Advanced Spine - Using & Customizing - Treatment Notes

For doctors who want to not only speed up their documentation, but make it more precise, our Advanced Spine may be the tool you are looking for.

Quick Overview Video

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Advanced Spine lets providers document their adjustments with speed, accuracy and detail. Advanced Spine is customizable and versatile making it useful no matter your adjusting style or documentation preferences.

With Advanced Spine record

• Technique (or tool)
• Listing
• Attribute (such as pain, asymmetry, tenderness, etc.)
• Areas to Avoid
• Notes

Before you get to using Advanced Spine you will first want to customize your techniques and findings. To do this go to Settings/Treatment Notes/Spine.

To add a new technique, click the action button on the bottom right. Then type name and save.

You will also notice check boxes at the bottom. These are global settings.

• Display Laterality - when checked, the system will show Right or Left for the segment you adjusted. As an example, if you clicked C7 on the right and selected a listing, when "Display Laterality" is enabled, the system would show "Right" in the output text for that adjustment in addition to the listing.
• Display Technique Name in Report - when checked, the system will show the technique name in the output text for that adjustment in addition to the listing. As an example, if your technique is "Activator" and you want the system to state in the output text that activator technique was used, you would then want to ensure you have "DisplayTechnique Name in Report" enabled for that technique.

You can edit techniques by clicking the pencil icon.

Arrange your techniques up/down using the handlebars. Techniques and Listings will appear in that order when you are using Advanced Spine in your treatment note.

To edit the listings, click the button to the right of the green pencil (see below).

Now that you have clicked the Edit Listings option you will see a dialog with the full spine and ribs. The spine is displayed with the patient in the prone position (laying face down on the adjusting table).

To add listings, click in an empty cell. As an example, the image below shows Occiput (left) selected in blue. You will see a list on the right showing those listings and their order. Here you can add new listings (using the "+ Add new listing" button). Use the handlebars to arrange your listings up/down.

The numbers in each column indicate the number of listings you have created for that section.

POWER TIP: If you create a listing for a segment and want that copied to other regions of the spine, click the "Clone the above listings to" button for the region you want to clone to.

Findings are just that, findings such as pain, tenderness, ROM abnormal, hypertonicity, tension, swelling, trigger point, spasm, restricted motion, asymmetry, etc.

To access Findings, click the Findings tab. Use the action button to "Add attribute".

Then use the handlebars to arrange and pencil to edit name and active status.

To use Advanced Spine you will need to add it to your custom treatment note templates. To do this go to Settings/Custom Templates/Template List. Click the pencil icon next to your template.

There are TWO WIDGETS YOU NEED TO ADD for your Advanced Spine.

• Advanced Spine - This is the "physical" spine you will see in your note. Here you can record adjustments and findings. Now, because adjustments should appear under Objective and Findings should appear under Plan, we've made it possible to separate where this data goes in your note.

• Advanced Spine Findings - This section should be placed in your Plan section of your SOAP note. You will not be able to edit the data "in this section". Instead, the findings you entered from the Advanced Spine will appear here.

Next, click the "Advanced Spine" option and add this to the objective portion of your note.

Next add the "Advanced Spine Findings" to your Plan section of your note. Keep in mind this section is a place. holder that populates the findings you entered from the actual Advanced Spine.

If you forget to add the "Advanced Spine Findings" section to your note not to worry. The findings will still appear in your printed note, albeit combined with the adjustments.

Now you have Advanced Spine added to your template.

There are two ways to document your patient's adjustment.

• Without Listings
• With Listings

For users who do not want to document listings, you can click the grey circle/check icon that sits to the right or left of the spine. This will mark that area as "adjusted".

Alternatively, click on a space. In the dialog that opens click "ADJUST".

For those that are using listings, click in a blank space. Then select the technique. Below I have selected "Common Listings".

When technique is selected you will see the listings. I have selected "Sp. Rt. Body Pivot ESR". Of note, you may select multiple listings if you want. In addition, you can select another technique and its respective listing(s).

To edit any of your inputs, select that space, then click "Clear".

To add attributes, select a space on the spine. Then choose the Attributes tab. Your attributes like tenderness, ROM, stabbing, etc. will appear. Choose one or multiple.

To add a listing or attribute to multiple segments at the same time use the "Actions" option.

• Start by right clicking in the space(s) you want to perform an action. In the image below I have right clicked on C1 through C7 (turning them green).

• Next, click the Actions button.

Now you can choose one ore more listings/attributes. I have chosen stabbing, muscle spasm and weakness.

Next click Apply to All.

Just like that, you can see the data was applied to all of the previously selected sections.

To mark areas to avoid (so that you do not adjust that area on the patient) click the center of the spine. Then click "Avoid".

You can see the area is now red with a note to avoid (on the right).

You may also populate ribs with adjustments or attributes. This is done in the same way as Spine. To see ribs click on the Ribs tab.