Proper Patient Imaging Procedures Using 3DO Systems

Proper Patient Imaging Procedures Using 3DO Systems  (A to Z)

 

How Dr Craig Lowe Does It. . .

 

Marketing & Practice Management

The Ideal Practice Model. . .  Maximize quality of patient care and revenue.

"There is nothing wrong with Practicing Good Medicine and making a profit",
Dr Craig Lowe

According to Federal Studies including the CDC, demonstrate that up to 85% of the American Population have biomechanical positional and structural diseases necessitating intervention.

Therefore, I recommend, ALL patients, (New and Returning Patients), should get imaged.  Make the 3DO Imager part of the traffic flow to the back treatment rooms.   

Rational:   Since Cyclic Load Bearing Biomechanics is the baseline of most diseases seen in the office, enabling the patient to see their progress through a quick and efficient 90 second, analysis educates and builds the value proposition.    

Current Statistics:   Less than 3% of the patient load in a normal practice are provided with biomechanical or ergonomic intervention, despite the fact that 85% of the population has problems.

How?
As Back office staff performs analysis, they asks the following questions; making notes in chart.

• Where do you Work? - Ergonomic Work Footwear?

Patients who work in manufacturing, shipping, utilities can not only benefit from Ergonomic Footwear, but could open the doors for employers and other employees to seek benefits as well.

• Do you have Children? - Pediatric Screenings (free)

Treating children is critical in developing a normal limb structure.   Many deformities are inherited.   Providing Pediatric Screenings free is a great way to prevent disease(s).

• What kind of Sports do you like to play? - Sport Devices?

Many patients participate in Sports and they should know that there are specialized devices to enhance their performance and reduce injuries while it maintains good health.   Examples are Golf Orthotics, Tennis Orthotics, Running Orthotics, Skiing, Cleted Sports etc...

 

Create a Information Intake Sheet;

• Do you have any Joint Implants? Where?
• Have you had any Load Bearing Surgery of the Foot, Leg, Knee, Thigh Hip or Spine?
• Who is your Primary Care Provider?
• Do you see any of the following Specialists? Orthopedic - Neurology - Rheumatology - Podiatry?

Send a cover letter (see below sample) and make physicians aware of your ability to help them with Organic Disease patients using 2 mile walking programs.

Organic Diseases

"Lets Go For A Walk"

Bioengineered Devices are used as a baseline foundation treatment of ALL Cyclic Load Bearing Diseases.   In addition, Ergonomic Footwear (Footwear + Bioengineered Devices) are used in Aerobic 2 Mile Walking Programs to treat Organic Diseases (CHF - Hypertension- PVD - Obesity - Diabetes).

Market Primary Care Physicians:   Majority of their patient loads consist of Organic Diseases.   Physicians know that walking greatly improves health.  

• Reduce reliance on toxic medications
• Titrate down medications used for Organic Diseases
• Eat right and exercise

How do I market Primary Care Physicians?

• Send a cover letter with the 3DO Report explaining you are seeing the same patient.
• Let them know that they can review the report and bill the report to the insurance carrier on a 99080 CPT code which enables them to make up to $150.00 for the service.  This encourages them to send more of their patients.   They are aware their patients do not want drugs and surgery. 
 

3D Imaging Procedures 

 

Step 1 - 3DO Imaging
The 1st procedure is to perform a 3DO Static and Dynamic Scan on the patient.    As you are doing the scan, discuss the overview data you observe and view images in 2D and 3D.  

Why. . .

New standards of care are developing.    Any load bearing surgeries require biomechanical assessment post operatively, (especially Joint Implant Surgeries) to prevent implant failures and or transfer lesions (other joint breakdowns).   Patients do not want more surgeries.   Let them know you are there to help them with pain and to prevent further problems.

Static 2D - 3D

• Areas of high pressures (gradient pressures based on color pallet) based on percent of total surface area.
• Percent weight on each Limb
• Body Balance Bubbles, (body sway (bottom bubble) and balance (side bubbles).
• Center of body mass
• Body Sway

 

 

  

Dynamic 2D - 3D - Ordering

• Demonstrate how to walk on Imager Media.   This takes the fear out by walking over media with non abrasive shoes, (so that the top cover does not get damaged).   If patient has difficulty walking over media, (children and elderly), then perform Static Images only.  Tap your foot on imager to cycle through dynamic section.
• Gather data and demonstrate the 2D Mass Curve against normal (right side of screen).   Show data in motion.
• Repeat in 3D and rotate images to better visualize plantar feet.  Note:  The bigger the screen, the better for the patient.   They want to see what is going on.   If possible, port image to larger plasma or LCD screen.
• View Gait Analysis in Autoplay or Frame by Frame
• Rotate Foot Objects in 360 degrees  
• Add Videos, Photos, Documents as attachments for technicians to evaluate
• Bring Up and review and print the Outcome Measurement (Assessment) Report and go over quickly the results of Static and Dynamic Data.   Do not get too technical. . . make it easy for them to understand.

