How to Avoid the Chiropractic Documentation Slow Down

Recent surveys have indicated that EMRs are causing doctors to lose 48 minutes per day (literally slowing down their pace) which is…umm…exactly the opposite of most chiropractor’s goals for utilizing an EMR system and for  accelerating their practice growth in general.

But this is largely the doctor’s fault and totally preventable, in my opinion. I know that you didn’t want to hear this, but allow me the liberty to tell you why:

Reasons Your Chiropractic Documentation Suffers From Deceleration

  1. Temporary Transition – it’s normal to expect an EMR system to slow things down temporarily simply due to the fact that it’s new. There’s a learning curve for virtually everything new you adopt, it’s just painfully visible with EMR. But if the learning curve is beyond 90 days, there are other problems beneath the surface. Think about it.  If you went out and got a new smart phone and you’ve never had anything but an old cell or better yet, a landline, you can expect to spent some time wrestling with it until the phone actually did what it was designed to do.  You would also admit that the fault was not the phone but the operator (you).  And if after 6 months, you were still wrestling to dial your sweetie pie, surf the net or create a calendar item, you would probably conclude that either you need to sit down and learn the blasted thing right or pitch it to the curb.  Yet, on the EMR front, I’ve seen systems gather dust for years from non-use.  Or I’ve seen docs who have the equivalent of a smart phone in their EMR system who are using it as nothing more than a word-processor. To fix this, you must resign yourself to make the transition temporary and not let it linger on for months or years. Just like your smart phone, you don’t need to use every feature to feel its value, but you’ve got to go beyond the basics — otherwise, why have it in the first place?
  1. Mirroring Mistake – EMR should not mirror your paper notes. Yes, you are subject to the same requirements in documenting your care with paper or with EMR.  But, you are losing many of the functional gains if you utilize the exact same approach and produce the exact same note, just in a different format.  EMR should help you improve the note because macros, buttons, programmable shortcuts should enable you to report more than you could even with a fast set of fingers. So the goal is not to mirror but to improve.  If your notes are so darn good that all you are doing is typing them up so that they are legible, you don’t need an EMR, you need a transcriptionist.
  1. Verbal Vomit – for some, the EMR system sends them to the other extreme on a quest for the chance of a lifetime to finally produce that “perfect SOAP note.” Squash that temptation as soon as you can, else you end up producing 10 page novelletes that serve no additional purpose that to trap your time and let your ego loose.  Auditors are not interested in reading how to perform tests.  They aren’t looking for definitions or other drivel to pad your notes and make them look “beefy” — they are looking to see if you met medical necessity, which is not related to the quantity of note you produce but the quality.

When EMR Still Doesn’t Fix You

Over the past several years, an interesting problem has begun to emerge from doctors who HAVE already implemented EMR and, in their opinion, “it didn’t work.”

By this, the chiropractors are not saying their system is broken, but they should be.  To be most accurate, it’s not the EMR system that is broken, it’s the way the chiropractor utilizes it.  In other words, it’s there chiropractic systems that are the problem. Here’s why:

For many docs, migrating to EMR is a band-aid on the surface of the wrong wound. They believe EMR will make them more efficient (it will, to a degree); they believe that it will improve their notes (again, yes, to a degree); they believe it will solve the mystery ailments that seem to perpetually resurface that they don’t have enough time to get everything done. Sorry, this ain’t a life fixer. It’s a documentation tool – and a good one, check. It can be used for practice management – check. Billing – check. Patient communication – check. Running reports, generating stats, sending postcards, emailing, texting and doing many things shy of getting your patients out of bed and dragging them into your office.

But here’s the deep dark dirty secret about EMR:

Just because EMR can do all these things for you doesn’t mean YOU should be doing them.

In fact, you (aka — the doctor) should not do most of them, but certainly you can train your staff to utilize those features. And for some doctors, you, shouldn’t really get near your EMR at all…

How to Better Utilize Your Chiropractic EMR System

What could I possibly mean? Face it, there are some of you who are either busy enough or technologically challenged enough that using the EMR should not be on your to-do list. Notice, I did not say EMR should not be used.

It just should not be used…by you.

In other words, part of conquering your documentation nemesis is not trying to increase your efficiency, streamline your processes or procedures to build more time in your schedule to do your notes.

It should be to DELEGATE those tasks to someone else who can do them more efficiently (and with better quality) than you and most importantly…who CANNOT do what you can do (take care of your patients).

The Real Question About EMR You Need to Ask

So, the real question which many chiropractors continually fail to ask themselves is NOT “Should I get an EMR system?”

It is: “Should I be doing my documentation at all?”

If you think this is a foreign concept or some hare-brained idea I made up, apparently you aren’t visiting many other health care professionals (that could be a good thing) because you’ve neglected to notice that MD’s do not do their own notes and neither do dentists and neither do a whole host of other professionals.

Once you tackle that question, you can begin to see a whole new way for your documentation to be better, faster and…not your enemy.  Primarily, your role then moves to teaching someone ELSE how to document (we call this a “scribe” in my coaching programs and we teach you how to effectively set this up.) Then, the next step is to let your scribe use the EMR while you focus on what you do best — which hopefully is taking care of patients, not taking care of paper.

Want to WORK SMARTER with Your Documentation and MUCH MORE?

Consider joining us for our upcoming Smarter Chiropractic Online Workshop — where we will show you the 4 focus points to dramatically increase your chiropractic income and decrease your audit risk!

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