Here is a quick look at some of the other articles recently posted on some of the other HealthcareScene.com websites:

EHR and EMR Videos
Medical Billing Software & Practice Management Software Demo Video from ADP AdvancedMD – Medical billing software, like AdvancedMD from ADP, will help improve your insurance collections and workflows in your entire medical practice. With cloud software you never have to install software or maintain servers again. Just login from anywhere and you can manage your patients and your entire practice.

Cerner CareAware MDBUS® Demonstration Video – This video is a demonstration of Cerner’s CareAware MDBUS®, a platform which connects medical devices to the electronic medical record using plug-and-play functionality.

EHR and EMR Screenshots
These three posts provide numerous screenshots from the Simple EMR. Check them out and I’d love to read some feedback on what you think about their EMR interface. Is it a Simple EMR?
Screenshots from the Simple EMR
More Screenshots from the Simple EMR
Even More Screenshots from the Simple EMR

Smart Phone Health Care
Future of mHealth Dependent on Interoperability and Use of Available Technology – One of the biggest stumbling blocks with mHealth is there are way too many people developing products rather than businesses.  That is the problem with most of the companies in mHealth at this point.  There are tons of apps and gadgets and other fun things out there, but there is no one company that is trying to bring it all together.  Interoperability is the real basis of success in this industry.

iPads Not Adopted as Quickly by Hospitals as Doctors – iPads are all the rage amongst doctors right now and it is understandable with all they are able to do.  They provide a great amount of convenience for a relatively small financial investment.  For some reason hospitals have not been as quick to adopt this great technology.

One of the really interesting companies that I’ve seen at both the Digital Health Conference in NYC and now at the mHealth Summit in DC is a company called Force Therapeutics. This company is part of the Startup Health crew of companies and have a pretty interesting product for ensuring patient compliance using a really cool mobile and web based app.

Force Therapeutics is their first product which is focused on physical therapists which is a smart first step since the founder is a physical therapist. At its core, Force Therapeutics is an application where a physical therapist can “prescribe” exercises that need to be done by their patients. Those doing the exercises can log into the app and see the video demonstrating the exercise and then mark down whether they did the exercise or not. By having the video present during the exercise, it helps the patient to perform the exercise properly and then the physical therapist can know how well their patients are complying with the exercises they prescribed.

The app is available on the web or on the iPad and I believe Android. Plus, they offer a pretty cool online store where physical therapists can direct their patients to purchase the various products they need to do the physical therapy. I imagine that could be a nice revenue stream for Force Therapeutics and could be really convenient for physical therapists and patients.

Force Therapeutics also has a consumer version of their application available on the app store that could enable those interested in trying some physical therapy exercises without going to their doctor or the physical therapist. This feels wrong for many in the US who are so use to needing a doctors referral to go to physical therapy. Could be an interesting play for Force Therapeutics to help out with those aches and pains that we all have (and are getting more the older we get) that aren’t worthy of a doctor, but could benefit from some mild “therapy.” I’m sure this will have many doctors and physical therapists cringing a little bit, but whether it’s Force Therapeutics is used or some other app, there’s little doubt that patients will be doing this sort of self directed therapy anyway.

As I saw an app like Force Therapeutics, I could see it as a nice add on to EMR software. My only fear is that it feels more like a feature of an EMR software as opposed to a product unto its own. Although, I think Force Therapeutics has a chance for a number of different reasons.

First, I don’t see many EMR vendors really diving into this space. Sure, some might do some pieces of this, but they have so many things on their development plate that I think it’s unlikely for most EHR software vendors to develop these type of features.

Second, physical therapy is a space where EMR hasn’t gone very much. Sure, there’s WebPT, but most physical therapists are still in the paper world. The EHR incentive money passed over physical therapists and so it seems that many of them will continue sitting on the sidelines. That leaves a great opportunity for niche apps to satisfy the needs of these niche providers.

