The very essence of the concept of computerization is "CONTROL." This is obviously a two-sided coin. While we are thrilled to be able to do all of our typesetting in-house, the typesetting and photographic services that we used in the past aren't so happy. The net result for us is reduced costs and a better looking, more readable publication. The net result for the companies that used to provide those services is a serious loss of income.
The computer revolution in typesetting is adding jobs to companies who publish, but taking jobs away from companies who typeset. Desktop publishing is taking typesetting through a metamorphosis that has forced many typesetting companies to either make radical changes or perish.
In the most recent newsletter of the Agency for Health Care Policy and Research (AHCPR), the agency reports the awarding of 17 contracts to small businesses to "work in one of three areas: the American Disabilities Act (ADA), family primary care reminders, and the Department of Health and Human Services 'Healthy People 2000' objectives." The AHCPR has awarded "contracts for approximately $50,000 each under the Small Business Innovative Research (SBIR) program" for some very interesting projects.
Eight of 17 contracts awarded were for primary care reminder computer programs. This is how these programs are described:
"a software tool that enables individuals to create a primary care plan for themselves and/or family members."If you are beginning to get the picture, it should scare you to death!"a microcomputer-based system to help families track the health care needs of their members and obtain timely preventive care."
"an intelligence tool for personal computers to assist families with health maintenance."
"an expert system that will run on home computers to collect preventive medical histories directly from family members, then use the histories to make tailored preventive health care recommendations, based on practice guidelines stored on its knowledge base."
"a PC-based data base and user interface, which incorporate a consensus of the preventive care guidelines accepted by the clinical community, the federal government, and other relevant entities. The data base will provide the average family with the ability to describe each member in sufficient detail to receive a primary care management plan consistent with their descriptions for scheduling appointments with health care providers."
Without viable practice guidelines, inclusion as primary care providers and involvement in the development in these types of patient primary care reminder systems, chiropractic care could be eliminated with the push of a button on your patient's home computer. Patient health care choices could be made from a computer program that doesn't even acknowledge the existence of chiropractic!
The good news is that almost every one of these programs includes "preventive health care recommendations." This is where chiropractic can really shine. All we need is the research necessary to prove our place in preventative health care.
Computers are in the process of revolutionizing health care. It won't be too long before they begin preliminary diagnoses of family members and making appointments. There has never been a more critical time in our history for chiropractic research to show our effectiveness in other areas besides musculoskeletal.
These computer programs will be based on the scientific literature. The chiropractic profession must make an all-out effort now, while many of the factors that will affect our future are still on the drawing board.
If you have the time to read this article, you have the time to write out a check for $25 and send it to:
MPI-AMA Challenge
P.O. Box 6070
Huntington Beach, CA 92705
Or better yet, call 1-800-359-2289 to contribute by Visa or MasterCard.
All proceeds will be contributed to the Consortium for Chiropractic Research to be used for other than low back research (please see this issue's front page article "AMA Challenges Chiropractic Profession"). Should you decide that our future needs more than a $25 donation, Dynamic Chiropractic will publicly recognize all donors of $100 or more.
Don't let your patient's computer database tell them that chiropractic care isn't appropriate for anything other than low back care.
DMP Jr., BS, HCD(hc)
Click here for more information about Donald M. Petersen Jr., BS, HCD(hc), FICC(h), Publisher.