Drchrono Is the iPad App That Could Transform Your Doctor’s Office(singularityhub.com)
singularityhub.com
Drchrono Is the iPad App That Could Transform Your Doctor’s Office
http://singularityhub.com/2011/03/04/chrono-is-the-ipad-app-that-could-transform-your-doctors-office-video/
19 comments
Hi, thanks for your comment. I'm the Sr. Med Director, and just wanted to comment that I began practicing as a family medicine physician 3 years ago in a clinic-based practice. I have plenty of rich experiences seeing patients at an outpatient level of care, and am quite experienced with the day to day operations of such a clinic. I recently started psychiatry as I felt this was my true calling, as I greatly enjoy it as well. My work consists of collaborating with our 100's of doctors who use our system, and I spearhead the improvements in the workflow and design of our product. Again, thanks for your comment and feel free to contact me for further info if needed.
I've worked on an iPad app targeted at an entire state's hospitals.
Doctors, particularly specialists that travel, love their iPhones. They love tablets/iPads. You don't need to convince them. You need to convince the accountants, insurers and lawyers.
Doctors, particularly specialists that travel, love their iPhones. They love tablets/iPads. You don't need to convince them. You need to convince the accountants, insurers and lawyers.
Regardless of the interface? You seem to be saying that if an app is on an iPad, doctors will blindly love it (and it can't have a bad interface, which is obviously not true)
Drchrono isn't any uglier than what a lot of doctors using now. There's software out there that continues to use the blue and grey DOS style interface.
The hardware is the killer app here. The iPad and other tablets like it are off-the-shelf blank slates that cost less than $1,000 and run all day.
There are already proprietary tablets in the medical world, but they can cost thousands more per unit than the iPad and you're stuck with the software that's already on it.
You can go out and buy an iPad today and have electronic health records, medical imaging viewers, medical references and can move towards paperless environment for under five figures per year.
The hardware is the killer app here. The iPad and other tablets like it are off-the-shelf blank slates that cost less than $1,000 and run all day.
There are already proprietary tablets in the medical world, but they can cost thousands more per unit than the iPad and you're stuck with the software that's already on it.
You can go out and buy an iPad today and have electronic health records, medical imaging viewers, medical references and can move towards paperless environment for under five figures per year.
Ok, I've given some more thought to this. To give some constructive criticism. I've been watching the videos, watching people enter data, soap notes, and the transcription. It all seems so painful.
The interface is a lot of small screens, with buttons connecting them. In the dictation screen, you can't reach anything else. You can't seem to look at labs, look at xrays. Similarly, the soap note interface brings up a large text entry with an iPad keyboard. Several of the other interfaces bring up these somewhat jarring iOS inputs. None of this seems to flow well.
I feel like you have this open 10" multi-touch device, but you are using interface paradigms from old point and click interfaces.
Here are some interesting possibilities:
- Use the fact that you can scroll infinitely on the iPad. A page could have a ton of data vertically, that you can scroll up/down.
- Maybe you can also scroll/swipe left/right to get to different sections. from Note to Xrays to Labs. Let there be a definite order of those pages. I'm thinking like the Wired magazine app for iPad. Swipe left a couple of times, I'm at labs. I can find what I want, swipe right a couple of times to be back where I started. Or at least short cut buttons for every section so you can jump back and forth easily.
- Current labs could be embedded in the current note/encounter page. It's obvious I'm going to want to see those. Scroll down to see them, swipe left/right to see older ones.
- Why are soap notes in full text input? Why not a large page of customizable Positive/Negative toggles? Most EMRs are like this, but having it on the touch screen seems like it might be nice, especially if you can scroll past ones you don't care about quickly. This also helps to minimize pulling up a full keyboard, which is an awkward event on the iPad. You don't want to be typing long passages if you can avoid it.
- Seems custom interfaces could be explored for making data entry easier. Be it medicines, or complaints etc...
anyhow, obviously those things are just top-of-the-head wild thoughts, but the abilities are there. I just don't see this as an "iPad EMR" but an EMR that was put on the iPad.
The interface is a lot of small screens, with buttons connecting them. In the dictation screen, you can't reach anything else. You can't seem to look at labs, look at xrays. Similarly, the soap note interface brings up a large text entry with an iPad keyboard. Several of the other interfaces bring up these somewhat jarring iOS inputs. None of this seems to flow well.
I feel like you have this open 10" multi-touch device, but you are using interface paradigms from old point and click interfaces.
Here are some interesting possibilities:
- Use the fact that you can scroll infinitely on the iPad. A page could have a ton of data vertically, that you can scroll up/down.
- Maybe you can also scroll/swipe left/right to get to different sections. from Note to Xrays to Labs. Let there be a definite order of those pages. I'm thinking like the Wired magazine app for iPad. Swipe left a couple of times, I'm at labs. I can find what I want, swipe right a couple of times to be back where I started. Or at least short cut buttons for every section so you can jump back and forth easily.
- Current labs could be embedded in the current note/encounter page. It's obvious I'm going to want to see those. Scroll down to see them, swipe left/right to see older ones.
