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A Next Step For Personalized Medicine? Vendor Brings Genomics To Ambulatory EHR

Posted on October 8, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Most physicians have some sense of the value personalized medicine can bring to their practice, but I doubt that many have ready access to the tools they’d need to harness its power.

In an effort to close that gap – and of course, to make its platform irreplaceable – a vendor serving medical practices has struck a deal giving physicians the ability to order genetic tests and leverage them to improve care.

The vendor, DrChrono, offers a suite of electronic systems for physicians, including an EHR which can be customized by bundling in affiliated apps. Its new partner is Genomind, a personalized medicine platform offering genetic testing for psychiatry practices.

Physicians using DrChrono will have access to two Genomind test kits, along with some analytics tools they can use to make use of the testing data.

One of the tests is Mindful DNA Professional, a genetic test used by clinicians to help them guide wellness decisions. The test targets aspects of a patient’s genetic details which could have an impact on overall health, such as variants suggesting that they could have sleep issues or a predisposition to anxiety, depression or impaired cognition.

DrChrono users will also have access to the Genecept Assay, the results of which can guide the treatment of psychiatric conditions. Once test results become available on the Genomind system, doctors can use its gene-drug-environmental interaction tool, the Genomind Drug Interaction Guide, to inform their treatment decisions. With the help of the Guide, clinicians can analyze the patient’s current medication regimen and flag gene-drug interactions.

An interesting side note to all of this is that the final test results from Genomind will be stored in the DrChrono information library for the patient and become part of the patient’s medical record.

Looked at one way, sharing the Genomind test results seems almost like a no-brainer in a world where casual genetic testing (think 23andMe) is becoming the norm. On the other, though, I don’t want to gloss over the fact that using genetic data to search for relatives is one thing and putting it into your personal medical record is quite another. It suggests that of consumer-driven demand for precision treatment is maturing, and that Genomind is on the right side of this trend.

This takes me back to DrChrono, which while not itself reinventing the wheel has struck a smart deal here. Not only has it brought a tool on board which could offer some benefit to physicians, its supporting the collection of information (genetic data) that patients are beginning to want. If DrChrono can give patients their genetic info via a decent portal, the company may find itself to be in demand with patients. Way to stay abreast of the times.

DrChrono App Store Illustrates Important Point

Posted on July 16, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

In a recent post, my colleague John Lynn argued that EHRs won’t survive if they stick to a centralized model.  He contends — I think correctly — that ambulatory practices will need to plug best-of-class apps into their EHR system rather than accepting whatever their vendor has available. If they don’t create a flexible infrastructure, they’ll be forced to switch systems when they hit the wall with their current EHR, he writes.

Demonstrating that John, as usual, has read the writing on the wall correctly, I present you with the following. I think it illustrates John’s point exactly. I’m pointing to EHR vendor DrChrono, which just announced that billing and collections company Collectly would be available for use.

Like its peers, Collectly built on the DrChrono API, and will be available in the DrChrono App Directory on a subscription basis. (The billing company also offers custom pricing for large organizations.)

Other apps featured in the app directory include Calibrater Health, which offers text-based patient surveys; Staple Health, a machine learning platform that providers can use to manage at-risk patients and Genius Video, which sends personalized video via text message to educate patients. Payment services vendor Square is also a featured partner.

Collectly, for its part, digitizes paper bills and sends billing statements and collection notices to patients via text or email. The patient messages include a link to the patient portal which offers a billing FAQ, benefits and insurance info and a live chat feature where experts offer info on patient insurance features and payment policy. The live chat staffers can also help patients create an approved payment schedule on behalf of a practice.

While some of the DrChrono apps offer help with well-understood back-office issues – such as Health eFilings, which help practices submit accurate MIPS data –  those functions may be duplicated or at least partially available elsewhere. However, apps like Collectly offer options that EHRs and practice management platforms seldom do. The number of best of breed apps that an EHR won’t be able to replicate natively is going to continue to increase.

Integrating consumer-facing apps like this acknowledges that neither medical practice technology nor its staff is terribly well-equipped to bring in the cash from patients. It may take outside apps like Collectly, which functions like an RCM tool but talks like a patient, to bring in more patient payments in for DrChrono’s customers. In other words, it took a decentralized model to get this done. John called it.