Plus, when I talked to the Force Therapeutics founder, I think that one of their biggest opportunities is outside the physical therapy space. Sure, it would be easy to expand Force Therapeutics into orthopedics or other medical specialty that wants to measure and support compliance in treatment. However, even more interesting to me is the idea of a Force Fitness type of app that focuses on trainers and exercise. When you start to think about trainers need to monitor their client’s exercise habits it makes a lot of since. In fact, if played right, Force Fitness could become a network that connects trainers with those interested in finding a personal trainer. Considering the amount of money spent on exercise each year, this is a really tremendous opportunity.

It’s still early in the life of something like Force Therapeutics, but it’s a pretty interesting little insight into the future of how various apps could impact healthcare. One of the panel speakers at the mHealth Summit said that there were 17,000 healthcare apps on the market today. I’m not sure where he got his number, but no matter how you slice it that’s a lot of healthcare apps. Multiply an app like Force Therapeutics by 17,000 and you can see there’s a sea of change happening in the mobile health space.

Many people in healthcare are still debating the value of the iPad in their medical practice. For example, Dr. West has expressed his iPad hesitations. That’s why I was fascinated when I saw this video which demonstrated a $9.99 iPad like tablet. This tablet even has some features the actual iPad has. Check out the video below to see what I mean:

I’m reminded of a previous post I did (which I can’t find right now) where I discuss the perfect solution to charting. It’s flexible, easy to learn, portable, etc….it’s a paper chart. Of course, don’t let the humor distract you from the benefits of an EMR or EHR.

I hate to keep bashing Silicon Valley, since I’ve come to think that it’s venture capitalists, not tied to one particular region, who are the ones not “getting” healthcare. That said, we got a bit more overblown hyperbole coming out of Northern California this morning from drchrono.

The Mountain View, Calif.-based company, which likely is correct when it says it created the first EHR that it native to the iPad—and a free one at that—announced today that it has received an new round of $650,000 in seed funding  from the VC community. (Congratulations on that.) Drchrono today also introduced OnPatient, an iPad app that replaces the hated clipboard and paper form for taking patient history at the doctor’s office. Here are the details, from the drchrono press release:

drchrono Launches iPad App to Replace Paper-Based Check-In at Doctor’s Office; Closes Additional $650,000 in Seed Funding

Free OnPatient App Digitizes Patient Waiting Room and Integrates Seamlessly with Electronic Medical Records

Mountain View, CA – August 18, 2011 – drchrono, the company modernizing healthcare through a free Electronic Health Record (EHR) platform on the iPad, today announced a new patient check-in app which replaces the traditional paper check-in process in the physician waiting room. OnPatient is an app that can be downloaded to the iPad for free and integrated into a medical practice as a stand alone onboard app. The patient check-in app also seamlessly integrates with drchrono’s Meaningful Use-certified iPad EHR.

On the heels of the OnPatient product launch, drchrono recently closed an additional $650,000 in seed funding from prominent start-up investor Yuri Milner, founder of DST Global, and venture capital firm General Catalyst. This follows $675,000 in seed funding from General Catalyst, Charles River Ventures, 500 Startups and angel investors, previously announced in July.

“The OnPatient check-in app digitizes the waiting room and eliminates significant barriers to mass adoption of patient check-in technology by leveraging sophisticated iPad technology. Proprietary check-in hardware is prohibitively expensive and integration with existing EHR systems is too complex,” said Michael Nusimow, co-founder and CEO of drchrono. “We designed the OnPatient app to be intuitive for both physicians and patient users to create a better patient check-in experience.”

OnPatient is a full-featured app with customizable templates that enable physicians to eliminate paper forms and clipboards in the waiting room. There are no contracts or monthly fees; the only hardware investment is the iPad itself. Upon download, the OnPatient app allows patients to:

• Complete family medical history and demographic information
• Complete insurance information
• Snap a profile photo
• Sign the HIPAA consent form with a digital signature

The touch screen interface is user-friendly and the information auto-populates directly into the drchrono EHR platform. On subsequent visits, patients do not have to complete duplicate forms—they need only review their information and make any necessary changes on the iPad. OnPatient meets all industry security standards, ensuring the privacy and safety of patient data.

For more information on drchrono and the OnPatient app, please visit www.drchrono.com.

About drchrono: 

drchrono focuses on Apple’s iPad and cloud computing to build a better healthcare experience.

