Be:
A BETTER CLINICIAN
HINTS ON LANGUAGE SO PATIENTS HEAR WHAT YOU MEAN.
Click below for a guide explaining some of the language that isn’t necessarily helpful.
View Unhelpful Language
"Your MRI shows degenerative disc disease / disc bulge / arthritis / bone spurs / spondylosis, etc"
I will never get better
"Your MRI shows wear and tear"
My spine is worn out
"You have damage"
I have a severe injury to my spine
"You have a chronic condition"
I will never get better
"There's nothing wrong with your back"
He/she thinks it's all in my head
"Stop when you feel pain"
Activity will harm my back
"Let pain be your guide"
The pain is in charge; I'm not
"Take it easy and rest"
I should avoid all activity
"You need pain medication and injections"
Making the pain go away is my only hope
"Pain is normal for someone your age"
I am going to get steadily worse as I get older
"You need pain control"
The pain is a vicious monster that has to be controlled
"You have pain when you go back to work (or exercise) stop working (or exercising)"
Any pain I feel when I go back to work or exercise means I have re-injured myself
"The goal of treatment is for you to be pain-free"
Anything short of that goal means failure
"Your pain is psychogenic or psychosomatic"
He/she thinks it is not real pain
"Your test findings are negative"
Negative? That must be bad
"Don't worry"
There must be something to worry about
"You are going to have to live with this"
My life is ruined
Make sure patients are hearing what you mean, click below for a helpful guide.
View Helpful Language
"Your MRI doesn’t show anything to worry about"
There’s nothing seriously wrong with my back
"Your MRI shows normal things that come with aging, like gray hair"
Those scary-sounding words are nothing to be afraid of
"The cause of your pain may not show up on an MRI"
My pain is real
"You should increase activity as tolerated"
Activity is good for me
"Your back problem should respond to nonsurgical care"
I probably won't need surgery
"Self-treatments and exercises are the most important aspects of spine care"
I can take charge of this
"Medication and injections are sometimes helpful so you can get more out of the self-treatments and exercises"
Self-treatment and exercise are the keys to recovery
"Having pain at times is a normal part of life but it can almost always be managed"
The pain doesn't have to go away; I can learn to take charge of it
"I'm confident in your ability to overcome this"
I have a better chance of recovery than I thought
"Working (or exercising) will not cause damage to your back, even if you have some pain while working (or exercising)"
I will be able to return to work/exercise
"Together we can help you overcome the pain"
Pain is not a vicious monster; it is something I can move beyond; I am not alone in this
"Some pain on getting back to work is normal and usually fades as your body adapts"
Pain doesn't necessarily indicate re-injury
"The goal of treatment is for you to learn to manage and overcome your pain"
I may or may not be pain-free, but I can cope with it and get on with my life
"Stress might exacerbate your experience of pain"
My emotional experience may impact my physical symptoms
"Your pain is persistent, but you can overcome it"
The pain does not have to go away for me to get better
"If you make some changes, you can enjoy life despite any pain you may have"
I can get my life back
A BETTER PRACTICE
The Spine Institute for Quality® – or Spine IQ® – is a private, non-profit organization with the goal of transforming spine care. We provide resources for doctors of chiropractic, primary care physicians, physical therapists, and other clinicians who wish to focus on non-invasive, non-drug treatments for spine-related disorders. We also help patients make informed decisions by providing information about evidence-based treatment options and by providing a searchable database with access to Spine IQ recognized physicians. We believe that conservative approaches to spine-related disorders will help reduce the number of unnecessary surgeries and prescriptions, and we are committed to evaluating the effectiveness of this type of care by tracking clinical outcomes in real world clinical settings.
Data Driven Care
- We enable spine care clinicians to measure the quality of care they provide through our MIPS eligible SpineIQAir™ Clinical Data Registry.
- We give patients a voice by evaluating their experience with spine care delivery through direct collection of patient satisfaction data.
- We offer the Spine IQ Chiropractic Quality Recognition Program, the only independent recognition program developed exclusively to recognize clinicians’ expertise and commitment to high quality spine care.