Ways To Minimize Physicians’ Administrative Burdens

Posted on January 24, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

It’s hardly a secret that physicians are buckling under the weight of their administrative responsibilities. The question is, how do we lessen the load? A new article published on a site backed by technology vendor CDW offers some creative ways for doing so.

One suggestion the article makes is to have patients write and add notes to their personal medical charts.According to the piece, doctors at UCLA Health and Beth Israel Deaconess Medical Center will pilot “OurNotes,” a tool allowing patients to input medical data, in 2018. Patients will use the new tool to add information such as symptoms, emerging health issues and even goals for future visits. OurNotes is an outgrowth of the OpenNotes project, an initiative that encourages clinicians to share their notes with patients.

Will the OurNotes effort actually make things easier for physicians? Dr. John Mafi, assistant professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA, believes it can.

“If executed thoughtfully, OurNotes has the potential to reduce documentation demands on clinicians, while having both the patient and clinician focusing on what’s most important to the patient,” Dr. Mafi said in a statement about a research project on the OpenNotes approach. (Mafi was the lead author of a paper on the project’s results.)

Another option is using “remote scribe” services via Google Glass. Yes, you heard me right, Google Glass. Google is relaunching its smart glasses and it’s retooled its approach to serving the healthcare industry. The number of applications for Glass has crept up gradually as well, including an EMR accessible using the smart glasses from vendor DrChrono. DrChrono calls it the “wearable health record,” which is pretty nifty.

San Francisco-based clinical practice Dignity Health has been working with Google Glass startup Augmedix to access offsite scribes. Dignity Health vice president and CMIO Davin Lundquist told MobiHealthNews that after three years of using Glass this way, he’s cut down on time spent administrative tasks from 30% per day to 10% per day. Pretty impressive.

Yet another way for healthcare organizations to reduce adminsitrative overhead is, as always, making sure their EMR is properly configured and supports physician workflow. Of course, duh, but worth mentioning anyway for good measure.

As the CDW piece notes, one way to reduce the administrative time for physicians is to make sure EMRs are integrated with other systems effectively. Again, duh. But it never hurts to bear in mind that making it easy for physicians to search for information is critical. There’s no excuse for making physicians hunt for test results or patient histories, particularly in a crisis.

Of course, these approaches are just a beginning. As interesting as, say, the use of Google Glass is, it doesn’t seem like a mature technology at this point. OurNotes is at the pilot stage. And as we all know, optimizing EMRs for physician use is an endless task with no clear stopping point. I guess it’s still on us to come up with more options.

Mobile EHR Use

Posted on November 14, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

One of the most fascinating sessions I attended recently was by Mihai Fonoage talking about the “Future of Mobile” at EMA Nation (Modernizing Medicine’s EHR user conference where I was keynote). At the start of the presentation, Mihai provided a bunch of really interesting data points about the EMA EHR use on mobiles:

  • 3,500,000 Screens Viewed Daily
  • 50,000 New Visits Each Day
  • 35,000 Photos Taken Daily
  • 12,000 New Consents Each Day
  • 8,000 Rx Prescribed Daily

The most shocking number there is the 35,000 photos taken daily. That’s a lot of photos being stored in the EHR. It is worth noting that Modernizing Medicine has a huge footprint in dermatology where photos are very common and useful. Even so, that’s a lot of photos being taken and inputted into an EHR.

The other stats are nearly as astounding when you think that Modernizing Medicine is only in a small set of specialities. 3.5 million screens (similar to pageviews on a website) viewed daily is a lot of mobile EHR use. In fact, I asked Modernizing Medicine what percentage of their users used their desktop client and what percentage used their iPad interface. Modernizing Medicine estimated that 80% of their EHR use is on iPads. This is a hard number to verify, but I can’t tell you the number of people at EMA Nation I saw pull out their iPads and log into their EMA EHR during the user conference. You could tell that the EMA iPad app was their native screen.

