Vermont Naturopathic Physician Continuing Education

• Summarize the United Nations (UN) Decade of Healthy Aging and its initiatives
• Describe challenges specific to conducting clinical research on older patients
• Examine epidemiological trends and opportunities related to an aging population
• Define agism and elderspeak
• Explore relevant concepts of, and goals for, healthy aging
• Outline relevant clinical considerations for aging patients in a chiropractic practice
• Specify red flags in older patients that would warrant clinical referral
• Assess general function in elderly patients using simple clinical tests
• Examine our unique clinical opportunities (and challenges) relating to providing chiropractic care for older patients
• Recognize the clinical impact of multi-site pain in elderly patients
• Cite existing data on chiropractic care patterns for older patients
• Summarize and critique the existing body of research on chiropractic care for spinal conditions in older patients
• Explore the relationship between hip and spine function in elderly patients
• Integrate existing literature pertaining to the patient experience and understand what matters to them
• Summarize best practices for providing chiropractic care for older patients
• Discuss the rational use of imaging in chiropractic practice
• Define osteoarthritis and review the societal impact of this condition
• Identify risk factors for the development of osteoarthritis
• Outline our current state of knowledge on the pathophysiology and diagnosis of osteoarthritis
• Appraise the state of the evidence regarding general treatment recommendations for osteoarthritis
• Explore the scientific literature regarding various treatment modalities for osteoarthritis
• Recognize the value of exercise for managing osteoarthritis
• Critique the literature regarding common medical interventions for osteoarthritis
• Define lumbar spinal stenosis and review the societal impact of this condition
• Classify pathognomonic signs and symptoms of lumbar spinal stenosis
• Differentiate lumbar spinal stenosis from other clinical conditions
• Breakdown the evolving evidence relating to the management of lumbar spinal stenosis
• Discover the important role chiropractic can play in the treatment of lumbar spinal stenosis
• Outline our current state of knowledge on the pathophysiology and diagnosis of degenerative cervical (spondylotic) myelopathy
• Recognize the importance of identifying this pathology in aging patients to facilitate appropriate care

• Discuss ethical standards of insurance reporting and coding
• Illustrate how documentation can affect state board complaints
• Discuss why insurance companies file complaints against chiropractors
• Discuss why patients file board complaints against chiropractors
• Define the Problem Oriented Medical Record (POMR)
• Illustrate taking a thorough history using the OPQRST method
• Discuss the components of the ortho/neuro exam

Hours 1 - 3

• Discuss ethical standards of insurance reporting and coding
• Illustrate how documentation can affect state board complaints
• Discuss why insurance companies file complaints against chiropractors
• Discuss why patients file board complaints against chiropractors
• Define the Problem Oriented Medical Record (POMR)
• Illustrate taking a thorough history using the OPQRST method
• Discuss the components of the ortho/neuro exam

• Discuss the misrepresentation of certain orthopedic tests
• Illustrate sensitivity and specificity of orthopedic tests
• Define the 2021 changes to Evaluation and Management codes
• Discuss the differences between using time vs. medical decision making for E/M
• Distinguish between subjective and objective outcome assessments Illustrate methods of proving medical necessity
• Illustrate the CMS requirements of chiropractic documentation
• Illustrate condition-specific functional outcome questionnaires
• Define the A of P.A.R.T. from Centers for Medicare/Medicaid Services
• Define the R of P.A.R.T. from Centers for Medicare/Medicaid Services
• Illustrate the different methods of evaluating spinal range of motion
• Define the T of P.A.R.T. from Centers for Medicare/Medicaid Services
• Describe the timing of the first re-assessment
• Demonstrate proper coding for range of motion measurements
• Describe the P.A.R.T. format of documentation
• Define the P of P.A.R.T. from Centers for Medicare/Medicaid Services
• Describe the concept of outcome assessments in clinical practice

• Illustrate different outcome assessments for the T of P.A.R.T
• Demonstrate the POMR and P.A.R.T. formats for the initial patient encounter
• Integrate the POMR and P.A.R.T. formats for subsequent patient encounters
• Discuss proper diagnosing in notes and on a claim form
• Define the short, moderate and long-term diagnoses for Medicare
• Define proper Assessments
• Illustrate how to determine an assessment for each condition
• Illustrate complicating factors that can be documented for each condition