Research
- We collect the information necessary to evaluate clinical outcomes of patients with spine-related pain and disability receiving care from providers across nationally representative geographic and practice settings.
- We conduct studies that will provide the critical evidence needed to improve patient care, identify future research questions and help policymakers make decisions regarding the value of conservative spine care.
Education
- We are working to improve the quality of spine care across the country by providing training materials that help clinicians meet performance standards and improve patient care.
- (Coming soon) We will be offering web-based bi-monthly journal club for clinicians interested in spine care delivery.
The Only Registry Designed Specifically for Conservative Spine Care.
The SpineIQAir Clinical Data Registry is our most powerful tool in transforming the culture of care.
SpineiqAir collects data from state-licensed or certified health care professionals who assess and manage spine pain to describe the natural history of disease, determine the clinical effectiveness, assess cost-effectiveness of health care services and to measure/monitor safety and quality. This results in leading-edge opportunities for spine care practitioners to demonstrate quality and improve their practice through reporting and benchmarking. Spine IQ’s registry can be used for the Centers for Medicare and Medicaid Services (CMS) MIPS quality payment program and the BCBSKS Quality-Based Reimbursement Program.
Spine IQ is partnering with Quality Value Health Systems
Spine IQ is partnering with Quality Value Health Systems (QVH) to provide the SpineIQAir Clinical Data Registry.
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Why should I join the SpineIQAir Clinical Data Registry?
- Achieve gold level recognition in the Spine IQ Quality Recognition Program.
- Track outcomes – such as change in pain intensity and pain interference – across your entire patient population.
- Improve patient follow-up by using data to identify patients who are not meeting performance benchmarks.
- Demonstrate the value of your practice to patients, payers and other stakeholders by bench-marking yourself on 28 performance measures.
- Meet Centers for Medicare and Medicaid Services (CMS) regulatory requirements for Merit-based Incentive Payment System MIPS. (Note – Review MIPS calculator to see if you qualify.)
- Contribute real patient data towards research efforts that can answer important questions about spine care best practices and performance-based payment systems.
How can the data be used?
- Payers and purchasers will be able to use the data to identify practitioners committed to quality care and performance benchmarks.
- Scientists will be able to use de-identified data to answer important questions about the quality and outcomes of spine care delivery.
- Practitioners will be able to establish baseline data and improve care through measurement and educational opportunities.
Performance Measures
Spine IQ can help you stay focused on patient-centered care.
Our surveys are convenient and easy to use for you and for your patients.
Spine IQ can help you stay focused on patient-centered care by collecting patient satisfaction data directly from your patients. We use a standardized, HIPAA compliant, multi-disciplinary web-based survey. The Spine IQ Patient Satisfaction Data Collection Program is affordable and convenient for your patients. You’ll receive confidential quarterly reports that compare your patient satisfaction data with other clinicians across the country. By selecting this option, you’ll be able to use patient satisfaction data to:
- Patients who are satisfied with their care are more likely to make referrals.Â
- Identify opportunities for improvement, including overall satisfaction with your care, helpfulness of your staff, and ease in making appointments.Â
- Use patient satisfaction data to market your practice to patients, insurers, and referral sources.
How Does the Program Work?
A patient-centered practice requires direct feedback from the patient. However, this information can be difficult to collect in a busy clinical practice. Spine IQ can help.
Spine IQ addresses this issue by collecting satisfaction data directly from the patient in a rigorous and cost-effective manner using the AHRQ CAHPS Clinician & Group Survey 3.0 questionnaire. This process involves HIPAA compliant web-based methodologies and secure text messaging methodologies.
It is important to note that Spine IQ is not able to access patient satisfaction data unless both the clinician and the patient agree. The patient is required to initiate the contact in order to provide his or her data, which can only occur at the clinician’s request.
Spine IQ will provide participating clinicians with confidential quarterly reports. However, individual patients are not identifiable – all data provided to the clinician is in aggregate from only. Clinicians have the option of posting their aggregate patient satisfaction data on the Spine IQ website for public viewing as part of the Spine IQ Chiropractic Quality Recognition Program.
What Does the Program Provide?
Patient satisfaction data collection by Spine IQ provides clinicians with the following:
- Quarterly reports are available to participating clinicians providing patient feedback on a number of domains related to patient satisfaction, including provider communication, access to care, overall provider rating, and care coordination.
- Each report includes aggregated patient satisfaction data compared to an average of all clinicians who are participating in the Patient Satisfaction Rating Program and existing national benchmarks.
- Custom reporting is available for an additional charge.
- Clinicians in the Patient Satisfaction Data Collection Program have the option of participating in the Spine IQ Chiropractic Quality Recognition Program.
Quality Recognition Program
We’re dedicated to conservative care to create better outcomes. Therefore, we want to enable high-performance providers to be recognized in the marketplace for their high-levels of expertise.Â
What it provides you
As a member of the Spine IQ Quality Recognition Program you will:
- Let your patients and others know that you have achieved recognition by the Spine IQ Chiropractic Quality Recognition Program at either the bronze, silver, or gold level.
- Be included in Spine IQ’s searchable database that publicly recognizes your level of quality participation.
- Keep up to date on chiropractic research that is directly relevant to your practice through access to Spine IQ’s exclusive bi-monthly “Quality School” webinars hosted by leading muscular skeletal pain scientist, Dr. Christine Goertz.
- Show your patients how you stack up against your peers using Spine IQ’s patient satisfaction data collection program.
- Use the SpineIQAir Clinical Data Registry to Benchmark your patient outcome success and participate in quality payment programs such as the Centers for Medicaid MIPS Program.
You deserve to be recognized!
You have contributed data to the CMS Quality Payment Program.
Spine IQ is independently collecting patient satisfaction data directly from your patients.
You make your patient satisfaction data publicly available on the Spine IQ website.
You are reporting data to the SpineIQAir clinical data registry.
You make the summary data from at least two SpineIQAir clinical data registry performance metrics publicly available on the Spine IQ website.
Contact us or call 1-800-531-0987 to learn more about how you can earn Silver or Gold Quality Recognition for your practice.
A SMARTER PRACTITIONER
Access Evidence-Based Training
As a registered practitioner with Spine IQ, you’ll have access to evidence-based training materials to help you engage in evidence-based, guideline congruent, patient-centered care of those suffering from spine-related disorders.
Educational Tools
Webinars
(Future)
Presentationas & Panel Participation
(Future)
Subject Matter ExpertBlog Posts
(Future)
We collect the information necessary to evaluate clinical outcomes of patients with spine-related pain and disability receiving care from providers across nationally representative geographic and practice settings.
Research Library
Articles
Krebs EE, Gravely A, Nugent S, et al. Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain: The SPACE Randomized Clinical Trial. JAMA. 2018;319(9):872–882.
Read Article
Goertz CM, Long CR, Vining RD, Pohlman KA, Walter J, Coulter I. Effect of Usual Medical Care Plus Chiropractic Care vs Usual Medical Care Alone on Pain and Disability Among US Service Members With Low Back Pain: A Comparative Effectiveness Clinical Trial. JAMA Netw Open. 2018;1(1)
Read Article
Goertz CM, George SZ. Insurer Coverage of Nonpharmacological Treatments for Low Back Pain—Time for a Change. JAMA Netw Open. 2018;1(6)
Read Article
Heyward J, Jones CM, Compton WM, et al. Coverage of Nonpharmacologic Treatments for Low Back Pain Among US Public and Private Insurers. JAMA Netw Open. 2018;1(6)
Read Article
Chou R, Deyo R, Friedly J, et al. Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med. 2017;166:493–505. [Epub ahead of print 14 February 2017].
Read Article
Rubinstein Sidney M, de Zoete Annemarie, van Middelkoop Marienke, Assendelft Willem J J, de Boer Michiel R, van Tulder Maurits W et al. Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials BMJ 2019; 364 :l689
Read Article
Guidelines
CDC Guideline for Prescribing Opioids for Chronic Pain
View PDF
American College of Physicians Guideline for Low Back Pain
For Patients (Link)
For Clinicians (Link)
VA/DoD Clinical Practice Guideline for Diagnosis and Treatment of Low Back Pain
View PDF
BETTER INFORMED ABOUT SPINEIQ
News & Events
Duke University is looking for Volunteers to Provide Input on Telehealth Policy
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A multidisciplinary team at Duke University Margolis Center for Health Policy is studying whether telehealth (via computer, phone, smartphone, or other device) can affect access to care for people with Medicaid insurance in North Carolina. They especially want to know whether using telehealth has helped people who have musculoskeletal health conditions access the care they needed and what challenges could be addressed with state-level policy reform.
They are seeking licensed chiropractors, physical therapists and occupational therapists to serve as subject matter experts for a conversation on access to care, telehealth, and health disparities. Are you willing to share your perspectives on this issue? Please click for more information, including who to contact if you are interested.
Participants will be compensated $50 for sharing their perspectives and helping us brainstorm ways to inform state telehealth policies.
Frequently Asked Questions
What is Spine IQ?
The Spine Institute for Quality™ (Spine IQ™) is a private, not-for-profit organization with the mission to define quality, demonstrate value and build trust in conservative spine care delivery.
Our vision
Spine IQ’s vision is a future in which health care systems consistently provide evidence-based, patient-centered spine care to the right individual at the right time, beginning with the safest, most conservative, effective, approaches available.
Goals
- Clinical Data Registries: Establish clinical data registries that capture patient outcomes and process measures that enable spine care practitioners to benchmark the quality of care they provide.
- Chiropractic Quality Recognition Program: Enable high-performance providers’ expertise to be recognized in the marketplace.
- Practitioner Education:Â Increasing practitioner understanding and participation in relevant local and national quality initiatives. Spine IQ also serves as a conduit to evidence-based training materials that can assist practitioners in meeting performance measurement benchmarks and/or standards.
- Spine Care Research: Conduct rigorous research using pragmatic study designs that answer policy-relevant questions about spine care delivery in real world settings.
Why was Spine IQ developed?
Spine IQ was developed to transform spine care by promoting conservative management of spine-related disorders. This is critical given the overwhelming public health significance of spine-related disorders and increasing concern that current widely used interventions may be ineffective and/or carry unacceptable levels of risk.
Who is eligible to join the Spine IQ registry?
Spine IQ is a multidisciplinary endeavor and is open to all state-licensed or certified health care professionals who assess and manage spine pain.
Why should I join the SpineIQAir Clinical Data Registry
- Track outcomes, such as change in pain intensity and pain interference across your entire patient population.
- Improve patient follow-up by using data to identify patients who are not meeting performance benchmarks.
- Demonstrate the value of your practice to patients, payers and other stakeholders by benchmarking yourself on 28 performance measures.
- Meet Centers for Medicare and Medicaid Services (CMS) regulatory requirements for MIPS.
- Contribute real patient data towards research efforts that can answer important questions about spine care best practices and performance-based payment systems.
What Data will the Spine IQAir Clinical Data Registry collect?
The registry includes a total of 28 performance measures. These include four custom measures focused on patient-reported pain intensity, patient-reported pain interference, repeated x-ray use and avoidance of early MRI imaging.
You can review the 28 measures here.
Clinician Resources
Spine IQ is often asked for resources on conservative spinal care delivery. Below are our favorite research studies and websites that provide important information for high-performing conservative spine care clinicians who want to transform the culture of spine care.
Resources
Quality Payment Program
The Quality Payment Program improves Medicare by helping you focus on care quality and the one thing that matters most — making patients healthier.
Learn More
Choosing Wisely – “Five Things Physicians and Patients Should Question for Pain Medicine”
An American Chiropractic Association article.
Learn More
Choosing Wisely – “Five Things Physicians and Patients Should Question”
This American Chiropractic Association article on the Choosing Wisely website is a great resource when talking to patients about conservative care.
Learn More
Choosing Wisely – “Five Things Physical Therapists and Patients Should Question”
This American Physical Therapy Association article on the Choosing Wisely website is a great resource when talking to patients about conservative approaches of physical therapy.
Learn More