finishing the five-year program in three and one-half years and earning her D.C. degree in 2002.

Dr. Zarzana regards herself as a “progressive” chiropractor, with a mission of getting patients well and maintaining that wellness with a regimen of limited visits for check-ups and reinforcement of her recommended exercise programs.

“Patients get better faster and stay better,” she says. “Once they are released from treatment, I like to see them about once a month for as long as necessary, but not longer.”

In her Long Beach, California practice, Dr. Zarzana normally sees about 30 patients per day in a six-day week – a workload that affords her the kind of time she likes to spend with each patient. Her clientele is weighted towards sports medicine, young athletes and their families, along with the traditional mix of personal injury and workers compensation cases and wellness patients. She employs two massage therapists and an acupuncturist/herbalist.

Like most of her peers, Dr. Zarzana often found herself bogged down in paperwork—handwriting SOAP notes and composing and issuing reports to attorneys, insurance companies, regulators and referring doctors. She tried dictation and outsourced transcription but found the process unsatisfactory, ultimately choosing to be her own transcriptionist rather than suffer the frequent delivery and quality problems. The  paperwork added the equivalent of a full day to her schedule each week.

Dr. Zarzana found her solution at ACOM Solutions, Inc., also headquartered in Long Beach, which was beginning to market diagnostic and document management software for chiropractic offices.

The solution, RAPID EMR, resides on a tablet computer that doctors can  carry in patient visits to streamline diagnoses and SOAP notes recording and later, to automate production and printing of patient reports. The software can also be installed on desktop and/or laptop machines. The RAPID EMR Total Solution includes the wireless-ready tablet computer, the RAPID EMR software suite, a multifunction printer/fax/copier, and a wireless interface card.

Building patient files in RAPID is highly automated. The software features intelligent interactive graphics and checklists for diagnoses, patient progress updates, and it also allows insertion of hand-written input. Doctors can simply tap on an on-screen  diagram point or check-box and associated text within the RAPID system is sent directly to the patient file. Handwritten notes are entered using an “Inking” feature, and external documents such as photographs and accident diagrams can be scanned into the file and automatically indexed.

The array of interactive screens include, among others, Patient Information, Chief Complaints, Range of Motion, Neurology Exam, Orthopedic Exam, Impairment Rating, Narrative Report, Outcome Assessment Reports and pictorial “Helper” screens for the entire body, the muscles, the spine, acupuncture, auriculotherapy and a genealogical tree.

Doctors can select any of four outcomes assessment reports at any point for printing and distribution, and a Microsoft Word-based report generator that operates independently of RAPID enables creation of custom text or reports that reflect an individual doctor’s style and personality.

Dr. Zarzana was not disappointed, for almost immediately she found that she was able to recover the many evenings and Saturdays that she had been devoting to paperwork. She further streamlined the practice with the purchase of ACOM’s Patient Self-Registration module. Now, when a patent arrives for the first appointment, he/she is handed a tablet computer with the file opened, and brief instructions on inputting the information Dr. Zarzana needs to proceed with the diagnosis: nature of the complaint, type of complaint, degree and location of pain, and so on.

“This information starts the file for the initial visit, and on subsequent visits, the patient revisits the file and the various screens and updates his or her condition,” she says. “The responses again go into the file automatically and continue to build it.”

The consistency, clarity and organized presentation of RAPID reports improve patient understanding and, she believes, help to support the prompt payment of claims.

“If the insurance companies can’t see the value of the treatment, they are reluctant to pay for it,” she says. “When you can document what you’ve done, you have a far better chance for uncontested payment. The RAPID reports we supply to referring MDs have actually impacted our credibility. Several doctors have called after receiving their RAPID reports to say that the level of professionalism is not what they are used to seeing from chiropractors. That certainly helps to support a professional image!”

For more information on the RAPID EMR call 866-286-5315 or visit ­

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