They offer a free EHR platform built on the iPad that is Meaningful Use certified.  drchrono is also the first iPad EHR to implement real time clinical speech-to-text. drchrono handles everything a doctor needs to run their practice, including medical records, electronic prescribing, medical billing, and patient management.  For more information, visit https://drchrono.com

The drchrono iPad EHR is 2011/2012 compliant and has been certified by InfoGard Laboratories, an ONC-ATCB, as a complete EHR in accordance with the applicable certification criteria adopted by the Secretary of Health and Human Services. This certification does not represent an endorsement by the U.S. Department of Health and Human Services or guarantee the receipt of incentive payments. drchrono version 9.0 was Stage 1 certified on June 3, 2011. The ONC certification ID number is IG-2492-11-0083

 

What got me was the claim in the e-mail that accompanied the press release. “Today, drchrono, a hot Y Combinator start-up focused on Apple’s iPad and cloud computing to build a better healthcare experience, announced OnPatient, a groundbreaking app that digitizes the medical practice waiting room,” the message started. This was the same claim that drchrono included in a media advisory earlier in the week.

Sorry, there is nothing “groundbreaking” about software that collects medical history electronically and automatically populates an EHR with this information. Instant Medical History, a program from Primetime Medical Software, Columbia, S.C., has been doing this for years. Though it is primarily a PHR vendor, NoMoreClipboard.com‘s name betrays one of its products, a patient portal for medical practices that collects patient history online. ePatientHistory.com is similar.

No, IMH does not have a native iPad app, but it’s worked on tablets going back to the bulky Windows tablets circa 2003, even if few customers actually chose that option. NoMoreClipboard.com is Web-based, which means it’s accessible from any device with a Web browser such as, say, an iPad.

When I called the publicist on the “groundbreaking” claim, I got this back. “Of the physicians I’ve spoken to, the user-friendly interface of the iPad app really makes patient onboarding easy and they love the ‘novelty factor’ of using the iPad as well. It’s less intimidating for patients who have limited experience with healthcare IT.”

Fair enough. But that doesn’t make OnPatient “groundbreaking.” The iPad is groundbreaking. OnPatient is interesting, useful and frankly, long-overdue competition to Instant Medical History. I hope it catches on. But it’s not much of a breakthrough.

I can’t wait to see the breathless coverage from the other tech press who don’t know the, ahem, history (sorry, couldn’t resist). If you want the unvarnished, occasionally acidic truth, come here.

For that matter, here’s the company’s own message, via video:

It’s rather low-key, actually. I have just one question: Why do they say “tax breaks” for meaningful use? The money is in the form of Medicare/Medicaid bonus payments. As EMR and HIPAA readers know, those payments are considered taxable income. Just sayin’.

Once in a while, I run out of Big Ideas to share and resort to a rundown of short items. This is one of those times. Often, though, that approach turns out to be more interesting than a well-thought-out commentary. (Thus, the popularity of Twitter, right?)

Speaking of Big Ideas, I’m thinking that the age of the massive EMR project may be coming to an end. You may have seen my piece in InformationWeek today about the reported end of the national EMR in England. London’s The Independent reported earlier this week that the Cameron government will announce next month that it will scrap the national strategy in favor of allowing local hospitals and trusts to make independent EMR purchasing and implementation decisions.

This news comes on the heels of a decision by the government of Ontario to give up on hopes for a single EMR for all of Canada’s most populous province.

On the other hand, here in the States, we’ve seen a lot of consolidation among healthcare providers, but I’m guessing that has more to do with administrative Accountable Care Organizations and the prospect of bundled payments than any desire to build a more unified EMR. Though, consolidation does make health information exchange somewhat easier, and that’s going to be key to earning “meaningful use” dollars beyond 2013.

On a somewhat similar note, doesn’t a headline like, “Positive Outlook for Small Practice EHR Adoption” sound like a no-brainer? I mean, isn’t that the segment of healthcare providers that historically has had the slowest adoption rates? More than anyone else, small practices—particularly small, primary care practices—are the intended target of the federal EHR incentive program. And most of the news from health IT vendors of late has been about how they are going after this long-neglected market, right? The innovation seems to be happening in ambulatory EMRs, as evidenced by DrChrono’s newly certified iPad EHR app, aimed squarely at independent physicians.

