Know your ABCD’s of Tech to Grow Your Practice – IBH

Preson holding tech devices in their hands

Editor’s Note: Dr. Jay Greenstein is a keynote speaker at our upcoming Ignite2020 one-day conference. He will be presenting to doctors about utilizing Technology for Exponential Growth, to your staff about Strategies for Personal and Professional Growth, and to both you and your staff in a closing session about Chiropractic Entrepreneurship – An Evolved Approach for Practice Success. You can find out more about Ignite at

The future is now. In an ever-changing world, healthcare has never been more poised for disruption. While evidence-based healthcare (EBH) has been the hot topic over the last decade, I would encourage you and the rest of the profession to consider that we are moving rapidly into an era of Intelligence-based healthcare (IBH). Let’s review the ABCD’s of IBH!


A – Algorithms and Artificial Intelligence (AI)…

Think about the most successful and disruptive companies in the world. Google, Uber, Facebook… Algorithms are their DNA. What about the chiropractic profession? We have algorithms too! Just review the Clinical Compass Low Back Pain Guideline published in 2016. Here, science informs us of how best to manage patient care through a course of treatment. These algorithms can be used in your report of findings to let patients know why you are making recommendations (and that they are evidence-based). Further, they can be used to fight insurance denials. In addition, they can help referring physicians and others in the medical community understand the supported course of care you are recommending, and lastly, they can inform policymakers in order to move the needle on hot-topic issues like the opioid crisis. The next evolution of algorithms needs to be (and will be) embedded in electronic health records in order to help providers make clinical decisions. Imagine if your ROF were automated for patients after documenting their conditions and co-morbidities! Then imagine that machine learning takes over, aggregates all of your patient data, and helps to identify treatments that will get patients the best outcomes. Artificial intelligence/machine learning has been used to improve brain tumor identification in a fraction of the time that humans can perform this function1.  Artificial intelligence has also been used to estimate the impact of human papillomavirus types in influencing the risk of cervical dysplasia recurrence2. We are at the early stages of algorithms and AI in healthcare. So, what about its use in chiropractic? The opportunities are exponential.

B- Blockchain

When people say “blockchain,” the first thing that comes to mind is Bitcoin. Bitcoin was built on the blockchain. Yes, it’s a cryptocurrency. It’s the tech behind it that has made it such a story, and a disrupter…but blockchain is a lot more than that. If you want the long version, check out the Wikipedia definition. But for a more understandable definition, here’s what blockchain expert Jeremy Epstein has to say: “What blockchain basically is, is a globally distributed database. Everyone has a copy of the database. So, imagine we all have a Google Sheet or a Microsoft Excel spreadsheet and we’re all looking at the exact same copy of it. Instead of having a copy stored in one central location, we have a copy of that ledger of all that information stored at every computer, or all the participating computers around the world. And the security of that is guaranteed by some pretty cool type of cryptography and some other ways of making sure that the data is sort of tamper-resistant… The primary implication of blockchain as I see it is that, for the first time ever we are able to transact items of value directly between two people with lower cost, less risk, and increased speed, without the need for any centralized intermediaries. That’s the game-changer here.  So, if you’re a business owner, what you need to understand is, the third-party institutions that basically are brokering trust right now between other parties, they’re in the crosshairs of this disruption.”

Hmmm…Third-Party Institutions. Are insurance companies Third Party Institutions? Could they be disrupted? What about healthcare records? Why don’t patients own their own records where they can be stored, accessed and modified only by trusted parties? Did you know that healthcare data is up to 20x more valuable to hackers than credit card data? What about transactions? Can we completely eliminate third party administrators with the use of cryptocurrencies? The possibilities are endless, and only with our collective understanding and action will we be able to leverage blockchain for the chiropractic profession and the patients and communities we serve.

