Dr. Lucy Hornstein, solo practitioner at Valley Forge Family Practice in Phoenixville, Penn., was not a proponent of electronic health records. An active physician blogger and published writer, she spent quite a few of her words on the technology’s uselessness.
They were expensive, overly complicated and tough to use and provided little return on the investment for users. Besides, most physicians, in her opinion, only implemented them because of meaningful use and the federal incentives they received for using them.
Paper, she had long decided, was good enough for her and during the first 21 years of practice in her own practice, she had no plans to change. It was only after the loss of one of her two staff members that she soon realized that she’d have to re-hire just to maintain her practice at its current load. However, that wasn’t an option for her. Neither, she thought, was adding an EHR to handle the management of the records because other than her perception of the technology, the self-described “dinosaur” didn’t have the budget for such an endeavor. She had zero for such technology.
Even if she had a change of heart and adopted the technology, she had not seen one system that was not cumbersome, not hard to use, intuitive to maneuver and or that offered her the option to meet the needs of her small practice while running the business efficiently.
Michael Nusimow, CEO, and Daniel Kivatinos, COO, co-founders of drchrono discuss the company, its goals, how to disrupt health IT and how mobile is being embraced by those in healthcare.
Tell me about drchrono, mission, goals and how it fits into the current landscape.
drchrono created a free electronic medical record (EMR) platform on the iPad, iPhone and cloud, and recently announced its newest app for iOS7. This is the first mobile EHR to support Apple’s new iOS7. Physicians are using mobile devices such as the iPad as a key business tool in their practice and it’s drchrono’s mission to enable the world’s doctors and patients to be better connected.
Daniel Kivatinos
On a more local level, we are looking to bring Silicon Valley technology and people into the forefront of the healthcare space. We are using cutting edge technologies like the iPad and SaaS software to deliver clinical and business tools for office based doctors.
Why use your talents in health IT? What drives you to serve this space?
We went to college together back East and several years after graduating we met up to learn that we both had family members with unfavorable healthcare experiences. We felt this urge to improve healthcare practices starting at the physician/patient level. We realized that a healthcare system built on faxing and shuffling papers is inefficient and thought so much more could be done to streamline the process via new technologies.
Based on our experiences, we witnessed that many office-based doctors were using paper charts for clinical work. If they have a patient taking 10 or more drugs or who has a very complex chart, they will waste a lot of time trying to understand the entire patient’s history. Seeing this need and personally suffering through bad healthcare experiences due to inefficiencies was the inspiration to start drchrono with the goal to digitize healthcare. We both knew we could build a software application that would create a better care experience.
Are EHRs dead? Well, Healthcare IT News’ Eric Wicklund recently reported that EHR vendors “will have to find a way to modify their products to focus on data that the patient and his or her care team want, or they’ll become obsolete.” Will EHRs become so obsolete so soon after the height of their heyday? When further explained, some of the reasoning makes sense.
According to panelists at the Partners HealthCare’s 10th Annual Connected Health Symposium, we’re in the time of “para-EHR,” defined as all of the phone calls, texts, e-mails and other doctor-doctor and doctor-patient communications that are not entered into the EHR. They could include everything from Skype chats between doctors to Post-It notes to data residing on mobile devices and sensors.
As such, complete records are not being entered into the EHR, and most patient communication takes place outside the EHR setting. But, are EHR’s dead and flat line or do they have some life left in them? I posted the question to Jim Gerrity, director at Ciena.
Are EHRs dead? “The short answer is ‘no,’ however, what is contained in today’s EHR will most likely evolve. Let me expand on this a bit: Paper-based records are still the most widely used method in the healthcare industry, but that’s changing rapidly. EHRs are proving to significantly improve clinical efficiency and coordination and being adopted increasingly by healthcare institutions around the world. A relatively recent example in the U.S. was their great usefulness to provide continued care during and immediately after Superstorm Sandy … e-records backed up and accessible at disaster recovery sites. As one writer put it, EHRs are ‘ushering in a new era in how medical data is stored and shared.’ But is this transition to EHRs required?
Guest post by Mohan Ponnudurai, director at Sparta Systems.
The release of the FDA’s final rule requiring most medical devices to carry a unique device identifier (UDI) will allow regulators to track goods and expedite necessary recalls in order to manage quality and promote patient safety. This process will be streamlined with the population of the global unique device identification database (GUDID, pronounced good-I.D.), which will include a standard set of identifying elements for each device given a UDI. The system will allow healthcare providers to look up information about a medical device, then amend the electronic health record of a patient as needed.
GUDID has no mandate in terms of automatic connectivity to EHR; no matter what device is implanted into a patient, his/her healthcare professional must manually input that information cross-referencing the UDI record with his/her EHR. Without this data entry, the point-of-use component leading to better patient safety and monitoring becomes a moot point. Just like manufacturing and design are inexplicably linked, and quality is an essential part of both for safer products, GUDID and EHR must be connected for better patient safety.
According to the FDA, most of the information contained within the GUDID will be made available to the public, meaning individuals can easily look up information about their medical device. The UDI does not indicate, and the database will not contain, any information about who uses a device, including personal privacy information.[1] While the GUDID is a step in the right direction to promoting patient safety, healthcare providers should look to the database as a model for keeping all EHRs.