 

 

 

 





Step 2 - Non-Weight Bearing Optical Imaging
Image feet Non-Weight Bearing on the Optical Imaging System.   Patient is in a Sitting Position with both feet on imager for a Static High Resolution Optical Scan (barefoot) and knees straight.

Optical Images provide excellent high resolution imaging for;

• Plantar Lesions (Size & Locations)
• Foot Sizing
• Extension trimming on Bio Engineered Devices
• Custom Footwear Manufacturing

 

 



 

 

 

 

 

Step 3 - Digital Picture

Digital Picture of their Feet using a Digital Camera

• Attach photo to desktop
• Migrate Photo to "Attachment Icon on Digital Imager Live" so that it is part of the production order for technician.
• Use another photo of Footwear, especially style or difficult footwear.   The more the technician sees, the better.

 

Step 4 - Video Gait
 Attach Video to desktop

• Migrate Video to "Attachment Icon on Digital Imager Live", so that it is part of the production order for technician as well as medical record in the event of an audit.
• Video Gait is an allowable service under the 96000 sets of CPT codes.

Example



Step 5 (G3 Stereoscopic Laser - Optional)

• Amputees (trauma or Diabetic)
• Excellent for Dorsal Foot, Ankle and Leg 3D Imaging
• Custom Footwear (complex)
• Requires Technical Skill

 

 

 

 

 

 

Step 6 (Optimal Results)

Footwear Integration

• A service we provide that removes any errors in integrating the shoe with the device.   Simply send us the shoes and we will integrate, adjust and provide the perfect fit for the patient.



Step 7 - Bio Engineered Orthotic Dispensing
Patients need to know that they need to wear the bio-engineered orthotics to toleration because we are correcting positional, structural and load bearing disease(s) due to the following reasons;

1. Changes in Cerebellum (hind brain) function
2. Changes in Vestibular (inner ear)
3. Changes in Visual Cortex
4. Changes in the timing and firing of muscles (extra pyramidal track)
5. Changes in cyclic load in joints (feet - ankle - knee - hip - spins).  Condyle pressures change in all three body planes.

Note:  20 to 25% of the patients will have "break in discomfort" which can be managed by usage to toleration.   This obviously does not mean that the devices are not work, but in fact the opposite is occurring as we are changing cyclic load function. 

Step 8 - Follow Up Care 
Symptom Assessment:  Examine and assess how the patient is doing.
Gait Analysis:  This can be done visual or on the 3DO imager.
Static Load Assessment:  Place the bio-engineered orthotics on the 3DO Imager and have them stand in the devices and look at the metatarsal load pattern and compare it with pre-device studies and not load reductions.  You can also check balance and body sway as well. 

• 3 Weeks Post Dispense
• 3 Months Post Dispense
• Children and Type 1 Diabetics every 6 months
• Routine Patients every 2 years

There are billing codes for office visits, gait analysis, and orthotic training.

Specialized Billing Codes:





 

Conclusion

 

Following this Step by Step format should maximize your utilization of Digital Orthotics products.

Dr. Lowe is also available for consultations.   Please call us or visit our web site.

 

www.digitalorthotics.com

 

Sample Referral Letter to Primary Care (This is sent with 2 Page Outcome Measurement Report):

Example letter. . .

Dear Doctor _______________________

We (I), had the opportunity of seeing your patient (John Doe) at our office for pain associated with pathomechanical disease. Attached is a report from our 3D Weight Bearing Kinematic Imaging System and Analysis which we (I) believe will be of interest to you.

Our goal is to uncover complex biomechanical and ergonomic causes to cyclic load bearing conditions and provide treatment through the biomechanical etiology of the disease(s). This outcome measurement report, if reviewed by you, can be billed to the patient’s insurance carrier upon your review and notation within the medical chart on a CPT code of 99080. Most physicians bill on average $150.00.

Ergonomic Footwear Programs are a new method for identifying and treating complex cyclic load conditions that create deformities and pain as a result of acquired and congenital musculoskeletal diseases. I am sure you agree that you patients do not want to take medication or at least take the least amount of medication for the maximum therapeutic effect. Our goal is to get your patient walking 2 miles a day (10,000 steps) or 45 minutes with new Custom Ergonomic Footwear that will minimize pain, restore function and make the Ergo Walk programs fun as they improve overall health. I am sure you will agree that getting your patients off the couch and walking will improve their wellness and longevity and we know they will support any wellness intervention.

As you evaluate the (fully guaranteed), success all patients who you send to us we hope may result in further referrals. All patients sent to us will result in this outcome measurement reports.
Mechanical problems require biomechanical intervention. . .

By treating the biomechanical etiology of disease, we reduce their reliance on toxic medications. Your patients want this, and we are here to help.