Part 3 of 9: Invisible: How Technology and Interoperability Influence Chiropractic and Physical Therapy Positioning in Healthcare

Healthcare today is built on technology—and technology now drives everything from patient access to administrative efficiency to market influence. Once a locally-driven profession, healthcare has evolved into a large-scale enterprise controlled by national payers and multi-state health systems. Technology has made this possible.

In this new environment, interoperability between Electronic Health Records (EHRs), Health Information Exchanges (HIEs), and payer systems is the backbone of modern care delivery. Practices using interoperable technology gain critical advantages: more referrals, reduced administrative burden, better alignment with payers, contracting leverage, and visibility within healthcare’s decision-making infrastructure.

Practices that remain disconnected pay the price—fewer referrals, isolation from health system partnerships, administrative inefficiencies, and loss of influence.

Unfortunately, chiropractic and physical therapy have been largely excluded from these pathways. Most chiropractic and physical therapy EHRs do not participate in HIEs or offer open APIs, leaving providers invisible to referral networks and excluded from the population health data registries that increasingly shape payer programs, care initiatives, and policy decisions.

Key Findings of Arete Analysis

• The most commonly used chiropractic and physical therapy EHRs do not participate in Health Information Exchanges (HIEs) or provide open APIs supportive of middleware vendors

• Chiropractors (and less so physical therapists) have been excluded from EHR directories within medical systems, making referrals nearly impossible in today’s technology-driven environment. This exclusion is not due to ill intent, but rather the lack of a centralized provider registry, which is often supported by industry EHR vendors

• Automated feedback loops—common in EHR platforms like Epic, Athena, and NextGen—that inform referring providers of patient outcomes are absent for chiropractic care and physical therapy.

• Chiropractic and physical therapy data is largely missing from population health registries that inform payer contracts, care coordination models, and health system initiatives—further reinforcing invisibility.

Why It Matters

Referrals, care coordination, and payer partnerships increasingly depend on seamless data exchange. Clinics using modern, interoperable EHRs benefit from:

·       Automated referrals from medical providers and health systems

·       Real-time outcome reporting to referring partners

·       Direct integration with payer systems, reducing administrative burden

·       Participation in population health data registries that shape care models and payment structures

Chiropractic’s and physical therapy’s absence from these systems limits access to referrals, perpetuates fragmentation, and prevents the profession from influencing healthcare delivery at scale.

The Path Forward

To break this cycle of invisibility, chiropractic and physical therapy must modernize its technology infrastructure by:

• Embracing interoperable EHR platforms capable of connecting with HIEs and health systems

• Participating in directories that enable referrals from mainstream medical providers

• Establishing automated feedback loops to improve care continuity and demonstrate value

• Contributing to population health registries to shape payer programs and healthcare policy

Without these steps, chiropractic and physical therapy will remain isolated and undervalued—despite the proven outcomes the profession delivers.

Conclusion

In today’s healthcare landscape, technology determines access, influence, and opportunity. Interoperability is no longer optional; it is the gateway to referrals, partnerships, payer alignment, and visibility within the broader system.

For chiropractic and physical therapy to thrive, invisibility is no longer an option. It’s time to close the technology gap and secure the profession’s rightful place in modern healthcare.