That said, vendors and publicists, please do not start inundating me with news about other EHRs getting certified. There are hundreds of certified products out there now, and I cannot and will not write about, oh, about 95 percent of them.

While you’re at it, please stop using the word “solution” as a synonym for “product” or “service.” Tech journalists hate this trite, lazy and, frankly, inaccurate term so much that I’ve been instructed by the editors of InformationWeek not to use it, except in direct quotes. In fact, I get reminded not to use it pretty much every time I’m forwarded a press release laden with news about someone’s “solution.” Solution to what? I’ve been seeing that term since I started covering health IT more than a decade ago, and I still don’t see much getting solved in healthcare. With all the “solutions” out there, you’d think that healthcare had been fixed by now.

I could get a whole lot more curmudgeonly on you, but I think I’ll stop now and await your comments.

“It’s Friday, Friday! Gotta get down on Friday. Fun, fun, fun, fun. Looking forward to the weekend.” – Friday Music Video by Rebecca Black Dang those viral videos, but I have to admit that I’m grateful that today is Friday and I have a weekend to catch up on things. I’m sure that many of you can relate to this feeling.

As we head to the weekend, I’ll leave you with a little something to think about and discuss in the comments. Someone at HIMSS pointed this out to me and I thought it was worth sharing. Think about the patient interaction in the exam room. For some reason, doctors don’t and haven’t had any problem pulling out their mobile phone (or previously their PDA) in order to pull up Epocrates (or some other similar app) while in the room with the patient. It was perfectly natural for them to pull it up to look up a certain drug or other information.

Why are doctors comfortable with a smart phone between them and a patient, but a computer is not? Is there a relationship between this and why the iPad is so popular with doctors?

Hopefully none of you were expecting Meaningful Use Mondays. We’re taking the week off thanks to HIMSS, but there will certainly be some meaningful use discussion in my day 2 experience at HIMSS11.

I must admit that my morning was a little disappointing. I’d wanted to see Reich speak, but it ended up being too early for me. So, I followed what he said on Twitter. I’m afraid to say that following it on Twitter might possibly have been better than being there. There’s something really cool about the Twitter back channel conversation at a conference.

I was excited to go to the session Dr. No: The Response to HITECH, but it was a dud for me. Maybe it means I’m just too involved with the HITECH act that she didn’t offer me much to chew on. Plus, the presentation was pretty dry and flat. Oh well, at least I could enjoy the interesting Twitter chatter about the social media session by Mayo Clinic. Makes sense that Twitter would go wild during a social media session.

Next I attended the HIT X.0 presentation with John Glaser and Aneesh Chopra. Aneesh brought the rock star energy like usual, but John Glaser was pretty terribly boring. It’s not a good sign when the most memorable part of their presentation was Aneesh calling him Johnny G. I also was glad that they had the Twitter comments on screen. Too bad they were too strict with the filter of it, but baby steps.

Lots of interesting content from my meeting with GE healthcare. I loved how organized and professional they were about it all. Plus, their government liaison made an interesting comment about how the time frame for delivering meaningful use stage 2 details (Summer 2012 I think) and when hospitals need to show meaningful use stage 2 (October 2012 I think) is too compressed.

I also got a chance to look at the GE Centricity Advance iPad app. They’re following the same iPad EMR strategy I suggested previously where you only implement a subset of the EMR functionality on the iPad and as native iPad app that maximizes the iPad interface. I see most EMR vendors doing the same.

I had a very interesting chat with Jonathan Bush from Athena Health. I was excited to meet with him since you never know what’s going to come out of his mouth. I took a video of him where I did a “Tell me something I don’t know” with the most common HIMSS buzzwords. Once I get home, I’ll upload the video and post it on the blog.

After that I met with Rohit Nayak, from MedPlus (Quest Diagnostic’s EMR company that offers the Care360 EMR). Another day I’ll do a post to talk more about the Care360 positioning and what makes them unique. It’s really fascinating to see how a lab company is attacking the EMR market. It’s pretty unique.

