Many EMR companies offer online training and [demos] for you to determine if they are the right fit. technological security to help safeguard patient information. Many EMR companies offer online training and demonstrations for you to determine if they could be a good fit for your practice. Be sure to check with your regulatory college and perhaps your malpractice carrier to ensure there are no issues prior to adopting a new EMR. During the course of your clinical en-counter, there are many possible touch-points where technology can be included. I have already mentioned the use of an EMR service to help guide the process from intake through physical exam and charting, but there are other technologies that can be used. For instance, several apps are popular to use during the Phys-ical Exam portion including: • Goniometer Pro is a free app to meas-ure range of motion. It can be used in-office or at home for patients to monitor their progress. • PostureScreen Mobile is a paid pos-ture analysis, body composition, and movement screening application. It can be used to capture images and measurements of a postural analysis during the physical exam. One bene-fit of this app is that it has some peer reviewed literature to validate its us-age and is advertised as being HIPAA compliant. • CoachNow is a paid motion capture application. It can be used to capture motion analysis during the physical exam. This can be used by practition-ers who conduct movement screen-ings, gait analysis, or assess movement performance. It allows for side-by-side video comparisons, which can be useful during reevaluation to demon-strate improvements in technique and form. • Complete Anatomy is a paid anatomy app that provides 3-dimensional ren-derings of the human body. This can be used during the report of findings to highlight the relevant anatomy. It www.Cndoctor.ca Patient interaction offers the ability to layer through the body to show the interconnectedness of various anatomical structures. While the physical exam is only one part of the clinical interaction, there are many other technologies and services that could be helpful when developing a treatment plan and delivering a report of findings. These include: • ChiroUp. This is a web-based service that offers evidence-based informa-tion for physical examinations, re-search for treatment plans, rehabilita-tion, and much more. • Canadian Chiropractic Guideline Initiative (CCGI). The CCGI is a free, online resource that offers resources for clinicians and patients. This in-cludes: 1) Research summaries for various conditions including lumbar spinal stenosis, osteoarthritis, tempo-romandibular disorders, and many more; 2) Patient handouts to assist with education; 3) Outcome measures relevant to each condition to assist with re-evaluation and discharge; 4) Continuing education courses • Physitrack. There are several online home exercise programs, Physitrack is one of these programs and it offers exercise selection, educational re-sources, and outcomes measures. One benefit to Physitrack is that it provides instructional videos that can be emailed directly to the patient. Resources One constant struggle for many practi-tioners is the ability to stay on top of the latest evidence. Many of the aforemen-tioned applications offer resources to help stay up to date with emerging re-search. For example, ChiroUp offers emails to highlight various conditions and treatments. Complete Anatomy offers modules to develop clinical skills including an 8-hour course on kinesiol-ogy taping. Both the CCGI and Research Review Service (RRS) offer podcasts that can be listened to during your commute to the office. There are a plethora of vari-ous health and wellness podcasts that can be found through your preferred resource (Spotify, Apple Podcasts, etc), so there’s no need to discuss them ad nauseam in this forum. Other technological resources can be utilized to help patients monitor their progress at home. This includes some of the technology previously discussed in-cluding the goniometer application and Physitrack for home-based rehabilitation exercises. However, other pieces of tech-nology may be valuable for patients. This includes a smart watch such as Fitbit, Garmin, or Apple Watch to track steps and other physical activity metrics. Few studies have been conducted that show the use of these types of wearable tech-nology for patients living with specific conditions (Reeder and David, 2016). Although there is some debate about the accuracy and validity of the health met-rics captured by these devices, they may promote a less sedentary lifestyle (Mas-soomi and Handberg, 2019). A recent article from the British Med-ical Journal discussed the use of home pulse oximeter combined with telemed-icine support (Greenhalgh et al, 2021). The use of this type of wearable tech-nology could allow patients to monitor their blood oxygen levels and allow for medical decisions on when to seek ad-ditional support. In fact, both the UK guidelines as well as WHO guidance from January 2021 supported “…use of pulse oximetry monitoring at home as part of a package of care…” (Green-halgh et al, 2021). The authors of this study mention that it could exacerbate anxiety, so ap-propriate patient screening is important. However, the combination of at-home technology such as home oximetry and telehealth may enhance care and simul-taneously decrease some of the strain on the healthcare system by conserving hospital beds and reducing the risk of nosocomial infections. In summary, there are multiple touch-points within a typical patient encounter that could offer an enhanced patient or healthcare worker experience by inte-grating various types of technology. For a full list of references, please visit cndoctor.ca/tech-savvy March/April 2022 Chiropractic and Naturopathic Doctor 9
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