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’.

As many of you know, EMR and HIPAA is a big time news company. We have a really fat budget and pay our reporters huge amounts of money to sit and smoke cigars while producing very little content of value.

One of our biggest expenses here at HIMSS is in our investigative reporting department. Our motto is that if someone else breaks a story before us, then we spend the money to break them. Yes, we’re very serious about spending outrageous money breaking stories that no one else can break.

After 3 years of investigation (and no government stimulus money), we’ve finally cracked the code on who’s behind the famous (and hilarious) Extormity EHR software. They’ve been very good about concealing their identity before their big HIMSS press conference in 312C, West Building.

The people behind Extormity EHR is actually the obviously creative and innovative people at MIE – Medical Informtics Engineering and NoMoreClipboard

Credit them for their creativity and bringing to light the atrocities that I call Jabba the Hutt EHR vendors. The good thing for MIE is that I don’t consider them a Jabba the Hutt EHR vendor like the popular Extormity EHR that they created.

More news later after the press conference and presentation at HIT X.0 on Thursday.

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 recently sat down with Jeff Donnell from NoMoreClipboard. We had a fascinating all around conversation, but one of the most fascinating things he told me was the story of his last visit to his doctor’s office. I’ll do my best to recount what he told me.

When he decided he needed to go see the doctor for a visit his wife suggested that he call the doctor to make an appointment. Of course, Jeff “eats his own dog food” and decided that instead of calling for an appointment, he’d request an appointment through NoMoreClipboard. So, he logged into his account and sent off the request for an appointment with his PHR attached. Pretty interesting idea no?

Don’t ask me why, but when possible I’d much rather request something through my computer. Maybe it’s sitting on hold while you wait to talk to someone that’s turned me off to the phone call, but the idea that I could request an appointment online even if the doctor isn’t on NoMoreClipboard is a pretty attractive feature for a PHR.

Of course, since Jeff’s doctor wasn’t on NoMoreClipboard, his appointment request and health record were faxed to his doctor’s office. He got a call from the doctor and scheduled his appointment. The story certainly doesn’t end there.

When he arrived at the doctor’s office he wondered if they’d have his record or not. They handed him the standard clipboard to fill out all the paperwork. He still said nothing and dutifully filled out the paperwork. No one said anything about the record he’d sent until he was with the doctor and the doctor realized that Jeff was the one that sent in his PHR. I guess it was the talk of the office when that fax came in.

Obviously, the idea of requesting an appointment and faxing in your health record using a PHR still has a ways to go. In fact, NoMoreClipboard’s goal is to work with doctor’s offices like these so that the office gets the person’s health record on the forms that the doctor’s are use to getting it on. I think that’s a smart strategy. Not to mention the idea of the patients driving their doctors to use and work with a PHR provider. I think they call that Word of Mouth advertising right?

I’ve been thinking about this for a while when I recently talked with someone from Microsoft’s HealthVault division. I quite frankly asked this gentleman why I should use a PHR. Obviously, if I was a patient with a chronic or complicated illness I could see a compelling use case. However, what’s the use case that will drive and motivate healthy individuals to use a PHR. So far I really haven’t heard a good answer.

Requesting an appointment and not having to fill out that same lengthy cumbersome paperwork is the closest I’ve thought of.

One of the really interesting things that I’ve heard at the Mobile Health Expo has been the use of text messages to assist with patient compliance.

I think this is at least the third time at this conference that I’ve been hearing about the use of text messages in healthcare as a way to remind patients of their need to comply with the doctors instructions.

In one case, NoMoreClipboard is working with a hospital to use medical minutes (basically subsidizing their cell phone plan) for participants in a diabetes program. In this program, users would access the NoMoreClipboard PHR through their cell phone where they can update their blood glucose levels or other information as designed by their hospital.

This is pretty cool, but the interesting part is the way they’re using text messages together with the PHR. For example, if the patient doesn’t check in with their information, then a text message is sent reminding them to do so. Plus, once they enter in their information, they can get proactive messages about how they should deal with various blood sugar levels. For example, if their levels are low it might instruct them to eat or drink something to raise that level (although in a nice medically appropriate way).

I should have written down the exact numbers, but in the above case they found that they saved about $18,500 in treatment costs for a compliant patient vs. the non-compliant patient.

I of course had to ask if this could actually be a problem for the hospital. Sure, it improves healthcare, which is incredibly valuable. However, would this impact the revenue that a hospital was receiving previously to treat patients? Sure, it’s a bit ominous to think this way, but let’s be honest that the hospital revenue is an important factor.

Jeff Donnell from NoMoreClipboard brought up a good point that in many cases these patients were ones who had no health insurance and so the hospital was often not making money from treating these patients, but in fact was having to pay for these patients. So, being able to lower these costs is a huge benefit on top of the clinical benefits.

Of course, this is just one example of the usages of text messages in healthcare. I’m really finding it fascinating. Text messages seem to be one of the most innovative technology I’ve heard discussed and not all the various “Apps” that are out there. Yep, the simple text message is being used in all sorts of creative ways. Plus, text messages tied to a PHR or some other web source is really interesting as well.

Of course, I can’t help but imagine how text messages could be integrated into an EMR. Appointments is one obvious area. Patient compliance is another interesting one. What other areas of an EMR could benefit from the implementation of text messages?

One speaker said that on average text messages are read within 4 minutes. There has to be a way to leverage this attention in healthcare and EMR.

My very first meeting with a vendor at HIMSS was with NoMoreClipboard. I’d known of them for quite a while, but never really took them seriously before. After meeting with them, I was really impressed with what they’re trying to do in the PHR space. I was particularly interested in them since they have a PHR implementation in a university health center, but they go well beyond that.

In fact, I think the greatest potential for NoMoreClipboard is likely in partnerships with smart EMR vendors that want to integrate with a great PHR rather than putting up some half baked piece of junk software that they call a PHR. Yes, if you’re an EMR vendor you likely know what I’m talking about. It’s really hard to focus on creating a great EMR software and a great PHR software. Oh yes, and you have to do a Practice Management system too. It’s no wonder that PHR often gets set to the side.

That’s why it makes so much sense for smart EMR vendors to become channel partners with someone like NoMoreClipboard. Then, they can offer their users a PHR without having to build all of the features in house. Plus, NoMoreClipboard seems to have a nice set of API’s available so it almost seems like it is your PHR and not a third party PHR.

Sure, this has been around for a while, but I think that it’s taken a while for NoMoreClipboard to really build out the tools and features for doing this type of integration. The other key is that integrating with a PHR like NoMoreClipboard can also satisfy a number of the Meaningful Use requirements if it’s done right.

Of course, I had to also ask them what their take was on their “competitors” Google Health and Microsoft HealthVault. They are the 2 behemoths in the PHR space and so the question was certainly no surprise. What was interesting was NoMoreClipboard’s response to competition. They’ve basically decided to partner with them and integrate NoMoreClipboard with Google Health and Microsoft HealthVault. Yep, that’s right. You can import and export between the three PHR systems. That’s pretty unique if I do say so myself.

Now I’m not saying that NoMoreClipboard is perfect. There’s plenty they still have to work on, but I was impressed how far they’ve come since I last looked at them.

I’d love to here what other EMR vendors are doing as far as providing their users the PHR capability. Are you building your own or integrating with some other PHR vendor?