Care360 recently made an announcement about Care360′s participation with Microsoft HealthVault and the Direct Project. Aneesh actually made the prediction in the session mentioned earlier that by the end of 2012 80% of doctors will have a direct project address. Rohit agreed that it was possible and that Care360 would be playing a major part. He even said that Aneesh was considering a leaderboard for which company assigns the most direct project addresses. I’d be very interested to see that happen. It’s amazing how having your name on a leaderboard will motivate companies.

After this I met with a whole set of people from Henry Schein (which offers the MicroMD EMR). The dynamics of a large successful company with an EMR division (similar to Quest) I find really interesting. Plus, Henry Schein has had their Practice Management software for a long time (14,000 PMS users).

I was impressed by MicroMD’s approach to marketing their software. They acknowledged that it’s hard to be all things for every type of potential EMR user. So, they’re all about focusing on those specialties where their EHR fits well.

I was interested in how they were approaching meaningful use. Similar to how they’ve done ePrescribing tracking, they’re meaningful use certified EHR will be reporting back how many of their users are meeting the meaningful use requirements. I’m hopeful that once they start collecting this information in full, that they’ll share that information on here. They sounded open to the idea. It would be quite interesting to know which meaningful use measures doctors were generally finding hard to meet.

I already wrote about my time at the MTIA name change. Go and read it if you’re someone that transcription is dead.

Then, off to HIStalkapalooza. I was actually surprised that the event was pretty empty. Much nicer than last year where you basically couldn’t move. Plus, it was great to see the ESD people and see them get featured for their great set of shoes. They also loved the special ESD HIMSS top 10 shirt I was wearing. It was perfect for the event. Here’s what was on the shirt:

The Top 10 REAL Reasons I’m at HIMSS Orlando:
#10 Disney World totally beats Coke World.
#9 Orlando won’t have snow like Atlanta did last year.
#8 ESD’s plantable seed card which turned into a real dill plany for ccooking. The swag that keeps on giving!
#7 I’m secretly hoping Colbie Calliat will do an encore performance this year.
#6 I need to walk off those holiday cookies.
#5 I hope I get scanned by the RFID devices and magically transported to a tropical island.
#4 Booth Babes!
#3 Can you say parties?
#2 I’m just here for the food.
And the #1 reason….Anything for the EMRandHIPAA.com fan girls.
Enterprise Software Deployment – We Implement IT

I thought about going to a couple other events, but just opted to come back and write a few blog posts. Lots lots more planned tomorrow. Be sure to find me at HIMSS tomorrow so you can win a free HD TV.

EMRandHIPAA.com’s HIMSS11 coverage is sponsored by Practice Fusion, provider of the free, web-based Electronic Medical Records (EMR) system used by over 70,000 healthcare providers in the US.

I know I’ve talked far too much about HIMSS already, but I figured it’s the weekend and so not many of you are reading the site any way. So, I’ll take the topic du jour it seems and talk about my thoughts on making the most of your time at HIMSS.

I will offer the disclaimer that this is only my second year, so I’m interested to hear your ideas as well. However, I learned a lot my first year and so I figured I’d share a few thoughts.

Be Selective
My biggest suggestion for people is to be selective in what they want to do. 30,000 people, a ton of overlapping sessions and a ginormous (it’s not a word, but should be) exhibit hall. Yet, you have to pack that all into a couple days. It’s really important for you to be selective about who and what you want to see and make sure you make time for those important events and companies.

My mother always told me as a child that I can’t do everything. I’d always reply, “Yes mother…but I’m sure going to try.” Sadly, HIMSS is so large, that as usual, my mom is right (although, I’m still trying).

Keep Meetings Short
I borrowed this one from John at Chilmark Research. He makes a good point that you’re not really going to have time to take care of a whole lot of business at the event. However, you can get enough information to filter whether you should connect after the event. This said, be memorable enough that when you connect after the event they’ll remember who you are amidst the hundreds (or thousands) of other people they met.