Guest post by Garrett Taylor CEO of Uplift Comprehensive Services.
My organization, Uplift Comprehensive Services (residential services) is fully involved in “mhealth.” We use mobile high-definition video conferencing, which allows our doctors and clinicians to care for patients in geographically remote areas of North Carolina, and gives them full access to electronic health records and an easy way to collaborate each other. Along the way, we’ve improved patient service, enhanced productivity, and cut travel and office costs.
By combining video conferencing technology with a bring your own device (BYOD) mobile strategy, Uplift saves at least $500 for each scheduled physician visit. The thousands of dollars we save each year can be used instead to find grant opportunities for better patient care.
It’s not as hard as you might think to use video conferencing in a mhealth strategy. What follows is an explanation of Uplift’s mobile video conferencing approach.
Uplift Comprehensive Services has been in business for 12 years, covering 15 counties across North Carolina. We offer community-based assistance for children, adolescents and adults, with services substance abuse prevention to mental health treatment. Our treatment options include multi-systemic therapy, outpatient therapy, and medication management, among others. Continue Reading
Guest post by Greg Link, co-author with Stephen M. R. Covey of the national bestseller Smart Trust: The Defining Skill that Transforms Managers into Leaders.
As the name implies, patient satisfaction scores are nothing more than a measure of a patient’s healthcare experience. Like customers in any other industry, healthcare patients expect good, old-fashioned, caring customer service and to have their expectations met. Unfortunately, due largely to the extreme complexity of the healthcare experience, patients have historically lowered their expectations and defined extraordinary service as merely having their health issue ultimately resolved. That’s like ignoring all of the service aspects of a hotel stay as long as you slept through the night.
Now, in response to the Affordable Care Act, which links hospitals’ government reimbursement payments to how well they score in the Hospital Consumer Assessment (HCAHPS) on patient care, hospitals across the country are scrambling to improve their scores.
Stephen M.R. Covey
“The reality is, hospitals can’t talk themselves out of a problem they behaved themselves into,” Stephen M. R. Covey said, author of The Speed of Trust and Smart Trust.
Covey suggests that the patient experience is not a campaign or a department; it is a function of a high-trust culture generated by good, old-fashioned, common-sense behaviors demonstrated by all stakeholders. These behaviors are common to trusted people and organizations throughout history – behaviors like listening first, clarifying expectations, talking straight, creating transparency, extending trust, and demonstrating respect. One compelling example of a remarkable extension of trust is the Cleveland Clinic, where they are so transparent they give patients online access to their own charts and medical records, including doctors’ notes.
Vitera and Greenway merge. Goodbye, “Vitera.” The company is now officially known as Greenway Medical Technologies, Inc. According to a press release on the subject, the two “leading providers of clinical, financial and administrative solutions to healthcare providers, today announced the completion of a previously announced merger resulting in the combination of the two companies into an innovative leader in health information technology.”
The two are one, the marriage underway.
Vista Equity Partners, owner of Vitera, acquired all outstanding Greenway common stock for $20.35 per share in a transaction valued at approximately $644 million.
The combined company will be privately held and operate under the Greenway brand. Tee Green, Greenway’s CEO, will maintain that position. Vitera’s CEO, Matthew J. Hawkins, will serve as President. Both will serve on Greenway’s board of directors.
The combined company will maintain headquarters and principal operations in Carrollton, GA, Tampa, FL, and Birmingham, AL, serving 100,000 providers across nearly 13,000 medical organizations nationwide — including healthcare enterprises, ambulatory practices, public health, retail and other clinics.
Vitera, through Vista, bought Success EHS earlier this year, which is located in Alabama.
Despite the enormous amount of knowledge that was imparted upon you during your education, perhaps one of the most important elements of maintaining a successful practice was, most likely, barely touched upon. The concept of quality health care is not complete without a rigorous discussion of patient satisfaction. A good physician/patient relationship is a crucial element of a successful practice. The fact that patients do not complain does not necessarily mean they are satisfied with the care they are receiving.
The Necessity for a Patient Satisfaction Survey
Let’s face it: In the big picture, seemingly no matter which profession, a majority of complaints to licensing boards does not revolve around specific ‘practice-based’ issues. Instead, those complaints tend to be based on “client-expectation” issues. From this, we can make the claim that happy clients do not tend to complain. If your practice can meet your patients’ expectations then your patients will more than likely react favorably by continuing their relationship with your practice, and perhaps even recommend your practice to a friend. The best method to gauge your patients’ opinion of their experience is to ask them, and by far the most cost effective method of achieving that is by a properly constructed and thoroughly analyzed patient satisfaction survey.
The Objections to a Patient Satisfaction Survey
Certainly, there are what some see as “legitimate” objections to the patient satisfaction survey. Certainly high on that list would be the issue of cost. If your practice is a member of a medical malpractice insurance organization, it’s possible that the administration and analysis of a patient satisfaction survey is a member service, available to the practice for no additional cost. If not, there are independent consulting firms that can work with your practice to design and analyze a survey. Additional costs that would be incurred would include staff time necessary to distribute and collect the survey.
Vitera and 
The two are one, the marriage underway.