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Need Point of Care EMR Documentation to Meet Future EMR Documentation Requirements

Posted on April 12, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As part of my ongoing writing about what people are starting to call the EHR Backlash, I started to think about the shifting tides of EMR documentation. One of the strongest parts of the EHR backlash from doctors surrounds the convoluted documentation that an EMR creates. There is no end to the doctors who are tired of getting a stack of EMR documentation where 2 lines in the middle mean anything to them.

Related to this is the physician backlash to “having to do SOOOO many clicks.” (emphasis theirs) I still love the analogy of EHR clicks compared to playing a piano, but unfortunately EHR vendors haven’t done a good job solving the two things described in that article: fast predictable response and training.

With so many doctors dissatisfied with all the clicking, I predict we’re going to see a shift of documentation requirements that are going to need a full keyboard as many doctors do away with the point and click craziness that makes up many doctors lives. Sure, transcription and voice recognition can play a role for many doctors and scribes or similar documentation methods will have their place, but I don’t see them taking over the documentation. The next generation of doctors type quickly and won’t have any problem typing their notes just like I don’t have any issue typing this blog post.

As I think about the need for the keyboard, it makes me think about the various point of care computing options out there. I really don’t see a virtual keyboard on a tablet ever becoming a regular typing instrument. At CES I saw a projected keyboard screen that was pretty cool, but still had a lot of development to go. This makes sense why the COWs that I saw demoed at HIMSS are so popular and likely will be for a long time to come.

Even if you subscribe to the scribe or other data input method, I still think most of that documentation is going to need to be available at the point of care. I’ve seen first hand the difference of having a full keyboard documentation tool in the room with you versus charting in some other location. There’s just so much efficiency lost when you’re not able to document in the EMR at the point of care.

I expect that as EMR documentation options change, the need to have EMR documentation at the point of care is going to become even more important.

EHR Benefit – Accessibility of Charts

Posted on January 10, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

It’s time for the second installment in my series of posts looking at the long list of EHR benefits. In case you missed the first post, go and check out the EHR benefit of legible notes.

Accessibility of Charts
The second EHR benefit is similar to the Legibility of Notes benefit in that it is easily forgotten as a benefit to EHR and it can be hard to quantify the value of the benefit in dollar amounts. Plus, it is really easy to see how nice accessible charts are to an organization.

There are a number of ways to look at the EHR benefit of accessible charts. The most obvious one is when you think about the number of times a chart has gone missing in a clinic. In most cases, the chart isn’t really missing. It’s in the clinic somewhere, but no one can find it. Remember all those special places that a chart could hide: exam room, physician’s desk, front desk, nurse’s desk, lab sign off box, physician’s car, hospital, physician’s home, etc etc etc. Oh yes, I didn’t even mention HIM not being able to find the chart because someone (probably someone other than HIM) misfiled the paper chart.

I’m sure most HIM people who read this will have a visceral reaction. I’m sure many are likely thinking, “But we do an amazing job keeping track of all those paper charts.” I agree with them 100%. A good HIM person has done an amazing job keeping track of paper charts. It would be 100 times worse if they weren’t there. The problem is that if a dozen people are using the paper chart, the reality is that charts are going to go missing.

Now think about the concept when it comes to EHR. None of those lost chart locations exist. The nurse can’t accidentally take the chart and forget to file it. The doctor can’t forget the chart at home or in his car. No one can misfile the chart.

Think about it. An EHR solves 100% of the problem of missing paper charts.

Besides misplaced paper charts, the idea of chart accessibility is an important one when you consider the idea of accessing an EHR remotely. Even if you use a less than ideal remote desktop solution, a physician can access an EHR anywhere they have an internet connection. For web based EHR, you get exactly the same experience accessing the EHR remotely as you would in the office.

I’ve heard horror stories (at least their pretty horrible to me) of doctors getting late night patient calls which require them to get dressed, go into the office, open the medical records room to access a patient chart. With an EHR, that same workflow has the doctor booting his computer and logging into the EHR. This doesn’t apply to all doctors, but for those that do it’s a dramatic difference.