• Illustrate the two types of Plan
• Discuss common therapeutic modalities
• Demonstrate proper documentation for time-based codes
• Illustrate how to document measurable treatment goals
• Describe the red flags of a record review
• Demonstrate the determination of causation for a motor vehicle collision
• Discuss the different mechanisms of injury for motor vehicle collisions
• Discuss some of the key value drivers of Colossus
• Discuss the difference between impairment and disability
• Illustrate the determination of the end of justifiable treatment
• Define the main components of an impairment evaluation
• Illustrate Duties Under Duress and Loss of Enjoyment
• Illustrate the important diagnoses for personal injury cases
• Define the 5 Colossus prognoses
• Demonstrate the 5 grades of injury severity for the Croft Guidelines for the Treatment of CAD Injuries

• Prepare to manage and document protocols, for litigation protection, in a crisis, such as Covid.
• Discover how to avoid a HIPAA investigation and becoming a ‘HIPAA statistic’, often by surprise.
• Operate an office with protocols to avoid ransom ware and other Cyber-attacks.
• Complete a HIPAA program to be prepared for document production, demanded by the government, when a complaint (or even a simple inquiry) is made by a patient, peer, or ex-employee.

• This contains all courses with the educational objectives listed in Government HIPAA and Cybersecurity Compliance 201 - 208

• Prepare for the required OIG compliance program, required for all who treat one of more Medicare patients per year.
• Aid in understanding and preparing required written documented policies under the HIPAA law.
• Identify what thieves do with stolen patient information.
• Discover what is included in a comprehensive table of contents for a HIPAA compliance program.
• Describe the type and number of complaints against doctors and their often surprise origins
• Use of required accounting logs

• Classifying what you say and when, when notified of an investigation or audit, to avoid saying the wrong thing and complicating your case.
• Examine what every office must do, regarding the ONC law, to deliver patient records electronically if so requested, even if you don’t have computers.
• Show a step-by-step approach to responding to the government in the event of a breach, investigation, or audit.
• Solve the puzzle as to avoiding audits and compliance investigations.

• Explain tele-health pros and cons.
• Categorize the risks that lead to being turned in for violations, often not knowing you were doing anything wrong.
• Point out the most common HIPAA scams that involve impersonating a federal official.
• Examine the parts of the HIPAA law that enforcers are enforcing and those parts they are not enforcing.

• Discover how to conduct the required ISAR (information system activity review) that leads to maximum fines if not completed.
• Aid you and/or your staff in conducting the required risk analysis that leads to maximum fines, if not completed.
• Prepare an electronic device maintenance schedule to protect yourself relative to data breaches.
• Examine how to reduce your exposure to HIPAA fines.

• Discover illegal fee structures and the legal options that do exist.
• Prepare the four requirements relative to the notice of patient privacy policy.
• Generate a legally required BAA process for every individual or company with whom you share or provide access to your patient data.
• Discuss the requirements for data recover and emergency mode operations under HIPAA.

• Prepare a protocol for creating required policies under HIPAA.
• Assess the risks of seeing Medicare patients with inadequate use of the ABN form.
• Operate proper procedures to appropriately use the ABN form in a Medicare practice.
• Summarize the Ohio workers’ compensation requirements that elevate chiropractic and put restrictions upon spinal surgeons.

• Generate proper staff training to meet HIPAA requirements.
• Examine the pitfalls around a physical plant audit and what you must do to avoid them.
• Completing a required disciplinary policy that will pass an investigation.
• Classify the little-known training requirements above and beyond the ‘annual HIPAA training’.

• Identify ePHI assets within the clinic and assess exposure to threats and vulnerabilities
• Understand how to create an action plan and implement Security Safeguards
• Recognize the components of the Risk Assessment that must be considered when developing policies and procedures

• Manage Risk Assignments and assign Target Dates to comply with federal requirements
• Audit Risk Factors that may be present
• Manage Security Events that may come up during the course of everyday workflow
• Set up Workforce Security Standards to be complied with by all team members
• Ongoingly Monitor Security Safeguards to ensure the integrity of your data and minimize risk

• Recognize PHI Identifiers- Know what you are looking for
• Identify important components of the Notice of Privacy Practices and how it puts the patient in the driver seat
• Execute, track and audit Business Associate Agreements
• Apply the rules of Patient Authorizations regarding when TPO applies

• Summarize some of the key components of HIPAA Privacy Rule.
• Breakdown what a compliant Notice of Privacy Practice should look like.
• Summarize HIPAA Use & Disclosure- the often-overlooked portion of Notice of Privacy Practice
• Demonstrate how to respond to a patient’s request for a copy of their medical record.
• Determine how to avoid a Right of Access violation.

