Are you amazed about the planet being photographed by Google? You could see a real image of your house or you can go to Rome, New York, Sydney and walk virtually on any street.  Please take a moment to think about everything a cell phone can do now.  It takes pictures, records videos, makes them available to be seen by every human being on earth in seconds, has detailed maps and GPS, reminders, and thousands of other applications.  They say iPhone has more than 100,000 applications available.  OH! I almost forgot.... On a cell phone, you can make calls, too!  When we stop for a moment and think about it, we are all amazed and excited about all this.  It makes our life so much easier, saving precious time for other activities and having a much better control on our life.  Just think about paying our bills online replacing mailing checks every month, using bank teller machines, instead of waiting in line, and the list goes on and on and on....

Maybe you don't realize it, but chiropractic is one of the best well served professions for technology.  Just like any other technology, it is hard for you to keep up with all the new  innovations.  I am sure there are a ton of new stuff you don't even know about.  Knowing about a new technology does not mean you have to jump on it right now.  In fact, you should always be a little patient to make sure you will make good use of any technology before spending your money.   In the chiropractic profession, software competition is very strong. There are many companies out there battling to have new functions and tools to get or stay ahead of each other.  This competition creates an ideal situation for chiropractors.  Chiropractors can use the very best technology for a low price.  In fact, right now, chiropractors can use some amazing tools for way less money than what they should pay in reality, which is wonderful.  Lately, I have been thinking about how well served chiropractic is with technology and I wish to share with you some (just a few among so many) of the greatest chiropractic software innovations.

Computerized calling system

To my knowledge, chiropractic is the first profession to use an automated computerized calling system.  In fact, I have never seen another calling system anywhere else.  A member of your team uses a microphone to record the patient's name.  This takes about 2 to 3 seconds and it is done forever.  On his arrival to the clinic, the patient signs in electronically by swiping a Chiropractic Health Card in a waiting room computer.  The system builds a queue of patients.  The magic starts here. When the doctor releases his treatment room, the system calls patients and directs them into the proper adjustment room, through speakers located in the waiting room.  You hear real human recorded calls and not a digital computerized voice.  I have personally seen this system in action and all patients are very impressed.  Many patients think someone from the back room is calling them with a microphone.  It frees up the CA completely and manages peak time perfectly.

Automated credit card and debit payment system

Everyone knows about how a credit card system works.  With the patient at the front desk, you grab his card, swipe it in a terminal, key-press the amount and wait for the approval.  After confirmation, you need to enter the payment transaction in your billing system. An automated credit card system is an upgraded version of what you have.  You do not swipe the credit card in a terminal anymore.  You swipe it in a card reader attached to your billing system.  While processing the payment, it updates your billing system simultaneously.  You can also set up recurrent monthly or weekly payments.  At a specific date, the system will process all the credit cards and update all patient financial files.  Great for a payment plan.  You will be able to keep your actual credit card processor or probably obtain a lower fee than what you actually pay.  Some software providers offer this system completely free of charge, included in their basic software package.

Insurance payments automatic posting

Talk about saving time!  This is the tool.  Imagine, no more insurance payments to enter in every single patient's file.  Insurance carriers (clearing houses) are now providing an electronic remittance file.  They all do, unless you submit your claims on paper.  This software will read the remittance file and will automatically enter all insurance payments in every patient's file.  This simply means turning hours of work into a few seconds.  No more mistakes, no more time lost searching why your billing system does not balance.

Digital X-Rays (with film, too)

Wouldn’t it be nice to have the patient's X-rays on the screen on every single visit?  Now, it is easy, quick and cheap to get this.  When the patient gets in the treatment room, he swipes his Health card in a reader.  He lies down on the table, ready for his adjustment.  When you get in the room, there they are.  X-rays are displayed on the computer screen.  If you are using X-rays on film, there are some easy and quick ways to get them in the system and do the same thing.  You may also have other pictures, such as the patient's posture, etc.

SMS (Short Message Service)

Time is to emails and cell phone texts.  You wish to remind all your patients about tomorrow's appointments?  No problem.  Press on one single button and the software will select all patients with an appointment scheduled for tomorrow.  It will send them a formatted text message (including their name, the date and time of their appointment) on their cell phone.  The patient does not have a cell phone with text feature?  Then, the message will be sent to his email address automatically.  As a bonus, some software providers have found ways to send SMS free for you.

