By Pattie Stechschulte
A paperless office, plasma flat screens, walk-through body scans, intelligent
software … are these all elements of the latest Star Trek movie or could
these be elements of the chiropractic office of the future?
Based on conversations with several industry leaders, Today’s Chiropractic
has aspired to make some predictions on how current technology will evolve to
encompass every aspect of the chiropractic office of the future—from check-in
to patient records to exams to billing.
Front
Office
As the patient pulls into the chiropractor’s office, the first noticeable
difference will be the outside sign; a plasma-type flat screen display that
runs a continuous loop of changing messages. The messages are part of a program
the chiropractor or staff member has programmed into the sign.
Patients will check in by swiping a credit card-size ID card that contains their
entire health history on a small chip. They will use either a touch screen notepad
or voice activated system to complete the check-in process.
“Patients will be able to check themselves in using touch screens and answer
questions about how they are feeling which will be automatically transmitted
to their file and the doctor,” predicts Tonio Cutrera, sales manager of
E-Z BIS.
“A think-pad kind of form or machine would take the place of an intake
form, and they would basically fill that out with the information being transmitted
through a wireless service instantaneously. There would be no inputting,”
says Dr. Maurice Pisciottano from Pro-Solutions for Chiropractic.
The front office will also have smaller plasma-type flat screens on the wall
that will have changeable art and/or messages, displaying the latest health
news. Picture one of these screens running a loop of patient testimonials. Touch-pads
will be lying out, sized similarly to magazines; these interactive posts will
serve as brochures or information kiosks. These touch-pads might contain a health
talk, through a projected 3-D image of the doctor and an audio spotlight which
focuses the sound to the immediate area, prerecorded by the doctor about certain
conditions.
The office will utilize different mood setting or subliminal environmental therapies
such as chromatherapy, which uses certain color and lighting to help the patient
achieve balance in their physical, mental, spiritual and emotional systems.
“There is no doubt that every aspect of a patient’s visit has a purpose
to it. We know that mood and environment, all these things play a role, the
patient will certainly be drawn to something multi-faceted,” explains Dr.
Scott Bautch of Wausau, Wisc.
Examination Room
In the basic examination room of the future, doctors will be able to extract
more information from the patient without using invasive measures. A patient
will just sit or lie down while a few monitors, similar to the grocery-store
blood pressure testers, will analyze your entire bodily functions.
Pisciottano
predicts a world where technology will provide a complete analysis of health:
“You will hook patients up to a couple monitors for a few minutes and when
you come back you know everything about them—antioxidant level, blood platelet
levels. At some point we will be doing blood work without puncturing the skin,
just with an instrument that will look straight through the system and be able
to read what’s there without running it through all the chemicals.”
Many experts also believe there will be some marriage of current imaging technology—MRI,
CAT scan and X-rays. They might pass through a special scanning device which
will analyze their entire body. “While the majority of these units in use
today at airports look for hidden weapons and metal, some machines can literally
look right through your clothes and get close to the bone,” explains Dr.
Joel Margolies of Tucker, Ga. “I foresee digital scans of the spine programmed
into these specific units. Patients while walking through will be analyzed and
marked for specific non-force adjustments being performed, either by hand or
instrumentation.”
“The image will be basically transmitted and stored on a computer program
so you can pull it up and might not have a physical X-ray. We are not going
to be using the same kind of systems we have right now which are very manual
and hand operated,” said Bautch.
“Further progressive instrumentation will have patients enter an enclosed
machine for electrical stimulation, not as a therapy but as an adjusting protocol,
allowing enough energy to stimulate the soft tissue component of an adjustment
creating the same effect. This will be adapted for all ages,” said Margolies.
Adjusting Room
Once in the adjusting room, the patient will be placed on a new computerized
adjusting table that will have a great range of maneuverability. “Today,
doctors need different tables to do different type of adjustments, but in the
future, one table will be able to do everything and run off a computer system.
