Imagine an office in which there is almost no paper, there is no need for filing, there are no double entries, your notes generate your billing, and the patient signs an electronic pad proving that he or she was in the office and accepted responsibility for paying your bill. Imagine that when you are finished with patients at the end of the day, you are also finished with all your record keeping and there is never a need to stay late, enabling you to go home early enough to enjoy your family. This is no longer a dream for the future. Paperless, chiropractic-specific software already does this and more.

Electronic Records

Most offices today use tremendous amounts of paper. Every record made by the doctor and every report that comes from outside the office—travel cards, fee slips, and many other items—use paper. Many offices enter information on paper and then transfer that same information to a computer program. And then all the paper needs to be filed. A truly paperless system eliminates more than 90% of this paper.

Electronic patient records are part of the paperless solution. For an office to become really paperless, it is essential that the electronic patient file is integrated with the office-management program. A single entry places the patient in the system. Access to patient information is available only to authorized persons on the in-office network. As soon as the doctor enters the diagnosis in the documentation, it is available in the insurance area. Documentation entered in real time in the adjusting room generates the charges for the day at the front desk, and memos or other messages can be sent to and from each staff member. Electronic claims are easily generated. This is done without paper.

New features are constantly being developed for all the software programs in the marketplace. Some development is dictated from outside the profession, such as adding fields to work with the National Provider Identification (NPI) number and new claim forms, but most development is geared to the needs of the profession.

Single-Screen Functions

The Diagnostic Imaging Report speeds entry by using point-and-click technology, allows entry of additional notes, and saves the entry in dictation-quality English.

In the airline industry, "SST" refers to Super Sonic Transport for those planes that fly faster than sound. SST represents speed and quality. At Life Systems Software, SST describes Single Screen Technology, and it is employed whenever possible to fit specific functions on one screen. The most recent SST functions incorporated into a paperless system are the Diagnostic Imaging Report, Sensory Testing, and Muscle Testing. These SST screens are fast, using point-and-click entries, and then generate their reports and findings in dictation-quality English. Each SST includes an area to type or write in additional information.

The Diagnostic Imaging Report (DIR) gives you the ability to enter imaging findings from any type of imaging exam (such as x-ray, MRI, CT, or ultrasound) on a single screen. It includes an area for spinal anomalies that adjusts the view of the spine to show only those vertebrae that actually exist. On this single screen, you enter all the information about the film you have viewed, and upon clicking "save," the system generates an imaging findings report, saving it both as a separate report and as part of the current day's SOAP note. The DIR findings are also generated in narrative reports produced within the software.

Sensory Examination findings are rapidly noted with just a point and click. Extra comments are entered in the Additional Notes area. The findings are produced in English sentences, and generate a Sensory Exam report, the current day's SOAP note, and narrative reports when needed.	You can note the muscle-testing results using point-and-click methods. Special remarks are entered in the Additional Notes section. Selecting the Extended Detail button opens another screen for unique muscle findings related to complications from disease or medication.

The SST for Sensory Testing includes the typical manual and reflex tests, dermatomes, and an option to select spinal nerve testing instead of dermatomes. Everything is on a single screen. The manual and reflex testing scores use the standard 0 to +4 scale, whereas the dermatome and spinal nerve areas use the grading system described in the AMA's Guides to the Evaluation of Permanent Impairment. The screen includes entries for pain and paresthesia for each dermatome or spinal nerve. And if you check off the spinal anomalies, the system will prevent you from entering information for non-existent areas. When the information is saved, the data entered is converted into clear sentences and paragraphs, and is saved as both a separate report and part of the current day's SOAP note.

For a discussion on software, check out our October 2006 article, "Get Technical."

Muscle testing uses SST for the common level of muscle examinations. The information about muscles can be noted as just strong or weak, or use the grading scale from the AMA found in the text Guides to the Evaluation of Permanent Impairment. The Muscle Testing SST has an area for electronic measured testing, noting strength in pounds or kilograms of pressure. Abnormalities are noted just by clicking on the appropriate item. Once a muscle is selected, its innervation, motion, and organ relationship is shown. For those that gather much more than most about muscle information, the SST screen includes a button that opens a second screen for very extended details.

Each of the screens, and each of the features discussed in this article, are found in the ChiroSuite Paperless and the ChiroPad Documentation and Narrative programs from Life Systems Software.

Paul Bindell, DC, is president of Life Systems Software and is a 1975 graduate of Palmer College of Chiropractic. He has practiced in Rockaway, NJ, since 1976. He has lectured on chiropractic in Brazil and Israel. Contact him at , or at (800) 543-3001.