• Recognize acute situations for which homeopathic remedies are appropriate and effective
• Apply limited homeopathic remedies to acute care situations that arise in practice and day- to-day life
• Evaluate methods of application of homeopathic remedies to fit the situation at hand
• Distinguish between the available homeopathic remedies for a specific situation in order to select the most appropriate remedy for the individual
• Use homeopathic remedies in concert with existing therapeutic training

Hour 1

• List 3 factors which impact the mechanical properties of fascia
• Recall 3 important functions of fascia
• Cite 3 negative biological effects of fibrosis
• Describe 3 proposed neurophysiological effects of IASTM
• Itemize three biological effects of IASTM

Hour 2

• Cite 8 indications for using IASTM for upper/lower quarter musculoskeletal conditions
• Provide 8 indications for using IASTM for upper/lower quarter musculoskeletal conditions
• Enumerate 8 indications for using IASTM for upper/lower quarter musculoskeletal conditions
• when using IASTM for musculoskeletal disorders.
• List 2 features of IASTM tools and the effect that these features have on the treatment effect (tissue penetration)
• Summarize 5 IASTM basic stroke techniques
• Apply IASTM techniques for over 30 common upper quarter musculoskeletal conditions

Hour 3

• Outline 3 general purposes for using instrument-assisted soft tissue mobilizations (IASTM) for lower quarter musculoskeletal disorders.
• Recall 3 clinical indications for using IASTM to the hip
• State 3 clinical indications for providing IASTM to the lumbar spine
• Present 3 clinical indications for using IASTM for knee-related musculoskeletal disorders
• Itemize 3 clinical conditions of the lower leg and foot for which IASTM would be appropriate

• Acquire additional skill sets in impairment and disability rating
• Develop cognitive interpretive thinking in addressing impairment and disability issues
• Expand the current knowledge base required by the AMA Guides 5th edition

• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to apportionment
• Minimize risks and failure risks when addressing the apportionment issue
• Encourage development and nurturing of skill sets risks when addressing the apportionment issue based on evidence-based literature and science
• Identify action steps for minimizing risks when addressing the apportionment issue

• Identify some of the criteria used by formally trained forensic examiners
• Identify certain practices that lead forensic examiners to question the credibility of reports or "IME providers"
• Develop a level of knowledge, comprehension, and understanding of the criteria used by impairment rating reviewers
• Identify certain practices that lead impairment rating reviewers/auditors to question the credibility of reports or raters
• Encourage development and nurturing of skill sets when formulating an impairment rating based on evidence-based literature, science and AMA Guides 5th edition criteria
• Identify action steps for minimizing risks when submitting an impairment rating report

• Identify some of the criteria used by formally trained forensic examiners
• Identify certain practices that lead forensic examiners to question the credibility of reports or "IME providers"
• Develop a level of knowledge, comprehension, and understanding of the criteria used by impairment rating reviewers
• Identify certain practices that lead impairment rating reviewers/auditors to question the credibility of reports or raters
• Encourage development and nurturing of skill sets when formulating an impairment rating based on evidence-based literature, science and AMA Guides 4th edition criteria
• Identify action steps for minimizing risks when submitting an impairment rating report

• Produce accurate impairment rating reports.
• Identify AMA Guides the criteria for CTS
• Develop a level of knowledge, comprehension, and understanding of the criteria used for rating CTS
• Identify certain practices that lead impairment rating reviewers/auditors to question the credibility of reports or raters
• Identify the commonly occurring errors seen in rating impairment due to CTS.

• Define an IME and identify key concepts
• Comment on ideal qualifications of the examiner
• Discuss IME methodology and procedures
• Suggest a generalized report format and quality assurance
• Discuss the job task analysis (ABFP) for the IME process

• Define the terminology of decontamination, disinfection and sterilization in a clinical setting.
• Explain the basis of universal precautions and its implementation
• Discuss the latest research and evidence for risk of treatment table contamination in chiropractic and manual therapy offices.
• Learn the recommended evidence based disinfection methods of clinician hands, tables and equipment for manual providers.
• Identify the Spaulding Classification System for disinfection and sterilization of patient care items and equipment.

• Recall and integrate the function of the individual endocrine organs and all hormones into the diagnosis and treatment plan
• Identify the causative factors present in the patient that led to a hormonal imbalance
• Discuss Estrogen Dominance and thus educate the patient
• Diagnose Metabolic Syndrome
• Differentiate Adrenal Fatigue from menopause and perimenopause
• Explain lifestyle modifications to the patient
• Prepare for the intricacies of treating the hormonally imbalanced patient