The biggest fear I’ve heard from doctors in this regard is they often equate chart accessibility with their accessibility. The argument goes that if they can access the chart 24/7, that it also means they have to work 24/7. I think this is a myth that doesn’t match most realities. Just because you had a key to your office and could go and work on paper charts 24/7 doesn’t mean you had to do it. The same is true with remote access to EHR. You choose when is appropriate and important to access and work on the EHR and when not to do so.

The key difference between EHR and paper charts is that when you do want to access a patient’s record remotely you have that option available to you. That doesn’t mean you always have to do so, but it is nice to have that option available.

When talking about EHR accessibility, I think also about the landscape of connected mobile devices (smart phones, tablets, etc). All of these devices are connected to the internet at all times and could provide a doctor access to their EHR almost anywhere in the world. Try doing that with paper.

The problem here is that most EHR don’t do well on mobile devices. Remote desktop from a smart phone or tablet works, but is a pretty terrible user experience. A native mobile app provides a much better experience for users, but we’re still in the early days of EHR mobile app development. As this matures, the accessibility of charts will become an even bigger EHR benefit.

Phreesia Makes Going to the Doctor Easier

Posted on December 17, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

The other day, we had to visit the doctor after hours. Because of this, we went to the local “instacare.” However, as soon as we realized it wasn’t going to be so “insta,” with an hour and a half wait, my husband and I decided to drive about 10 minutes to another after-hours facility. We ended up at the wrong one, but decided to stay as soon as we discovered they took our insurance.

First off, I was immediately impressed with the office. The staff was extremely friendly and professional. Especially because at the first place we went, the receptionist was eating an egg roll as she tried to get our information. Secondly, I noticed right away that they had some sort of tablets sitting at the front desk, and I was really hoping I would get a chance to use one and check it out. None of the doctor’s my family usually go to have any type of technology like that (I think I’ve mentioned how my OB/GYN is about as ancient as they come,) so I was excited to see this here. As soon as the receptionist scanned my insurance card, she handed me one of the tablets and asked me to fill out the information on the tablet. I readily agreed and went back to my seat.

When I say down, my husband saw what I was holding and said, “I bet you love this. You can totally write a post about it,” so, I thought I would.

The tablets that the office used are called Phreesia, the patient check-in company. They are bright orange, and a series of questions are asked. The questions ranged everywhere from insurance ID numbers, symptoms, past medical history, and allergies. It includes automatic insurance verification, to reduce the instance of denied claims, and the patient can swipe their debit card on the machine and pay their deductible. Here are a few of there other features listed on the site:

  • Simplify your check-in with a selection of expertly-designed specialty-specific interviews
  • Automate the administration, scoring, and reporting of clinical scales before patients enter the exam room
  • Collect sensitive healthy information with proven technology
  • Obtain a legible list of medications and drug allergies
  • Obtain patient consent for managed care initiatives

Phreesia offers different varieties of the product for all kinds of specialties  so any practice could probably find use for it. It’s also secure, so patients and providers alike can be confident about inputting information.

After using the tablet, I was definitely converted. So much, that I was very tempted to switch my family over to this practice. One thing that I always hate doing is having to tell a receptionist all of my personal information, and sometimes the details of why I’m there. I would much rather have my privacy, and be able to provide as much or as little details as I wanted. I felt like I was able to be more thorough in the descriptions of past medical history, as well as about why I was coming in. Overall, I love that some practices are implementing this kind of system, and I hope to see it more often. When I worked at a therapy clinic, I always loved the little PDA’s that we handed out for patients to answer questions — something like Phreesia.

Five Helpful Mobile Apps for Radiologists

Posted on November 27, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

After seeing the popularity of my post about great mobile apps for medical students, I thought I would do a few more posts like that, focusing on different types of medical professions. Today, radiologists.

There are TONS of mobile resources for radiologists. Granted, the best ones are rather expensive, but from what I gather, well-worth the cost. However, there are also some pretty handy free (or really inexpensive) ones as well. After doing some research, here are a few of the apps I think could be helpful for those in radiology. Unfortunately, they are all for iOS devices, though some may be available for Android in the future.

