Interview / iPad EHR demo video during Health 2.0

At the health 2.0 conference we did a live demo for Essinova.com showing off how an iPad EHR works in a physicians office. Great fun!

Free iPad for doctors! DrChrono co-founders Daniel Kivatinos and Michael Nusimow show off their slick iPad App to me and Essinova audience. By the way, as you can see from their demo, Michael’s narration and Daniel’s fingers were so well-coordinated I wondered if there were wireless signals between their heads too. -BeiBei Song, Essinova Host

Billion Dollar Medical Market for iPad Medical Apps (iPad EHR)

The DrChrono team spoke this week at the Institute for Health Technology Transformation. We focused on how the iPad is going to truly change healthcare. This is a clip of the presentation.

Health IT As a Game Changer

There’s a specialty in medicine where health IT has already revolutionized their practice.  In this specialty, successful, profitable software companies sell generally appreciated products that increase practice revenue and shorten their workdays.  What’s the specialty?  Radiology.

I’ve worked with a couple of PACS (picture archive and communications systems) and RIS (radiology information systems) vendors and people selling associated products and seen their financial.  These guys offer interoperable systems that allow digital radiology systems (x-ray, CT, MRI, etc) installed in hospitals to share the images with radiologists working anywhere.  The radiologists get easy access to systems, all the utilities they need, and reporting templates.  Many of the systems include workflow utilities that push radiologists to finish cases on a schedule, resulting in shorter work days or more revenue.

Contrast this with the typical medical records system.  Research I’ve seen suggest that for first 18 months, most clinicians are less productive with EMRs.  There have been articles published in scientific journals detailing inefficiency, risks, and even increased neonatal mortality with a commercial, off-the-shelf CPOE system.  In two EMR deployments I’ve been involved with, the consensus was that each added an hour a day to the physician’s work.

Why is this?  Most HIT systems are designed around the abnormal situation: preventing errors, streamlining emergency access to data, making medical information available if the patient is hospitalized (or re-admitted).  Many of the docs I work with now resent their hospital’s EMR system.  Some reject it, sticking with paper, others accept it but gain no benefit.  Some physicians accept and even like their EMR, but they gain no workflow or efficiency benefit.  When I ask a doc to tell me how many patients with a specific diagnosis they have, usually they can only give me a count of the primary diagnoses.  And for all the work on interoperability, many find out that one of their patients is hospitalized from the patient’s family — if they find out at all.

There’s a parallel for this that is illustrative.  In the 1980′s American and Japanese automobile manufacturers each experimented with robots.  Americans viewed robots as superior to humans, and designed robots that did incredibly complicated things, but slowly.  Japanese viewed robots as faster than humans, and designed robots that did simple things quickly.  (Really, the difference was that American’s made robots whose motion was so complex that it had to be modeled using quasi-static assumptions, thus slowly, whereas the Japanese planned their robots’ simple motions using full dynamic models.)  By using robots for the routine, hum-drum tasks of automobile manufacture, the Japanese workers were more engaged with high-level, thinking tasks, while their American counterparts found the most interesting tasks were being done, slowly, by robots.

We need to better design our health care systems to optimize the routine parts of healthcare rather than targeting the uncommon risks.  With PACS, we’ve cut everything out of the job of radiologists except doing radiology.  For most EMR users, there’s been no similar benefit.  We need to change this.  Physicians don’t want a system that warns them of every minor (and well-known) potential risk (we’ve all head of “alert fatigue”) but they do want a system that helps them do their high-level work better, faster, or more profitably.

DrChrono.com University: Meeting Meaningful Use 101, Are you an Eligible Professional?

Many doctors can become bewildered by the onslaught of new information coming at them regarding meeting meaningful use criteria. They just want the cash, and they want it to be simple and straightforward and move on with their busy practices. As a doctor myself, I can completely relate. The first step in the process, of course, is to answer the question “Am I an eligible professional?”

The incentives for meaningfully using EHR technology is based on individual providers. This means that if you are part of a practice with more than one provider, each eligible professional (EP) within that practice may qualify for their own individual incentive. Each EP can get only one payment annually, regardless of how many places they work at.

A Medicare EP under the EHR incentive program must be one of the following:

• Doctor of Medicine or Osteopathy
• Doctor of Dental Surgery or Dental Medicine
• Doctor of Podiatric Medicine
• Doctor of Optometry
• Chiropractor

**Of note, Medicare EP’s may not be hospital-based. They are considered hospital-based if 90% or more of their services are performed in the inpatient or ER hospital setting.

The Medicaid EHR incentive program includes one of the following types of practitioners:

• Physicians (Pediatricians have special eligibility and payment rules)
• Nurse Practitioners
• Certified Nurse Midwives
• Dentists
• Physician Assistants who provide services in a Federally Qualified Health Center or rural health clinic that is led by a physician assistant

**Of note, Medicaid EP’s must not be hospital-based. A Medicaid EP is considered to be hospital-based if 90% or more of their services are performed in the inpatient or ER hospital setting.

If you are eligible as an EP for both the Medicare and Medicaid EHR incentive programs, you must choose only one.

When talking about the Medicare Advantage program, incentive payments are made only to Medicare Advantage organizations that are licensed as HMO’s, by a state.   Medicare Advantage EP’s are individuals that are either employed by the Medicare Advantage organization, or employed by a partner of the Medicare Advantage program. The partner must furnish at least 80% of that entity’s Medicare patient care services to enrollees of the Medicare Advantage organization. In addition, these EP’s must furnish at least 80% of their Medicare-related services to enrollees of the Medicare Advantage organization. They must also furnish, on average, at least 20 hours per week of patient care services.

DrChrono.com has guaranteed that it will meet all meaningful use criteria and will be a certified vendor of EHR technology.

It is the purpose of DrChrono.com University to keep you up to date with the latest information revolving around Meaningful Use so that all clinicians who utilize DrChrono.com’s iPad EHR will smoothly transition to a better, brighter, and patient-centered EHR system that will notably enhance the lives of practitioners and patients alike. The information posted on this blog is applicable only to Eligible Professionals, not Eligible Hospitals or Critical Access Hospitals. Stay tuned for weekly to biweekly updates.

DrChrono iPad EMR Featured on Apple.com

Sept 9, 2010 apple started to feature the drchrono.com EMR app! For more info click here!