- Why are soap notes in full text input? Why not a large page of customizable Positive/Negative toggles? Most EMRs are like this, but having it on the touch screen seems like it might be nice, especially if you can scroll past ones you don't care about quickly. This also helps to minimize pulling up a full keyboard, which is an awkward event on the iPad. You don't want to be typing long passages if you can avoid it.
- Seems custom interfaces could be explored for making data entry easier. Be it medicines, or complaints etc...
anyhow, obviously those things are just top-of-the-head wild thoughts, but the abilities are there. I just don't see this as an "iPad EMR" but an EMR that was put on the iPad.
That's a "burning platform". The correct solution to this kind of problem is government backed centralized system for all doctors. Like in Estonia: http://eng.e-tervis.ee/overview.html . Sooner or later all countries will have this kind of solutions in place and unfortunately DrChrono will lose.
It works in Estonia so that all doctors are _forced_ to use that system, which results to a wonderful end result where _every_ doctor has access to _all_ data there is about you 24/7 - so for example when you lie unconcius on the street, 911 knows all your allergies, illnesses and treatments, everything that every doctor has ever written about you etc in that second.
It works in Estonia so that all doctors are _forced_ to use that system, which results to a wonderful end result where _every_ doctor has access to _all_ data there is about you 24/7 - so for example when you lie unconcius on the street, 911 knows all your allergies, illnesses and treatments, everything that every doctor has ever written about you etc in that second.
That approach might work in somewhere the size of Estonia - but large centralized IT projects have been a bit of a disaster for the UK NHS:
http://news.bbc.co.uk/1/hi/8397854.stm
The chances of it being made to work by the government for somewhere like the US are pretty small.
http://news.bbc.co.uk/1/hi/8397854.stm
The chances of it being made to work by the government for somewhere like the US are pretty small.
large centralized system with ALL the private data.. being accessed from hundreds of thousands points. What can go wrong..? (watch for a torrent with all your medical records coming to a p2p near you)
I own an IT services company and we have a medical vertical. There is a demand for this and I am a big fan of what you are doing. What I can tell you however is that no amount of iPad UI wizardy will overcome the hairball that is EMR/EHR. Table stakes are Meaningful Use certification and assurance, HL7, Labs, PACS, HIS integration and the list goes on and on. The hardest work happens there, and Dr. Chrono will need "street cred" there to grow.
Unless you work with the doctor, assistant, nurse or office manager for at least 6 months you will have no idea what actually needs to be done or how things could be streamlined. Sometimes it's not just data organization. Surveys won't help, online chats or discussion will not suffice either. Understanding the problem will require more attention.
However much like how another HN post showed us, the baseline market will eat this up even if the product is mediocre at best.
So take note readers, this segment is ripe for a competing startup.
I had a doctor tell me just last week, nextgen is shit. Which by the way would probably be your best corp competitor or prospective buyer as they're coffers are filling up.
Disclosure: I have many years experience in this field.
Update: when I say working with, I mean you need to tail and do the work as if you were an employee for some time.
However much like how another HN post showed us, the baseline market will eat this up even if the product is mediocre at best.
So take note readers, this segment is ripe for a competing startup.
I had a doctor tell me just last week, nextgen is shit. Which by the way would probably be your best corp competitor or prospective buyer as they're coffers are filling up.
Disclosure: I have many years experience in this field.
Update: when I say working with, I mean you need to tail and do the work as if you were an employee for some time.
Kaiser doesn't use mobile devices, but they have all this and more. They are an HMO, so they're integrated from top to bottom. There's a computer in each exam room and your chart follows you from Dr. office to lab to therapy to pharmacy. They have bracelets for those admitted to the hospital, and before giving you medication the bracelet is swiped and the computer-controlled delivery mechanism will only give you the meds if you should get them. (Cuts down on deaths due to incorrect medication.)
I could see them augmenting their system with a tablet, but it would be software they build themselves, I'm sure.
I could see them augmenting their system with a tablet, but it would be software they build themselves, I'm sure.
Am I wrong to stop reading at the grammar error in the second word?
As a patient something that I would really appreciate is a realtime queue showing how much behind schedule the doctor is on that given day. Ive had to wait for over an hour on occasion inspite of having a prior appointment.
Also self serve appointments would be nice.
It would be nice if an article about "new cool" ipad app was viewable on the ipad (videos).
All of our videos are on youtube. Feel free to check them out:
http://www.youtube.com/user/DrChronoTV
http://www.youtube.com/user/DrChronoTV
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Neither of the founders are from medical backgrounds: https://drchrono.com/team/
They do have a "Senior Medical Director" who is currently a psychiatry resident, which means relatively few years practicing medicine. I don't want to discount his abilities just for that, but for instance, it seems unlikely he has really worked in a private practice which is what this seems whole package seems targeted to.
I know disruption can happen from outside the system, but in the case of physician's medical record systems, I feel like the main hurdle is trying to show/teach doctors that your system can be a more efficient system in day-to-day. And to do that you really need to understand that day-to-day workflow. Especially since they are targetting these small practices it seems.