1) Diagnostic Radiology App

iMedicalapps.com made the claim that this app is “possibly the best radiology app for iOS.” This is actually more like an interactive textbook. There is a very comprehensive, searchable database with over 30 different cases. The results from each case can be hidden in order to help the user think up their own solutions. There are excellent image sets included in each case as well. The app is meant for the iPad, but apparently, works rather smoothly on the smaller iPod and iPhone screens. This specific app is geared toward abdominal radiology, though other emphases are in the works. The app does cost quite a bit at $44.99, however, there is a free version which apparently is still very good. One reviewer claimed that “this app is amazing. I . . . expected a freebie with perhaps a bit of useful content. How wrong I was.”

This app is amazing. I downloaded it yesterday and expected a freebie with perhaps a bit of useful content. How wrong I was.

Download the full version here, and the free version here.

2) RSNA Radiology

This app is for Radiology, a top-rated, peer-reviewed journal. It contains tons of great articles that can be easily searched, as well as sent to colleagues. The font size is also adjustable, which accomodates the young and old radiologist. There are also included podcasts which can be listened to through the app. As I mentioned, the articles can be searched, which is definitely useful if someone is looking for a specific part of a certain article. New research with commentary and critiques from different experts in the radiology world is one of the highlights of RSNA Radiology. This app is totally free, which is awesome, considering all the great resources that it includes. It isn’t currently available for Android devices, though it can be accessed from Android phones and tablets at m.radiology.rsna.org.

Download for iOS devices here.

3) Radiology Toolbox

According to the description on iTunes, Radiology Toolbox is “the radiologist’s ectopic brain.” This app was created to anyone involved in radioloy, from the student just starting their studies, to the seasoned radiologist. There are two versions, the lite and the pro, and each include useful tools such as a GFR calculator, gastric emptying times, and a radiographic contrast premedication. The pro version has a lot more tools like a adrenal adenoma calculator and charts of AFI, pediatric spleen, and kidney size. The apps are still in their beginning stages, so expect updates to come regularly, but this is definitely an app that anyone in the radiology field should have.

Download the pro version for 4.99 here, and the free version here. This app is only available for iOS devices at this time.

4) SeeMyRadiology Mobile

This app allows users to view medical images and reports, right on their mobile device! Not only that, but photos can be taken directly with the mobile device and saved directly to the app or shared with others. It is HIPAA compliant, a secure cloud-computing platform, and approved by Accelarad for medical image review. Images can be searched for very easily, using either a patient’s name, time-frame, or medical record number. There’s a bunch of other neat features, and the app creators have gone to great lengths to ensure the security of the app (such as requiring a pin after a period of inactivity, and making sure no PHI is stored on the device upon closure of a case.) The app goes hand-in-hand with SeeMyRadiology.com. Best of all, it’s free.

Download for iOS here.

5) Radiology 2.0: One Night in the ED

For those that can’t afford Diagnostic Radiology, or simply would like another reference guide, this is another great option with tons of features. It has different cases that can be viewed, and the user is able to act as if they are actually reading and interpreting the CT scan from a PACS workstation. There are over 7,000 images included in the app and hundreds of pages of information, all of which can be viewed offline. It’s an excellent way to improve one’s ability to interpret images. Important information is highlighted and explained, and images are shown in a very realistic way.

Download for iOS here (the complete version, for free!)

Although I only highlighted five apps here, there are many more worthy to be on this list. Feel free to let me know what your favorite radiology app is!

Is there a specific field of medicine you’d like me to find good apps for? Leave a comment, and I’ll put in on my list! 

My First (Actual) Experience With A Patient Portal

Posted on October 8, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

During my time of writing about mHealth, I have had the opportunity to discover many apps, patient portals, and PHRs that have been created. However, I haven’t been able to use them beyond my initial review, for the most part. Why? Because most of the physicians my family aren’t really into the whole mHealth trend. I mean, my OB/GYN doesn’t even have a website (granted, he’s about 70 years old, and very much set in his ways). I’ve been kind of disappointed by the lack of technology that my son’s pediatrician’s office has, however. Until recently. A few weeks ago, when we were visiting with one of the PAs in the office, I was absolutely thrilled to see him using a tablet as he talked with us. He quickly pulled up information about our past appointments, and it was neat to actually see this new “era” of medicine in work. Well, besides this, I hadn’t seen much else available.