I still remember when I first saw the ClearPractice iPad EHR called Nimble in 2010. It was the first time I’d seen someone really make a deep effort to do an EHR on the iPad. DrChrono has always made a big iPad EHR effort as well. I’d love to see how their iPad EHR use compares to the Modernizing Medicine EMA EHR numbers above. Can any other EHR vendor get even close to 80% EHR use on an iPad application or any of the numbers above?

I’d love to hear what you’re seeing and experiencing with EHR iPad and other mobile EHR use. Is Modernizing Medicine leading the pack here or are their other EHR competitors that are seeing similar adoption patterns with their mobile EHR product lines?

Full Disclosure: Modernizing Medicine is an advertiser on this site.

Another EHR Glass Implementation

Posted on July 18, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

HealthTech has a really terrible write up of the latest EHR vendor to put out a Google Glass EHR implementation. The iPatientCare EHR application is called miGlass. However, the article states that it’s the first wearable EHR App for glass, but we’ve already written about one from DrChrono and Kareo’s Google Glass implementation was probably the first one that I saw. Plus, there are a number of hospital based EHR implementations that have happened as well. Maybe iPatientCare was the first and they just didn’t get any coverage until now.

Timing aside, the article lists the technology available on this new Google Glass EHR application, miGlass:

  • Web browser based EHR and PM System
  • Microsoft .net Technology
  • Services Oriented Architecture
  • HL7 CCD and ASTM CCR for Interoperability
  • HL7 Integration with leading Lab
  • Information Systems
  • SureScripts/RxHUB Certified ePrescribing
  • Reporting & Analytics using Cognos and Business Objects
  • Available on iPhone and iPad

Maybe the article just made a mistake (I make them all the time as you know), but that list seems like a list of EHR technology and not Google Glass application functionality. iPatientCare also has a video that’s not even worth linking to since it doesn’t say anything about what the Google Glass application really does.

While I love to see EHR vendors experimenting and testing the integration of Google Glass into their EHR, I still haven’t seen the killer use case in action. Although, there are a few hospital EHR Google Glass implementations that I’d like to see in action. I do love the potential of Google Glass. There’s something beautiful about an always on, always connected application that’s sitting there waiting for you when it’s needed. Plus, as the camera recognition technology gets better, the workflow will get better as well.

Imagine walking into an exam room and as you do it, your Google Glass scans a QR code on the door and pulls up the patient waiting for you in the room. Hopefully that’s the naive and simplistic view of where the technology is going to be taken. As more EHR vendors tinker with the technology it will be really interesting to see what becomes a reality.

drChrono EHR Featured on Apple’s iPad Website

Posted on August 6, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Carl Bergman recently sent me a link to a video on the Apple iPad website that profiles an urgent care center in St. Louis using the DrChrono EHR software. Here’s the intro about the urgent care facility using the iPad:

iPad makes the rounds with physicians.
Trained to handle any medical condition that comes in the door, emergency room physician Dr. Sonny Saggar treats everything from life-threatening issues to small cuts that need a few stitches. Dr. Saggar is also the medical director at Downtown Urgent Care in St. Louis, MO — and its sister location, Eureka Urgent Care in West St. Louis County. He and his staff rely on iPad to help them deliver efficient, high-quality health care. “We can often get patients precisely the care they need in less than 20 minutes,” he says.

I think it’s brave for any doctor to put a time on how long it takes to give care. Does DrChrono have a module that tells you average patient times. Did Dr. Saggar get those times from the EHR? Plus, he says that they often can which I guess could mean that they often can not? Of course, the above copy was probably written by some intern at Apple.

The page also offers these benefits to using an iPad EHR:
-Health records go paperless
-Better communication at the point of care
-Smooth operation
-More personalized care

Are these the benefits you see of using an EHR with the iPad?

We’ve written a lot about ipad EMR software on EMR and EHR. In fact, we were writing about the iPad together with EMR well before the iPad even was officially released. While doctors love the iPad, I’m still not seeing very many doctors use the iPad for their daily documentation needs. The challenge has and still is that the iPad is a great consumption device, but has yet to be a great documentation tool. I’ll be interested to see if someone will be able to crack that second nut.