Subjective

Good SOAP notes are an imperative requirement.  The patient's subjective part is very important.  Don't you think the patient is the best person to produce his subjective part of the SOAP notes?  So, why shouldn’t he do it? On his arrival to the treatment room, the patient swipes his health card in a reader attached to a touch screen computer. A series of personalized and issue-related questions appear on the screen.  The patient answers all questions by pressing on the touch screen.  While answering, the subjective part is getting built professionally and accurately.  Subjective notes entered by the patient himself...you can't beat that!

Efficiency Control System

This morning, you are a little late and you arrive at your clinic a few minutes before the first patient.  Hurry up in the treatment room and start the day.  You have a busy day and have to cut out your lunch time.  At the end of the day, you are tired and want to go back home with your family and relax a bit.  As a business person, you need to take some time to make sure your office is running well.  Some doctors in chiropractic are now receiving all their office statistics and reports on their iPhone, Blackberry or personal email.  No human action is required. This is all done automatically, every day, every week and every month.  Being well rested and outside of the office, they can look at everything they need to maximize the potential of their practice.

These are a few examples only, among so many others, to show you how the chiropractic profession is well ahead of the game compared to many other health professions for technology.  Most of these features, or similar functions, are included in the basic price of some chiropractic software.

Now, you are excited and want to use all these features in your office right away? Don't do that.  Don't go from nothing to everything. The best way to make your office more efficient is to implement one new feature at a time, get used to it and, when it becomes transparent to your operation, you may implement the next feature.  A process like this will make you grow steadily and well under control.  Like everything else in life, common sense prevails.

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 This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

One of the biggest questions chiropractors are facing in X-ray today is what is the best way to "go digital".

The answer is, it depends on a lot of variables. However, proper up-front understanding of the technologies and alternatives can make for a better decision and can create a positive long term effect on your practice.

With respect to the different technologies, there are basically two approaches for going digital—CR (Computed Radiography) and DR (Direct Digital Radiography). Both technologies produce digital images, but in different manners, with their own set of pro’s and con’s.

CR (Computed Radiography)

A CR system includes CR cassettes and a CR scanner. The CR cassettes contain a special screen that captures the X-ray image. The cassettes are inserted into a bucky or grid cabinet, just like film cassettes, and all of the imaging is performed in the traditional manner. After the X-ray is taken, the cassette is removed from the bucky or grid cabinet and inserted into the scanner. The scanner can sit in the X-ray room, so no dark room is needed. The scanner will scan the image screen and display a digital image on the monitor. This process usually takes less than sixty seconds.

One of the biggest benefits of CR is that, in most instances, you can use your existing X-ray system, as long as it is reasonably current technology. It should be at least a 300mA/125kV system, preferably high frequency. Very old systems with limited power will have the same challenges making high quality CR images as they do making high quality film issues.

DR (Direct Digital Radiography)

Additional important issue when you go digital   

The equipment discussion above dealt with the technologies used for acquiring the X-ray image digitally. Also important is the viewing, storage, and transferring of the images. The key is to establish a plan up front of where and how you want to be able to review, recall and store the images. A PACS system is the proper way to complete the system and accomplish these functions (Picture Archive and Communication System)

Viewing images: Most doctors will want to send the images from the digital imaging system, either CR or DR, to a computer in their own office where they can review the images, mark angles, and add annotation. In addition, some may want to be able to display the images in an exam room for patient consultation. This will require computers with the appropriate viewing software and licenses. Web-based access to the images is also available for reviewing images remotely.

Image Storage: This is an important area to focus so images are always safe and secure. There are a number of alternatives based on your volume and budget. In addition, you may want the ability to burn images on a CD for patients to take with them. This can be a good way to market the modern digital imaging technology that you are providing through your practice.

Terry Yochum, DC, DACBR, Fellow, ACCR is director of the Rocky Mountain Chiropractic Radiology Center in Arvada, Colorado. He can be reached with questions pertaining to this article at 1-800-742-4476 or at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .