431- The Next Step in ROM Testing

Welcome to the Evidence Based Chiropractor where each week we deliver the latest chiropractic research and marketing strategies, all in the time it takes to get to your office. Now here's your host, Dr. Jeff Langmaid.

Hello and welcome to the Evidence Based Chiropractor. I am your host, Dr. Jeff Langmaid. If you perform range of motion in your practice, whether visually or with technology, you're going to want to pay attention to today's episode. A few weeks ago I got a DM from a gentleman named Orey and it was relative to a post that I had put out there. He said, hey, have you ever heard of neck care? It is a really cool high technology solution that he is involved in, that he is range of motion focused and beyond. And once I clicked over and looked at it, I knew I had to have a conversation with him. The design was awesome. The functionality looked great, the reporting was clean and clear. I respect people that can put out really awesome products onto the market and.

I believe Net Care is one of those products.

So I sat down for a conversation that you can listen in right now too with Orey from Net Care.

No, absolutely. Pleasure, Jeff. And yeah, it was great to connect with you last time. So I'm definitely looking forward to our chat today as well.

Awesome. So we have a lot to cover over this episode. I want to go into some of the software, I want to talk about some of the design, but let's start with the basics. Neck care that can go and mean a lot of different things to people listening out there. The product really caught my attention because of the design, but let's peel it back one layer. What is the neck care product and what problem does it solve in chiropractors practices around the world?

Yeah, absolutely. Based off of 20 years of research, actually the company is founded, as you can see, I'm holding here the neck care device for those listening. It is a helmet of some sort, a headgear to track movement of people's necks. And we do objective assessments of cervical spine. So anything from range of motion proprioception, movement control. Yeah, that's where we started and that's what we're doing.

One of the things that really got my attention was I'm used to seeing like range of motion devices that look like they were designed in like the 1950s. They got wires all over the place. The doc or the therapist is having to hold things. It just becomes such a cluster of. One of the things that took me by surprise and caught my attention early was, as you described, sort of that halo or crown that is a wireless controller. Talk to me a little bit about the design esthetic, why is it and why is it important to you and maybe just some of that process to come to the market with something that just looks so different and so obvious and that's the ultimate compliment that it's like, how has it not been done this way the whole time?

Yeah, it's a great question. What we really look to is to have it as user friendly as possible. It's super light, so the patient doesn't even feel it on their head and it's not impacting, I mean people in neck pain or post concussion to have, you know, big VR glasses, for example, or you know, the chrome device, the huge device that some used and the goniometer. I mean, honestly, are we still using gonios? You know, ultimately that's what we're, you know, replacing. And to have a device that, that fits anyone and that only takes two minutes to take accurate range of motion measurements. Yeah. Why would you do it any, any differently really?

I could not agree more. One of the other things you showcased, and maybe we'll do an overlay on the screen for those that are, are watching this and of course, if you're listening, we're going to drop the links down below. It's netcare.com but we'll be sure to drop that down below so you can head over and check everything out. But let's talk a little bit about the, the platform and the reporting as well. Because one of the second item once we started discussing, I saw the, the device itself got my attention. I was like, this is so cool. Then you started to show me a little bit of what's going on inside the platform. So I'm going to split that up and say there's platform and reporting. So talk a little bit about the development and benefits of the platform and the reporting because I just was so impressed with what I was seeing. It was clear, it was clean, it was easy to understand. And as a clinician, that makes my life easier when talking with a patient. But tell me a little bit about your experience building and developing the platform and the reporting.

Yeah, I mean, great to hear, Jeff. And again, we definitely take, you know, user first approach in everything we do. It has to be accessible, it has to be usable. And we know the speed in a chiropractic clinic. I mean you don't have time to, you know, to figure things out or to do, you know, very lengthy assessments. So it's straightforward, it should be self Explanatory. And that's really what we're all about. And even though all chiropractors I talk to just love those after hour documentations, then we, we do our best to actually do that for you. So our reports are auto generated right after you do the different assessments and they are often used to explain to the patient or the insurance company, hey, why am I doing this treatment? Why do we need to actually justify this treatment to the insurance company or to get that patient education and that patient buy in. That can be so, so valuable. Um, so that's, that's where we, we, that's our mission and, and that's what we, we hear from our, our customers all the time.

And tell me a little bit about some of the reporting. So when we look at those reports, there were some items on there that were familiar to me and then there were some of the assessments that I was like, that's interesting and cool. So what can docs expect with reporting when they're going through their range of motion?

So you know, for the range of motion in particular, you, you have the primary planes of motion, so rotation, flexion, extension, lateral flexion. But what you also have is you have the results compared to norms. So we have a normative database. So you actually can compare your patient results to what healthy looks like in green, yellow, red, not to overcomplicate things again. So the patient also stands, hey, is this good or bad? And for the clinician, however, we also have additional data because we have a three dimensional device. Then we pick up compensatory movement. And that's another thing that I think is a new to a lot of people to be able to objectively see. Is the patient compensating? They're doing lateral flexion, but they're actually rotating even more than they're laterally flexing. So to have that data right in front of you within, you know, a minute, that's proven very valuable.

That was super cool. And one of the other things that you showcased and highlighted to me with some of the visual tracking and I'll make an assumption, but you can correct me if I'm wrong, that this has to do with. It can be probably due to any injury, but specifically with concussion, motor vehicle accident, et cetera. Talk a little bit about how visual tracking plays a role with the range of motion device and how that comes together with reporting.

Great question. Yeah, we've mainly talked about the range of motion so far. However, the battery of tests is larger than that. So we have specific proprioception and People using the joint position error test often today with a laser. Well, no need for that. And then also from a tracking perspective for that movement control, that neuromuscular control in the neck. So over the last 20 years, we've been inventing a proprietary test called the butterfly test. So there's a dot on the screen traveling in an unpredictable manner. The patient is supposed to try to follow that. Like you said, the MBA cases, the concussion, any patients with dizziness or balance issues, it's very, very important to first and foremost assess, but also exercise that neuromuscular control. So that sensory motor integration is key. And we're able to objectively see how that actually is, not only to document the baseline for that individual, but also track the progress as the treatment goes on.

One thing I want to highlight for everybody listening and watching is this all took place with the single device, right? Which was really impressive because it wasn't.

Like, oh, if you want to do.

That, you have to have these 10 other things. And now it becomes cumbersome. It really was really clean and easy to understand. And I know that simplicity typically lives on the back of complexity, as we say, and that you guys have really done a lot in terms of research and even going to your website, you, one of the few products companies that I've ever come across that really have listings of publications, etcetera, on your website, highlighting who you are, what you do, and substantiating a lot of the technology advancements that you've made over time. Talk about how research. It sounds like it was a fundamental part of the founding of the product and software many, many years ago. But tell me a little bit about how has research played such an important role? Is it a legacy item? Is it something you lean in towards the future? How does research play a role with Net Care?

Yeah, I mean, it's definitely where we come from. If you think about it Today, it's taken 20 years to bring this product to market. If anyone told me today that, hey, 20 years from now you'll launch a product, I'd probably say, no, thanks, I'm good. Obviously, I joined the company here a couple of years ago to commercialize a product that has been research, but it remains an integral part of who we are. And just today we're working with both Harvard University, University of Miami, and other renowned universities in the U.S. they're using our product in their research efforts. So we definitely. Everything we do is based on research, and it's important to us. It's, you know, the core value of who we are and something that you know from our reliability and validity, we will definitely not discount anything on that. So we are, we're committed to further research in the area as well.

Let's talk a little bit about billing with netcare. Does this fall under existing classification? Do you have some docs doing cash, some insurance? How do you see this playing out? I know you're the service provider and the docs can do what they want, you know, as far as implementing in their practice. But I guess I'll maybe ask the question a slightly different manner. How have you seen some of some docs successfully implement Net Care from a revenue perspective in their practice? What are the most common approaches that you've seen?

Yeah, I mean and like, you know, both some providers are more heavily cash, others are insurance for the cash ones. We've seen people billing specifically for an advanced NAC assessment, either upcharging their initial one or providing it as an additional service for the insurance billing. Existing codes such as the 97750 which is a fiscal performance test with a written report has been a typical code to use and is being reimbursed by to my knowledge most insurance providers. And then also from an exercise perspective, both neuromuscular re education, 97112 is a code that we typically hear and then 97110 as well. So yep, people are getting paid for it either with their cash practices or from, from an insurance perspective.

Got it. And let's dive a little bit deeper into what you just mentioned with some of the therapeutic exercise. Is this something where you find most docs are doing a baseline, treating and doing care and then doing a follow up or are some patients actually wearing this as they're going through as if you know, the diagnostic component is the therapeutic component. How do you see that play out? I know there's probably some variation there, but I'd love to love to dive deeper on it.

