The Problem: Move an Established Chiropractic Practice to EHR
Cincinnati, Ohio-based West Chiropractic Inc., offers chiropractic care, physical therapy, and massage therapy. Two years ago, they decided to move decades of paper records into an electronic health records (EHR) system. “There’s a clear mandate from the federal
government to move to EHR,” says owner Hal C. Fine, DC. “And we are fortunate to have chosen a vendor with one of the first certified EHRs that will allow chiropractors to qualify for up to $44,000 in Medicare incentives.” But, he adds, “I think the time has
come, regardless of mandates or incentives. I was looking to EHR to help me be more efficient, to keep my practice profitable, and to have greater accessibility to my patient records,” he says. Although the practice had been using Compulink’s practice management software since 1993, they considered a range of options once the decision had been made to implement EHR.

The Solution: A Fully Customizable System Supports the Practice’s Team Approach to Complex Patients
“Nothing else matched Compulink’s ease of use or customizability,” he says. “We almost took it for granted, but when you start looking at other software, you quickly realize that it’s very unusual to be able to customize the system yourself. Yet that is exactly what helps you quickly and affordably adapt to changing practice needs,” he says. Fine treats a lot of post-surgical rehabilitation patients and has built exam screens in Chiropractic AdvantageTM to accommodate the level of complexity in his typical case. “The screens that our physical therapist and massage therapist use for their daily SOAP notes look completely different from mine, but they are all linked together to reflect our team approach,” he explains. When they need to send patient records back to a surgeon, for example, a few quick clicks are all that is needed to integrate the notes from all three providers into a single report.

The Result: Better Coordination of Patient Care and a More Profitable Practice
The financial advantages of EHR are significant, according to Fine. Since implementing EHR, the practice has eliminated a full-time front office staffer and shortened its reimbursement cycle from 45-60 days to 15-30 days. “A major advantage of having your records linked to your billing is that the EHR system won’t let you post charges that don’t match the daily record,” he says. “It prevents billing mistakes and helps you get paid faster.”

“There is no doubt in my mind that EHR has improved our communications with each other and with referring doctors about patients and their conditions,” Fine says. He and his partners use electronic “sticky notes” in the EHR system for internal communications. “That allows me to alert one of my colleagues about a change in the patient’s condition or a need to increase or decrease care much more effectively than a note scribbled in the chart,” he says. They have also created pop-up alerts to remind themselves to follow up on missed appointments. “It gives us another tool in managing the case to meet our ultimate goal, which is to get the patient well,” he says.

West Chiropractic has also been able to use the data it captures to define standards of care. “You can use the reporting features for so much more than just business management,” says Fine. “You can pull data from all patients with a given condition and analyze the average number of visits required and length of time to heal. That is powerful information.”

Pearls for Success
For anyone who is shopping around for an EHR system, Fine recommends focusing on three characteristics: Simplicity, customizability, and strong technical support. “They all go hand-in-hand,” he says. “If you have a customizable system and responsive, service-oriented support from a business partner you trust, your EHR system will be easy to use. That’s what you really want. After all, we aren’t IT people—we’re chiropractors who want to spend our time treating patients.

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