However, today I heard that the office had launched a patient portal feature to their website. Well, you’d better believe I called the office right away and got set up on it. I wasn’t expecting much, especially because it is still very new, but I have to admit, I’m impressed so far.

It has all the features I look for — the ability to message staff, set up appointments, refill prescriptions, and view information from past appointments. The format of the website is also very impressive. Here are a few screenshots I took (note, I did take out some of the identifying details, so that’s why there are some big blank spaces at times):

This is the main page for the patient portal. As you can see, it’s powered by eClinicalWorks. The front page has some essentials, such a appointment reminders and a quick link to a PHR. On the left, there is an easy to use menu.

I really liked the clinical information section. Because we’ve forgotten to bring my son’s immunization card with us a few times, it isn’t totally updated. Instead of going through the hassle of going to the office to get it figured out, all of the information can be found easily, and I also can find out the names of different problems that had been identified in the past. This did cause me to worry a bit, as there were some issues cited that the doctor never told us concerning our son

And finally, here is the last section I wanted to highlight. I’m someone who loves to keep records, and it’s nice to be able to see the history of the our appointments in the past, and who they were with. There are about 6 or 7 different physicians at this practice, and it sometimes is hard to keep track of who we’ve seen. We were wanting to switch my son’s PCP to one that we saw when he was first born, and I found out who that was easily just by looking at this chart.

 

As you might have noticed on some of these pictures, there is a mobile app in the works for this medical practice, which I’m so excited about. In just the past few months, this doctor’s office has really stepped up their game — first an awesome Facebook page, next the physicians are using tablets, and now the patient portal.

To be honest, I’m not a big fan of calling people and talking on the phone, so the ability to do a lot of that (schedule appointments, request information, refill prescriptions) is very nice. And just as a side note, as I’ve looked through the portal tonight, I discovered a few errors in some of the information that the office had on our family (as in, they listed my son as the emergency contact…for himself. And no phone number was listed for our family,) that I wouldn’t have noticed otherwise.

Anyways, I just wanted to share a little bit of my excitement to see how doctors and physicians are starting to embrace the digital world, and realize that’s what patients want. Now if only I can get my OB to get on board, I’ll be a happy camper.

Does your doctor’s office offer a service like this? What do you like about it?

EMR Social Media Integration, EMR and Tablets, and Compassionate EMR

Posted on September 30, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Another week has passed and we’re back with some of the interested EMR and Health IT related tweets this week. Tomorrow I’m flying to AHIMA in Chicago. It’s setting up to be a really great event that should produce some really interesting content. More on that in future posts. Plus, I’m bringing a camera with me and hoping to get a lot of the people I talk with on video.

Now on to the EMR tweets!


Most doctors cringe at even the thought EMR and social media in the same sentence. This is a huge barrier for any EMR to integrate with social media sites. Although, I agree with Dr. Sevilla that it’s going to happen some day.


This article was pretty terrible and felt like the journalist was trying to sell DrChrono. Who knows, maybe the were. Although, the headline and their conclusion is pretty insane. Their logic in the article is that because a large percentage (62%) of physicians use a tablet for professional uses, then it’s the perfect solution for EMR. Talk about a stretch. Maybe the tablet will eventually become the EMR device of choice, but it hasn’t happened yet. It’s fine for consuming content, but not so good at entering data.


Compassion in healthcare. What a beautiful concept. I agree we need to make sure that technology doesn’t get in the way of the many many compassionate people in healthcare.

Paper Has Healthcare Spoiled

Posted on March 16, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As I was thinking about the radical invention of something called paper, I realized that we’re really quite spoiled by paper and its amazing benefits. Let me just list a few of the radical benefits that paper provides a doctor using a paper chart.

* Immediate response to pen – Yes, tablets and styluses are getting better, but there’s nothing like the instant satisfaction of putting pen to paper and seeing the ink spread across the page. Sure, the pen runs out every once in a while, but that’s generally pretty rare. A nice pen just flat out works with an immediate response in the exact location you want something written. There’s no calibration needed. You just pick it up and start using it. It’s beautiful.