DrChrono EMR Raises $2.8 million and Has 15,000 Registered Providers

Posted on January 30, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

A few days ago the news came out that Y Combinator startup company DrChrono has raised another $2.8 million in funding. Here’s the summary from Techcrunch:

Drchrono, a startup that simplifies the professional lives of doctors by bringing electronic health records and much more to the iPad, has raised $2.8 million in funding led by Yuri Milner, with Google’s Matt Cutts and other investors participating. The startup had previously raised $1.3 million in seed funding from Milner, General Catalyst, Charles River Ventures, 500 Startups, Gmail creator and FriendFeed cofounder Paul Buchheit, Cutts, and the Start Fund.

It’s an interesting mix of people that are funding DrChrono. Matt Cutts interests me a bunch since he works on the search engine team at Google in charge of Spam. Obviously, this is a quite different space.

The most interesting information in the Techcrunch article is the number of providers and patients that DrChrono has in its system.

The company also announced it now has more than 15,000 registered providers, and more than 400,000 patients using the drchrono platform.

Of course, we know how EMR companies are with these numbers. It’s one thing to have a registered provider and it’s quite another to have them actually using the EHR software. Also, I can’t help but wonder if the 400,000 patients includes imports of a physicians past patients. I’d love to hear some real numbers. For example, how many daily active users (doctors) do they have using their iPad EHR?

I also find it interesting that DrChrono has only taken $4.1 million in funding versus funding like CareCloud’s $27.3 million and Practice Fusion’s $38 million. Seems like DrChrono has chosen the much more conservative EHR software route as opposed to the more ambitious healthcare platform route that the others are working on.

OnPatient iPad Patient Check-in From DrChrono

Posted on August 25, 2011 I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

Can you believe it that Steve Jobs is stepping down?!  Thank goodness he will still be chairman of the board, but it does cause some concern for the future of Apple.  Apparently, their after hours stock plummeted by $18 billion after the announcement was made yesterday.

However, the iPad mania is still burning brilliantly, and we now have a wonderful new techie toy to add the the EMR arsenal, OnPatient by DrChrono.  Why add the patient registration information into your system off of paper when you can have the patient do it themselves?!  Suddenly, I’m thinking every web-based, SaaS-based EMR should have this feature!

Dr. West is an endocrinologist in private practice in Washington, DC.  He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.

GE Healthcare Throws iPad into Mobile EMR Mix

Posted on August 24, 2011 I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

iPads are getting a lot of hype in the EMR and EHR press lately, so Apple is sure to benefit financially from the EMR, EHR-rush.  Entrez vous GE’s Centricity Advance-Mobile!  Apparently, DrChrono is being joined in offering an native iPad EMR app by GE, and I believe GE’s system is also certified.  The app can be previewed here and extends GE’s certified EMR, Centricity Advance, to a mobile application.  Gotta love the iPad mania!

Dr. West is an endocrinologist in private practice in Washington, DC.  He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.

 

 

 

First iPad EMR app eligible for meaningful use

Posted on August 1, 2011 I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

I read an interesting story on Sunday night regarding DrChrono, the first EMR to make use of iPad app technology to carry it. How powerful to have an EMR in tablet based form, indeed.  But is this the first tablet to be able to run an EMR in portable/mobile form?  I wouldn’t think so. But how many people out there crave the ability to carry around a tablet — with the style of an iPad — that they can integrate with the rest of their lives when they leave the office?  I’d wager it’s a lot.

The only problem I have with the announcement post about the DrChrono EMR app is that it claims that Drchrono is “the only app of its kind to receive such [meaningful use] certification so far.”  Interestingly, there is a much older announcement allowing Practice Fusion users — of which I am a member — to use their web-based EMR on an iPad via a Logmein app.  I haven’t done this yet, although I use PF on my MacBook Air at home all the time.  One key difference between Practice Fusion and DrChrono is the cost.  With PF, there is no data limit to this free EMR.  However, for DrChrono, the free version will only support up to 10 GB of stored patient data, beyond which there is a charge per provider which can be up to $799/month, depending on the amount of data to be stored.  Nevertheless, it’s certainly a welcome sign of the times that an app, in and of itself, is now meaningful use-certified.

Dr. West is an endocrinologist in private practice in Washington, DC.  He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.