The doctor will be able to program specific techniques and the table will do
the set up. There will be less equipment needed but it will do more,” said
Dr. Peter Fernandez from Fernandez Consulting.
“It will have scales that would take the gravity in the best possible position
for the person’s spine on that day which will automatically be calculated
through software. All of the information will be automatically stored in the
patient’s file so it can be called up during the next visit or transmitted
to the insurance company,” said Pisciottano.
The doctor will have a voice-activated or touch-screen computer system in each
room which will be loaded with intelligent software that will monitor the conversation,
type up SOAP narratives and offer the doctor a list of options for care. The
doctor may also use a legal-pad size wireless display unit which will display
the patient’s records and new exam results.
“A wireless smart display will be able to use the entire software program,
but doctors will be allowed to walk around with it and it will have mobile access
to patient information,” said Cutrera. “The devices will actually
be a remote access to the patient information but will not store the data.”
Currently, a new type of software—agent software—is in development;
the software uses voice recognition and is already in use by the U.S. military.
“You will have a conversation with a patient and the agent software will
hear the conversation and type up the conversation in narrative notes, provided
you ask the right questions, and the agent software will be able to decipher
what the patient is saying,” said Pisciottano. “The agent software
will be able to decipher what the diagnoses choices should be as based on the
findings. All this information will be stored in a database and help the doctor
think.”
These technological advances will be especially useful to new doctors fresh
out of school because they will have the ability to do instant consultations
with a live doctor with more experience or from a tutorial database. “There
might be a group out there that will look at records, help doctors with treatment
recommendations by looking at X-rays online to tell them if there are other
diagnostics things going on. I absolutely think some kind of systems in chiropractic
needs to develop partially because our residency programs are so short,”
said Bautch.
Back Office
On the business side, the experts all agree that the entire office will be paperless
with all practice operations done on the computer, networked via wireless radio
frequencies. This will also cut down on construction costs.
Fernandez
sees a more cost-effective office in the future thanks to some of the changing
technology. “The office overhead in the future will be dramatically reduced,”
he says. “All the patient information will be handled in the computer from
electronic billing to chiropractic assistants inputting exam results. The office
of the future will be less expensive to operate and will be more efficient.”
The actual work stations will also be connected to the computer that will allow
the staff to control their physical and virtual environments with the use of
a touch-screen or voice command. IBM and Steelcase Furniture are already on
the task, developing a series of work stations and computer systems called the
BlueSpace system.
The system includes a computer monitor and touch screen mounted on a rail that
slides horizontally, adjusts vertically and rotates to almost a complete circle.
This allows a user to sit almost anywhere in an office and face almost any direction.
Another feature of the system is the threshold, a mobile partial wall and ceiling
that can be rolled the length of the workspace to provide on-demand privacy.
Doctors might also record and store all their patient education seminars online,
perhaps to be downloaded from their website. “All your classes will be
kept on the site, so patients can just tune in to watch it off their computer
at home or in the office. This will double or triple a doctor’s educational
capability by doing it on the computer. Websites are also going to change to
sites that actually are used to make appointments by patients so they don’t
have to talk to the office. They will just flip through your appointment times
and select a time convenient for them,” predicts Fernandez.
“Not only will it be easier for doctors to practice in the future, but
more important, we will do a better job. That is the key piece to doing all
this. It is really all about patient care,” says Pisciottano.
Yet, says Bautch, there will be some stability in the profession: “In chiropractic,
our adjustments look almost the same as 100 years ago. Other than different
[clinic] décor, our adjusting techniques and procedures will be fairly
similar. I feel that chiropractors will be fairly similarly delivering the care,
I just think that all the technology around the delivery of care will change.”
About the author: Pattie Stechschulte is an award-winning writer and contributing
editor for Today’s Chiropractic magazine.
Provide your feedback on this
article.
© Copyright 2003 Today's Chiropractic