* Never a delay when flipping pages – Think about the beauty of paper’s ability to flip between pages. When I turn a page I get an immediate response to that flip and see the desired result (a new page) immediately. I’ve never seen an hour glass when flipping between pieces of paper. I’ve never had a page partially load and need to refresh. Paper has the unique ability to flip pages with instant display of the next page.

* Instant On – Speaking of instant, paper charts are the true epitome of “Instant On” technology. Computers are getting better at making boot times fast and computers turning on quickly. However, anyone who regularly uses a computer knows all the screens you have to see as your computer boots up. A paper chart is beautiful in its ability to immediately be available for you to work. It has true Instant On capabilities.

* No training needed – Ok, maybe this is a stretch of a title. There is no training needed for paper, because since elementary school we’ve been taught how to write with pen and paper. The ability to write is near universal thanks to training in doing so since we were children. You hand a new doctor some pen and paper and they can start documenting their visit. No login or password required. No needing to know how to access Citrix so you can open the chart. Just hand them the chart and a pen and they start charting.

* Multiple page view – The display area of paper is so expandable. If you need a dual monitor dual page view of the paper you just slide it open. If you need a quad page view, you’re only limited by the amount of desk space you have or you could even move to the floor if needed. This easy to manage multi page view is powerful since it’s quite often that you want to see multiple pages at the same time.

* Fast page switching – Take a paper chart and watch how fast you can switch back and forth between pages of the chart. I call this “thumb in chart mode.” With 5 fingers you can even instantly “bookmark” up to 5 locations in the chart which you can switch to and back very quickly with zero load time.

* Flexible to an infinite number of documentation methods – Does paper support the SOAP format? Yes! Does it support every specialty? Yes! Paper has the ability to morph to every medical specialty’s documentation needs. In fact, it can easily be adapted to a different documentation method for every doctor within every specialty. It’s designed so flexibly that there really are an infinite number of documentation methods it can support.

* Easily supports text and graphic input – Oh the beauty of paper. In the same input area you can easily add text or graphics. In fact you can easily link the text and graphics in whatever way you see fit. Some might prefer to write male or others might prefer to draw the universal symbol for male. It’s completely extensible to text or graphics in every area of the page.

I’m sure there are other areas where paper spoils us that I’ve missed, but this is a good start. Hopefully you’ll add any areas I’ve missed in the comments.

Watch for future posts in my “Healthcare Spoiled” series.

Silicon Valley Hype Machine Revs Up Again

Posted on August 18, 2011 I Written By

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’.

 

Guest Post: Why Traveling Nurses Should Use Tablets (iPad) Instead of Laptops

Posted on March 4, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The following is a guest post by Patricia Walling:

The market for tablet devices is fairly new. While they were originally created as a way for people to read digital books and newspapers, tablets now work as full functioning computers. In fact, nearly every function that can be performed on a laptop can be performed on a tablet. You can watch movies, write documents, play games and even surf the Internet. Thus if you are a nurse who travels a lot, carrying a tablet with you can be far more advantageous than a laptop. Not only are these devices highly mobile, but they also have great battery life, offer a plethora of unique features and serve as excellent medical transcription tools.

As a rule, tablets are much friendlier to travelers than other, bulkier equipment. If you have ever taken a laptop to the airport, you know how much of a pain it is to get through security. You have to take your laptop out of the case, place it in a bin, send it through the machine and repack it all over again at the end; this takes time and is always quite a hassle. However, when you travel with a tablet, you don’t even have to remove the device from your bag. Because the ATA assigns a different definition to tablets than laptops, you can just send the bag containing it through the scanner with little ado. Tablets don’t require you to carry a bulky case either, which makes one less thing for you to carry around. In fact, traveling with a tablet isn’t much more difficult than traveling with your mobile phone. For these and many more reasons, tablets are looking like smarter purchase.

You also won’t have to worry about bothering fellow travelers when using a tablet. Type on a laptop can generate a lot of keyboard noise, and chances are it will annoy the person sitting next to you. Tablets allow you to write almost silently using your finger, stylus or electronic pen, not only making the process of writing whisper quiet, but also letting you take notes in a more natural and off-hand way. In this way, tablets allow you to work even on overnight flights without giving others reason to be perturbed by your zeal.

