February 2008

ISO Certification makes our buying decisions easier

by Dr. Terry A. Rondberg

There are a million decisions to be made when you're in private practice as a doctor of chiropractic. Where should you set up your office? What type of insurance do you need? Should you go cash practice or take insurance patients?

Sometimes the choices are nearly overwhelming, especially when you're just starting out or when you need to make a major change in your practice, such as buying major new equipment.

When you think about how much time and effort we spend making buying decisions about relatively minor items in our lives ‑‑ a bigger screen television set, a better mattress, or even a new laptop ‑‑ it's amazing how we agonize over office equipment and devices we need to assess the health and needs of our patients. After all, these are the items that can make or break our practice!

We've all heard the typical advice over and over ‑‑ compare features, talk with other doctors, check out the competition, etc. But there's one critical factor I'll bet you've never taken into consideration when making an office equipment purchase: Was the company that manufactured the equipment ISO Certified?

We see references to "ISO Certification" all the time, but usually ignore them the way we do the BBB (Better Business Bureau) or Good Housekeeping Seal of Approval logos. I've recently learned, though, that the ISO Certification is in a league of its own and it's definitely something we should be looking for if we're at all concerned about the reliability and accuracy of measurement in our practice assessment tools.

Have you ever had a piece of equipment that gave two different readings on the same person within minutes? Which reading is accurate? And if we're reduced to having to rely on the "best two out of three" readings, we really can't trust the results or use them as the basis for our care recommendations.

One way to reduce this uncertainty is to make sure all our instrumentation has been produced by an ISO‑Certified manufacturer.

Although most people think the name ISO refers to the "International Organization for Standardization," actually the three‑letter name was adapted from the Greek word isos meaning "equal" (the reasoning being that, if two objects meet the same standard, they're equal). The name ISO eliminates any confusion that could result from the translation of "International Organization for Standardization" into different languages which would lead to different acronyms. This way, ISO is recognized worldwide in the 157 nations ‑‑ from Afghanistan to Zimbabwe ‑‑ that are members.

Why ISO Certification matters

In 1946, delegates from 25 countries met in London and decided to create a new international organization. Its object would be "to facilitate the international coordination and unification of industrial standards." The new organization, ISO, officially began operations on Feb. 23, 1947, in Geneva.

Basically, the ISO develops standards containing technical specifications or other precise criteria to be used to ensure that materials, products, processes and services are fit for their purpose.

Each standard is, as the ISO puts it, "a living agreement that can have a profound influence on things that deserve to be taken seriously ‑‑ such as the safety, reliability and efficiency of machinery and tools, means of transport, toys, medical devices, and so on."

If you surf the net, you're already familiar with one set of ISO codes: top level domain names that indicate the country. If you see an URL ending in dot‑jp, you know it's a Japanese site, dot‑au for Australia, dot‑fr for France, etc. These are all standard ISO codes, agreed upon by all ISO nations.

The same thing goes for international standards for everything from ATM cards to paper sizes. You can thank ISO standards for being able to use the same debit card at ATMs around the world. And, although no one forces paper companies to produce paper that's 8‑1/2" x 11," it's one of the agreed‑upon standard sizes listed by ISO and that standardization means you won't have any problem finding paper to fit your printer.

If standards are important for Internet URLs, bank cards and paper, you can imagine how critical it is with any scientific and health‑care endeavor like chiropractic. If we can't rely on the quality, environmental friendliness, safety, reliability, efficiency and interchangeability of the instrumentation we use in our offices, how can we provide the best possible health care to our patients?

I love the way the ISO puts it: "When standards are absent, we soon notice."

What it means for DCs

For chiropractors, the most critical ISO standards are the ones that promote standards for quality in manufacturing, known as ISO 9001. These standardization guidelines cover business processes, monitoring processes to ensure quality, keeping proper records, checking outgoing products for defects and regularly reviewing processes for effectiveness.

When manufacturers go through the rigorous process of earning ISO Certification, our confidence in their products soars. It means they have successfully undergone a comprehensive assessment and their process and organization meet defined standards of quality.

Teresa Phillips, PhD, an acknowledged expert in biotechnology, says that obtaining ISO Certification results in numerous specific advantages including consistency. "All processes from research and development, to production, to shipping, are defined, outlined and documented, minimizing room for error," she says in an online article for About.com's biotech and biomedical sections. "Even the process of making changes to a process is documented, ensuring that changes are well planned and implemented in the best possible way to maximize efficiency."

After knowing all this about ISO Certification, I can't imagine buying any piece of patient assessment equipment without checking first to see if the manufacturer has been ISO Certified!