Electronic Health Reporter

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.

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. 

How do you use your individual talents to drive and grow your vision? Do you consider drchrono a success story?  

One of the most critical things about our business is talking to the doctors. We want to talk to them about what they are doing, what they like and what they hate about practicing medicine. Physicians are pulled in so many directions that they need software that is as easy as writing on paper. We want to create that extension for doctors.

drchrono is always a work in progress; we have a saying inside drchrono, that we are only 1 percent done with our mission. So we have a lot of work ahead of us. We work everyday to see what we can be doing and how we can build amazing products.

What are some key contributions that drchrono is making and why is it important in the evolving mobile health IT industry?

We are always looking to disrupt healthcare with new technologies. drchrono was the first company to build an EHR on the iPad, the first EHR to have credit card processing built into the EHR (via Square), the first EHR to leverage amazing technology like AirDrop, our goal is to always think about what is next and how we can bring this new technology to physicians.

Thanks to iOS7 and the new AirDrop functionality, patients can now view their medical records on their iPhone, iPad or iPod Touch, and physicians can present information to an entire family waiting for news of a relative. Charts, medical records, prescription information, photos, X-rays or how to videos can be made available on any family member’s phone with the touch of a button. And physicians can instantly share information with one another on mobile devices such as an oncologist and a cardiologist working together to solve the mystery behind one of their patient’s diseases.

How has the company evolved since it began? Where is it going and why should others take notice? 

Our business has changed drastically. We initially started as a company that would remind patients about appointments, but as time progressed we improved the app more and more. We changed from a simple app to a whole platform in the last several years, having everything from a full meaningful use certified EHR, medical billing and patient management to also taking care of patients and creating the personal healthcare side.

Tell me about how physicians today are using drchrono’s EHR app on the iPad and other mobile devices.  Can you share with me some real-world examples of how it’s used in a medical practice? What it some specific feedback from physicians?

Millions of iOS devices are sold per day, millions of Android devices are sold per day. Doctors are using mobile devices for just about everything personal, our initial assumption was why not use an iPad for mHealth? We where right. Doctors in masses are buying iPads and downloading our app. Doctors really want to have a digital workflow and move their medical forms over to a digital format. Doctors enjoy clicking a few buttons on an iPad and checking a box on the screen. The EHR app is easy for the physician’s staff to manage and they can start the medical billing in real time.

For doctors, the EHR lets them all from an iPad instantly secure medical record sharing with patients and other physicians on their mobile devices. Second, improve medical billing, allowing doctors to tick off certain procedures and problems and automatically submit bills to insurance companies. Lastly, medical speech to text functionality, instead of typing notes on the iPad, this frees up a physician’s hands to deal with patient.

With AirDrop, right when a physician dictates medical information, the patient can see the updates in his iPhone, iPad or iPod touch. Rather than send long messages that patients won’t view until they leave the office; physicians can transfer information immediately to a patient for viewing on his mobile device. Feedback from physicians has been positive; Dr. James Andrew Rieger, MD, with 22 years of experience had this to say, “For the first time I can share medical data in real time with a patient at the point of care. The new design of the drchrono iOS7 app is simple and just works.”

Also, another great example is a doctor taking pictures of his old paper forms and uploading them into drchrono. He was writing on the forms with our FreeDraw technology, no fuss, no change in his workflow. The iPad really allows for a multimedia medical record experience, you can touch it, draw on it, record medical speech to text, watch videos, and upload paper, and have it all at your fingertips within seconds.

What is the benefit to patients who are using drchrono’s EHR app on their iPad or iPhone?

An important patient benefit is ‘transparency.’ We have a patient-facing app called OnPatient. The patient can communicate with a physician via secure messaging, the patient can also see real-time detailed bills, appointments, view lab results, X-rays, EKGs, sonograms and view just about everything within their medical record. How it works now is a patient calls into the doctor’s office to get copies of something faxed over to the patient. We want to change that. People have music, e-mail, contacts, calendars, banking on their phone, they should also have medical records. The new AirDrop feature is really going to enhance the patient experience. Whether it is a photo, a medical record or text document, patients now have access to all their own medical information instantaneously.

Would drchrono exist without the iPad?  

We built a web-based platform and the iPad is just one more access point to the medical platform. We also have apps for iPhone, iPod touch, Android and the cloud.

What is the impact of EHR apps on mobile healthcare? How is it streamlining business processes and making lives easier for physicians and patients?

For the first time in history, a doctor can simply have an iPad and download a free fully certified meaningful use EHR to use in their practice. Most vendors today make doctors pay large amounts of money, the generally mentality in healthcare is buy before you try. At drchrono, we allow doctors to use our free EHR and buy upgrades as they see fit. We offer a ‘freemium model,’ some of our users are on the paid platform EHR and some of our users are on the free platform EHR.

How are physicians’ lives changing because of mobile technology? What are some of the most interesting changes you’ve seen?

Doctors have access to more data then ever before. It really changes the game, before doctors had access to less data on patients and medical information, but now the cloud is changing all of that.

‘Geolocation’ in healthcare is something that is really interesting. Currently, we’re working on real-time patient check-ins, where a patient can just walk into a doctor’s office and the doctor knows when the patient is ready, after filling out all of the required forms on the iPad.

Tell me your thoughts about the iPad becoming a high performing business tool in the healthcare world.

In the past doctors purchased very expensive laptops or ‘computers on wheels’ and the battery life was horrendous. The interfaces were also extremely bad. Today, the touch screens are readily available and battery life is amazing on mobile devices. The technology will only get better over time; with every release of the iPad we see our usage rate skyrocket. The iPad is the defacto tablet among doctors and we don’t see this changing anytime soon.

Can you share some of your predictions on trends for the health IT industry in 2014?

The pressure from the government for doctors to move to EHRs is heating up.  Meaningful use stage two is coming up and this will push more doctors to go digital this year.

What’s next for drchrono in the months ahead? What are your growth goals?

Our goal is to double down in the mobile space and to really see how we can leverage the iPad even more. In terms of growth, our goal is to grow exponentially year after year. The time for change in healthcare is now and pushing doctors to go digital is in massive uptake due to meaningful use and amazing new devices like the iPad Air.