Another advantage to traveling with a tablet is the ability to use a variety of apps. If you are out of the country there are apps that can help you translate foreign languages as well as find a good place to eat and get quick weather snapshots. While you can use a laptop for this too, a tablet makes these tasks much more streamlined. And unlike a laptop’s relatively clumsy mouse-keyboard interface, a touch of your finger can instantly call up a wealth of information. There is no shortagve of travel apps that you can download no matter what operating system your tablet uses, providing you with a simplified and more pleasurable travel experience.

Finally, patient security is often an issue for traveling nurses. No matter the cause, there are serious legal repercussions to consider should a nurse release medical records. There are strict laws regarding patient information. If you pull up a patient’s chart on a laptop, you run the risk of someone else seeing that information. This can get you in to major trouble. A tablet is much more user friendly. The smaller screen, along with flexibility in where you hold the device, eliminates the threat that someone else will see patient information.

While laptops can perform many of the same functions that a tablet can, they don’t make traveling easy. Traveling nurses are always on the move, and a tablet will provide you with flexibility and ease that a laptop cannot match. Not only will having a tablet save you time and trouble at the terminal, but it will also be less obtrusive on the plane, and make it easier for you to provide patients with confidentiality. Clearly, traveling with a tablet is the smart thing to do.

Patricia Walling is a graduate student working toward her Masters in Conservation Biology. She has both professional and volunteer experience in a hospital environment and currently resides in Washington state.

Tablets vs. Convertibles vs. Laptops and EMR

Posted on August 3, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The one fundamental to every EMR is some sort of computer. Yes, I’m using this in the broadest since possible since there are many EMR today that are now even compatible with something like the iPhone. However, even the little iPhone is essentially a mini computer. However, computer makers have long believed that the tablet computers were great for healthcare.

As I look back over my 4 years writing this blog, it’s really interesting to see the evolution of the tablet technology. We first bought our tablet computers over 4 years ago as we implemented our EMR. Correction, we bought our first convertible tablet computers over 4 years ago. They served us quite well. The crazy thing is that almost none of our providers used any of the tablet functionality. I can count on my hands the number of times it was really beneficial to have the tablet functionality.

Since we actually ordered the convertible tablets (converts from a laptop to a tablet), all of our users pretty much just used it like a regular laptop. These convertible tablets came up for replacement as they went out of warranty and it was pretty much a no brainer decision to just purchase laptops instead of convertible tablets.

I’m not saying that the tablets aren’t without their merits. However, none of my users really adopted much of the functionality. In fact, I think I used it more than all of the clinicians combined. Although, there was one feature of the convertible tablets that was used quite often. The swivel screen. Yes, the least technical part of the convertible tablet technology is what they found so useful. They loved being able to swivel the screen to show another provider something in the EMR.

As I researched the various tablets available today as opposed to 4 years ago, I found that no computer manufacturer offered any convertible tablet larger than the 12″ screen. The ones we purchased for use with our EMR were 14″ and we didn’t want to go down. In fact, since we did away with the tablets and just went with laptops, we moved up to the 15″ monitors and all of the providers love the extra space to more easily navigate the EMR.

Of course, the computer manufacturers say that the reason they only do a 12″ size is because no one wants to carry the 14″ ones around. It’s true that 14″ is quite a lot for many providers to carry around. That’s why we just put computers in each exam room. No more carrying computers around and a nice size monitor for your EMR wherever you go.

This said, in one of my EMR consulting gigs I’ve done here locally, the doctor carries his 14″ laptop around no problem. He replaced his laptop recently and decided to continue with the same.

I was lucky enough to just get one of the second generation Dell convertible tablets. It has not only touch screen technology, but multi touch technology. It’s a lot of fun to demo and show off. However, I just don’t see much practical application for it. At least not until I implement an EMR that has touchscreen in mind when they develop the EMR.

What are your thoughts on Tablets, Convertibles and Laptops? Have you found a compelling reason to use the tablet technology in your office?