Leave Roaming Time
The thing I was most sad about last year was that I didn’t leave me really any time to just roam the exhibit floor. I had my schedule so tight that I never could just enjoy the adventure of seeing something new and unexpected. Maybe some people don’t like this type of experience, but I really enjoy it. Sure, you end up talking to someone for a little bit about laptop carts or something you don’t care much about. At least they’ll give you chocolate or something and you’ll be amazed at how much thought they’ve put into carts.

Follow #HIMSS11 on Twitter
If you don’t use Twitter, that’s no excuse. You don’t even have to sign up to read the tweets coming out of HIMSS. Just follow the hashtag #HIMSS11 (or click that link) and you’ll see that people are already talking about it. If you want a few less ads than what are sure to be sent on the #HIMSS11 hashtag, you can also watch this list of New Media Meetup people on Twitter.

Free TV
Find me on Tuesday of HIMSS and you can enter to win a free TV (42 inch I believe). That’s right. More details on this coming soon. UPDATE: Full details on HIMSS TV Giveaway posted.

Enjoy a Party or Two
Nothing wrong with letting your hair down and enjoying yourself at some of the many parties out there. Some even have live bands and dance floors. That should be fun.

Health IT Venture Fair
I’m sure many of you don’t even know about the Health IT Venture Fair at HIMSS. It’s on Sunday and many of you probably won’t even be at HIMSS yet. However, I’ve heard good things about this event. It’s real companies with real investors talking about their companies. I’m totally fascinated by venture capital, other investing and entrepreneurs and so maybe I’m biased, but I think this is going to be a really interesting part of HIMSS. I’m quite certain that it will present interesting views into healthcare that I hadn’t seen before. I love any event that stretches me like that.

Here are some other cliche suggestions:
-Wear good shoes (the floor is massive)
-Bring lots of business cards (I got my new ones printed…Woot!)
-Win an iPad – If I come home without an iPad I’m going to cry. It’s the de facto giveaway for sure. Makes me wonder why HIMSS didn’t just give away an iPad to each attendee.

Let me know if you have other suggestions I missed or suggestions of your must do items at HIMSS.

This weekend’s thought provoking EMR comment comes from Dr. Gregg Alexander, a grunt in the trenches pediatrician, in a post he did on HIStalk Practice (which seems to be a duplicate from his blog):

“I want a beautiful [EMR] system that works as easily as my iPad and as intelligently as WebOS, one that I can start using as simply as I need and which can then be “apped” silly at my discretion”

I must admit that I LOVED the description of a simple EMR system that could be “apped” silly at his discretion. Makes you think!

I think it was Wayne Gretzky that said that the reason he was so successful as a hockey player was that while everyone else is playing with the puck at their feet, he would instead anticipate where the puck would be and that’s what made him so special.

I think we see far too many companies in the healthcare IT industry that are just “working with the puck at their feet” instead of anticipating where the puck is going.

I’ve seen that to some extent this week at the Mobile Health Conference. Everyone seems to be talking about the smart phones and then they casually mention the iPad also. Both of these technologies seem to be the puck at our feet.

I haven’t seen many people really looking at where the “puck,” mobile devices, is going to go.

For example, I’ve regularly argued that the iPad is a really interesting device and will likely be a game changer. Although, it won’t be the iPad specifically that’s going to revolutionize everything (since it’s the puck at our feet). Instead, the iPad’s features and concepts are going to be widely adopted and provide the innovation for the future of mobile healthcare and mobile EMR.

One feature is the mobility of the iPad. It seems to be the right form factor for it to be reasonably portable. It also uses 3G network connectivity that makes it portable. These types of changes are what’s going to really take healthcare mobile. Certainly the iPad isn’t the only one. There’s plenty of Netbooks which do this also.

However, the iPad did something that the Netbooks don’t do and that is changing the input method to a touch based system. Combining the mobility of the form factor, the 3G connection and the touch interface and now you can see the innovations that make the iPad interesting.

These features are the innovations behind the iPad. Soon we’re going to have a few hundred device options which innovate on top of these main innovations. For example, the touch input ability is really just getting started. Watch for it to become mainstream as more and more companies adopt and improve the technology.

My point being that mobile devices won’t just be smart phones and iPads. Those are just the start and we’re about to see a whole wave of mobile devices that need to be considered by those working in mobile healthcare.