Michael Nusimow, the CEO & founder at Drchrono, was a recent guest on the TechnologyAdvice Expert Interview Series to share his insight on their leading EHR iPad app. The series, which is hosted by TechnologyAdvice’s Clark Buckner, explores a variety of business and technology landscapes through conversations with industry leaders.
Nusimow joined Buckner to discuss what makes Drchrono stand out from the competition, the importance of protecting the patient-to-provider relationship, and the company’s unique approach to creating a well-designed experience for users.
Michael: What makes Drchrono unique is that we’re a technology-driven and technology-focused company that’s working out of Silicon Valley, and we see ourselves as a tech company in healthcare. I think a lot of the other healthcare IT companies that are selling electronic health record software and medical billing software and services to doctors and medical organizations aren’t really coming from a healthcare background. What we’re really focused on is bringing the most cutting-edge and newest technology and putting them into the hands of the average doctor.
That technology focus shows in a few ways with us. We were the first company to launch an electronic health record app on the iPad, and our iPad EHR and corresponding web services at drchrono.com are completely free. So, everything a doctor needs to achieve Stage 1 or Stage 2 of the government’s’ meaningful use requirements, a doctor could sign up for free in about 30 seconds. We have a freemium model, so the way we make money is by selling additional services on top of the EHR.
TA: Most medical software today looks ancient and fails to lend itself to smooth user experiences and better client interaction. How does Drchrono address these issues?
Michael: We started working on [the system] in 2008 and launched in 2009. We’re bootstrapping the company and building web services for doctors to do patient communication and medical billing. We went to a lot of doctors offices right before the iPad launched.
When the iPad came out, it was just a quantum leap forward over the existing tablet technology. It was an order of magnitude cheaper: $500 for the first-gen iPad, over 10 times cheaper than existing tablet solutions. It had 10 times the battery life. It was 10 times lighter, which was a huge factor if you think about the mobility of doctors and wanting to give them tech they could use.
Around this time I was caring for my father and taking him to a lot of doctor visits in New York City, where we both lived. We’d go to doctors who were drowning in a mess of paper. They’d have a manila folder stacked with paper a few inches thick, and at every visit you have 20 minutes with your doctor, and they would slowly page through it, trying to figure out what’s going on— that lack of automation and efficiency really hurt doctors.
But at the other extreme, I recall going to Cordon Medical Center in New York City, which is a really great world-class facility. They were using desktop EHRs, and for some reason they were always built into the corner of the exam room. I recall going in and helping my father set up in the exam room and sitting there with him, trying to help him through the visit. The specialist that we had, [who we] waited like 3 or 4 months to get an appointment with, spent the full 20 minutes of our visit with his back facing me and my father as he worked on his desktop EMR computer.
And I saw what the software looked like. It didn’t look super well-designed and user-friendly, and it just took something away from the doctor-patient interaction. Your back is facing your patient. You’re really engrossed by the tech, and I think the iPad is the perfect solution for that. When we first launched with the iPad, we knew we were on to something.
I think doctors instantly got it. One figure I remember from Apple’s marketing research was that there were about 300,000 iPads pre-ordered prior to April 2010, when it was physically launched, and 10 percent of those in the U.S. were to physicians, so there were 30,000 physicians who bought an iPad before it ever came out.
The advantage we took of the iPad is two or three things. One is that it’s lightweight, [with a] super-great battery life. They can hold it like they would a chart, but it doesn’t have an external keyboard. It’s a little harder to type on a software keyboard. So designing a native app for it, we were forced to design all of our EHR technology to where the doctor wouldn’t have to type a lot. We use speech-to-text technology. In 2011, we integrated M*Modal speech-to-text before Siri was ever launched. We also designed our clinical workflow for the majority of the input where they’re using clinical templates; we designed where doctors are able to use a lot of touch inputs, so they’re able to choose selections, and choose from single and multiple selective views that they build out, that will replace a lot of their typing.
TA: It seems Drchrono’s goal is to bring back that personal connection between people and doctors and not let a piece of technology get in the way. Instead of being a crutch, it becomes an asset.
Michael: I was recently on vacation in Hawaii and I cut my hand while I was snorkeling. It kept bleeding, and when it didn’t stop I went to an urgent care center. They were actually using Drchrono. I did feel a much better interaction that he was using the iPad during that time, and I felt like he was more hands-on and less distracted. It was kind of funny because he knew that I was “Drchrono,” so I actually spent quite a bit of time there after they bandaged me, talking about our product and their interactions.
The form factor of the iPad is super-powerful, and as a patient I would prefer my doctor to not be encumbered by hacking away at the keyboard. I know they’re not focused on me. That’s the worst thing when you’re in the exam room with your doctor, to feel like your doctor is distracted in checking email and has pop ups and instant messages while he’s trying to treat you. I think the iPad form factor simplifies that, which makes for a more humane experience.
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