As the battle against opioids takes center stage in communities across the United States, policymakers are advocating nonpharmacological pain treatment methods. The Joint Commission’s new pain assessment and management standards that will take effect January 1, 2018 require for all accredited hospitals to provide alternative pain management options such as chiropractic therapy, acupuncture and relaxation and cognitive behavioral therapy. As a drug-free, non-invasive and cost-effective choice for acute or chronic neck, back and musculoskeletal pain management, chiropractic care is a key element in addressing the nation’s opioid crisis. However, to respond effectively in today’s value-based environment, chiropractors need to manage their data and electronic health record (EHR) documentation effectively. Chiropractic medical transcription service providers can play a significant role in ensuring this.
The federal government has labeled the opioid crisis a national public health emergency. Opioid crisis statistics are extremely alarming:
- Forbes reports that in 2015 more than 52,000 Americans died of drug overdoses.
- According to the December 16, 2016 national update of the Centers for Disease Control and Prevention (CDC), more than 300,000 Americans have lost their lives to an opioid overdose since 2000.
- The American Chiropractic Association (ACA) reports that every day, more than 1,000 people are treated in the ER for misusing prescription opioids.
A 2017 report from the Foundation for Chiropractic Progress notes that pain management doctors are beginning to recognize the importance of increased vigilance when prescribing pain medications, and are expected to become proponents of drug-free pain care. A recent nationwide online survey revealed that more than half of physicians across America are restricting opioid prescriptions, and nearly 1 in 10 have stopped prescribing the drugs. However, more than one-third of the respondents said the reduction in prescribing has hurt patients with chronic pain. Chiropractic provides the solution to this. The basis of chiropractic care is that correcting the body’s alignment via spinal manipulation will relieve pain, improve function, and help the body heal itself.
The 2017 updated guidelines of the American College of Physicians (ACP) propose first using non-invasive, non-drug treatments for the treatment of acute and chronic low back pain, before resorting to drug therapies. The ACP’s guidelines, published in the Annals of Internal Medicine, list heat therapy, massage, acupuncture and spinal manipulation-the mainstay of chiropractic care-as possible options for non-invasive, non-drug therapies for low back pain. The guidelines state that patients should move on to prescription opioids only when such treatments provide little or no relief. According to the guidelines, prescription pain killers should be a last resort for those with low back pain, as the threat of addiction and overdose may offset the benefits.
As chiropractors go all out to provide safe, effective, affordable drug-free care to patients in pain, they need efficient documentation support. In a Chiropractic Economics article, a healthcare data analytics expert summed up the importance of effective data management for chiropractors as follows:
“Collecting and using data opens a new world that can lead to better patient outcomes, more efficient business practices, greater patient safety, and a broader spectrum of patients who understand and utilize chiropractic services”.
However, reports suggest that there is still a lot to be done to optimize EHRs in chiropractic practice. A study published by ScienceDirect.com in 2016 found that documentation errors affect quality of EHRs in chiropractic offices.
The aim of the study was to review the literature on current challenges and propose solutions for the optimal utilization of the electronic health records (EHRs) in chiropractic practice. The researchers performed a search of relevant chiropractic literature databases from November 2005 to February 2015. Up to 45 papers were examined, which included case reports of EHR implementation, governmental insurance reports, commentaries, controlled studies, narrative reviews of past experiences with conversion from paper systems, and the implementation of EHRs in small offices and chiropractic offices. Though literature directly related to chiropractic EHRs was minimal, the study identified several factors affected the quality of chiropractic records:
- Improper utilization
- Incorrect use of the software
- Faulty implementation
- Workflow burdens
- Documentation errors
- Financial considerations, and
- Insufficient training
They concluded that solutions were needed that may decrease documentation errors such as EHR training, continued financial incentives, and appropriate implementation process and utilization of available software features.
Experienced medical transcription companies provide timely and accurate EHR-integrated documentation solutions that can help chiropractors improve patient care and increase patient compliance. Partnering with a reliable service provider minimizes time that chiropractors need to spend on documentation, billing, collection, and other administrative tasks, and allows them to focus on care, specifically their increasingly important role in tackling the nation’s opioid crisis. Industry stakeholders need to support chiropractors in their efforts. A recent POLITICO report recommends that health plans and other payers should realign financial incentives to put treatments other than drugs more within reach of more patients.