C- Cloud Computing (and the Internet of Things – IOT)…

Cloud computing continues to impact our world dramatically, and we are increasingly busting silos to become interconnected. Think about all of the devices that are connected to and through the internet. Can you say Fitbit? There are hundreds of new connected products being developed every day, so the opportunities to use these connected devices to improve health and wellness are endless. Another great example is Genesis Chiropractic Software, the company we use for our EHR and billing, which is a leader in cloud-based EHRs. Because it’s “in the cloud,” it can interconnect a variety of other platforms in order to improve efficiency and profitability of my business. Speaking of the IOT, we just became one of five practices worldwide to be a strategic partner for VRHealth/VRPhysio, the first virtual reality platform for rehabilitation. Because both data sets are stored in the cloud, with a simple API, or Application Programming Interface, data from the patient’s VR activities can be uploaded/connected to our Genesis EHR system. If your EHR is not in the cloud, you are behind…period. It’s a good thing for our profession that most EHRs are moving to the cloud because one of the most important elements of cloud computing is…

D – Data

Data is the glue that binds Algorithms/AI, Blockchain, and Cloud Computing together. As a profession, we are so fortunate that what we do works incredibly well to help patients heal. For the early decades, we relied on patient testimonials and anecdotal evidence. In the past two decades, there has been a virtual explosion of peer-reviewed, scientific evidence that demonstrates our value to the healthcare system. AND, moving forward because of A, B, and C, we will be able to leverage BIG DATA to demonstrate our outcomes to what I call the 4 P’s – Patients, Providers (MD’s), Payers, and Policymakers. With large aggregate data leveraged from EHR’s like Genesis or clearinghouses like Infinedi, there can be no disputing our impact on our communities and there can be no disputing appropriate clinical pathways that yield the best outcomes for patients. Leveraging that data will drive better policies, better decisions, and more transparency in healthcare. Whether its SpineIQ, the first spine care registry for chiropractic and beyond or emerging practice-based research networks (PBRN’s), data is the driver of change.

I’ve never been more excited to be a Doctor of Chiropractic. The coming years will see technology disrupt third party institutions and provide support for better decision making and better outcomes for patients. In 1895, chiropractic was a disrupter. Now, in 2020, we, as a profession, need to leverage disrupting technologies, to assert our importance in the new era of healthcare! Understanding how to leverage these technologies and more will be part of my presentation at the upcoming convention. Learning more about how to grow your practice exponentially will be a presentation you won’t want to miss!

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About Author

Dr. Jay Greenstein, DC, CCSP, CGFI-L1, CKTP, FMS

Dr. Greenstein is CEO of the Sport and Spine Companies – Sport and Spine Rehab, a six location practice in the Washington DC Metro region; Sport and Spine Athletics, Sport and Spine Rehab Clinical Research Foundation; and Kaizenovation® Lifestyle. Dr. Greenstein, is Chairman for the Council for Chiropractic Guidelines and Practice Parameters (CCGPP), is the Government Relations Chairman for the Chiropractic Summit, and is the World Olympians Scholarship Program Chairman. Dr. Greenstein served as a recommended provider for the National Football League Players Association for the Washington Redskins, and since 1997, has been the Official Team Chiropractor for the Washington Redskins Cheerleaders. Dr. Greenstein served as the Chiropractic Representative for the National Athletic Training Association, Inter-Association Task Force for Cervical Spine Injured Athletes, and the Maryland State Tae Kwon Do Association Medical Chairperson and team physician. Dr. Greenstein was selected to be the Chef de Mission for the International Sports Chiropractic Association to run the Chiropractic Sports Center at the World Olympians Association Reunion Center at the 2008 Beijing Olympics. He served as a committee member for the Federation of International Chiropractic Sportive (FICS) research and finance committees from 2011-2014. Dr. Greenstein is a sought out international speaker and consultant, teaching clinical guidelines, evidence based leadership, and the Entrepreneurial Operating System (EOS®). Dr. Greenstein sits on multiple community and business advisory boards in healthcare, banking and information technology.

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