Yeah, I mean definitely variation but everyone does the initial assessment if it's in the first or second visit. Depends. But what we've seen some of the most successful adopters actually like doing their, their manual therapy, their adjustments, but then after that, hey, let's go to an accurate system and do some exercises actually being able to provide better care and more comprehensive care to the patient. So and that way also creating additional revenue. So that's, that's been a very successful adoption for, for many chiropractic clinics.

Love that with docs that are looking towards Net care as a solution. You know I kind of said to you and the practice that I own, we do a lot of visual assessment, which I'm not going to recommend to everybody listening out there. You know, the specificity of what you can provide and the elegance of what you provide is just, you know, so head and shoulders above the other tools and resources. And quite frankly, the reason we've done visual is because I haven't been impressed by very many things I've seen until. Until we chatted. So when you look at this being implemented in a practice, do you find that many practices are upgrading existing, I'll say, old fashioned technology with neck care? Is this something where many practices that might be less specific in terms of their assessments, like myself, have brought this in, or is it a combination of both?

Yeah, I think it's a combination of both, Jeff. I think the good old eyeball test is still in much, very, very much out there. And I think, you know, the MBA clinics or the concussion clinics, some are using a dual inclinometry or a digital goniometer. But there always seem to be some issues with that. It's a learning curve to use it. I do it, you do it. We don't get the same measurements, all of that. The reporting is not there. So I think we've seen adoption from both worlds, really. And one of the things that we hear quite a lot is that anyone can really perform the assessment if it's a chiropractic assistant or even front desk, because the technology really does take care of all of that for you.

And when we look at range of motion, proprioception, movement control, all of these things can be objectively analyzed under the Net Care platform. Are you able to pick and choose? Do you have to go through every exam every time on every patient, or am I able to choose the best examination based upon the patient presentation and their goals?

Absolutely, yeah. You can choose to do one or all. You don't have to run the whole battery. If you run the whole battery, it takes about 12 minutes, but you can also spend a minute and a half just on doing range of motion if that's what you want.

Love that. So what are some of the exciting things on the horizon in the Net Care ecosystem? I know you have you mentioned some partnerships with some universities. That sounds awesome. You're continuing on the research and software development side. I'll ask you to peel open the box a little bit here. What's exciting on the horizon in your ecosystem?

There's a lot of interest in the market and you opened it up with Instagram. Honestly, like two months ago, we didn't even have an Instagram page. So we've seen such a great interest there. We are now in partnership with the Kirak Institute, so probably some, some functional neurologists on the listening as well, doing a lot of those concussion and cases. So we're partners with them. We're looking to partner with even more professionals and organizations like that. We're also now partners with Anuka, so upper cervical. We've seen a great interest there. And then as from a development perspective, we are continuously working on adding more assessments, more exercises to the PLAT platform and really listening to our customers is our most important thing to stay relevant and stay ahead of the curve.

That's fantastic. And I feel remiss if I didn't say we're talking from around the world right now. So you connected with me and some people might notice, some of you might say I have an accent. But so where are you tuning in from? I'd love to just touch on that briefly.

Yeah, I'm Icelandic so I am tuning in from Reykjavik, Iceland.

I love that. So you have a presence here. I know you spend a significant amount of time in the United States. So I love, I love the worldwide approach. For those docs listening and watching that would love to learn more. They want to understand how can I bring the Net care system into my practice. What's the best and easiest way for them to learn more and to connect with your team?

I mean, go to nicare.com, reach out to us there. You can even go ahead and buy the device and the software there. But if you want to know, you know, get a personalized walkthrough, definitely reach out and we'll set that up in a heartbeat. And definitely, you know, loving the whole chiropractic community. We sell to the different healthcare professionals. But real nice, looking forward to speaking to a lot more of chiropractic professionals.

Love that. So it is neck hair dot com. I'm going to drop that link down below and I'm going to encourage everybody. It's not too often that I come across a technology that is really just, you know, gets my attention. So I'm going to encourage you if you have been doing range of motion in your practice, proprioception, movement analysis, or you haven't and you know, you should, now is the right time to click on down below. Head over. I think you'll be super impressed with the website. You'll be super impressed with what they, what you see there. You'll also be able to access some of the research that orey and his team have been deeply involved in as well as some of their partnerships. He touched on a few of them, but as you scroll across that website, you're going to see many, many more which are incredibly impressive and a testament to the dedication of making an awesome product and service. So Orey, thank you so much for coming on and chatting with us today.

Absolutely, my pleasure Jeff, and really look forward to staying in touch and help treat those necks.

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