Top 10 EMR-EHR Solutions Beyond Disruption by beyond!

TOP 10 EMR-EHR SOLUTIONS BEYOND DISRUPTION

TECHNOLOGY

Issue 17 Winter 2018

Ashish Mehta CEO Pa entClick

10 Making it Possible to Access Healthcare Anytime, Anywhere Online Health Care Challenges Faced and How We Can Make a Win-win Situa on

Access, electronic health records, and the ecology of care P.32

Medical App Development: How to Build a Logbook App for Electronic Health Records P.40

P.20

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EDITOR’S CORNER

oday, medical records are increasingly becoming paperless, although some private practices continue to use a combination of paper and computerized records. Patient medical records are more accessible than ever before with data technology becoming increasingly portable and comprehensive. Current refinements in the medical records industry are aimed at the continued specialization of systems to further streamline workflows, boost productivity, and improve doctor-patient interactions. EMR and EHR solution providers are striving and thriving in this ever-changing digital landscape. However, establishing a company and building a reputation on a wide-scale is by no means an easy feat to achieve. Taking this statement into consideration, Beyond Exclamation is aiming to showcase some of the fastest growing EMR and EHR solution providers across the globe and their conventional way of going beyond to attain exclamation through its issue titled “Top 10 EMR-EHR Solutions Beyond Disruption.” Featuring as the Cover Story of this issue is PatientClick, a leading EHR company that makes it possible to Access Healthcare Anytime, Anywhere. By leveraging the power technology, PatientClick stands out with its EHR solutions that enable physicians to enhance the capability of their facilities and improve patient outcomes. Featuring as the Cover Story of this issue, Beyond Exclamation looks at the journey, the vision, and the rise of PatientClick. Aside from this, we have companies like eTherapyDocs, Medgre, Vee Technologies and Kaaspro, which are making a mark in the industry with their innovative approach and tiring efforts to attain efficiency. In addition to these, we have some of the most thought-provoking articles from various leading industry experts. Dive into the magazine and start scrolling through the journeys of these inspiring companies!

Editor in Chief CHRISTINE [editor@beyondexclamation.com]

Managing Editor JACK [jack@beyondexclamation.com]

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Jack London www.beyondexclamation.com BeyondExclamation @BeyondEx Beyond Exclamation beyondexclamation

In addition to our print magazine, we also provide relevant industry news and updates, as well as some thoughtprovoking articles and blogs on our website. Make sure to follow the same as we at Beyond Exclamation are looking forward to interact with our readers. Let’s connect on the web!

What’s Inside... Business Boulevard

B E O N 10

“We make it possible to Access Healthcare Anytime, Anywhere.”

Omniscient Voyage

Access, electronic health records, and the ecology of care

Excellence Causeway

20 Online Health Care Challenges Faced and How We Can Make a Win-win Situation

22 Delivering Extraordinary Outcomes

Newsmakers Locale

36 Bringing Doctors & Patients Together

Younick Corner

Y D

28 Making Practices Thrive

DeďŹ nitive Destination

40 Medical App Development: How to Build a Logbook App for Electronic Health Records

44 Providing Guaranteed Ease of Use

“We make it possible to access Healthcare Anytime, Anywhere.”

or the past several decades, the healthcare delivery model has not really changed. There used to be a time when provider or physicians used to make house calls as the patient volume had gone up as compared to the no of physicians available to meet the healthcare need. This model eventually changed to oﬃce-based care, wherein patients started visiting the physician’s oﬃce for medical care and diagnosis.

However, by the year 2020, there is predicted to be a huge gap between the demand and supply for primary care providers as well as for any other specialty of medicine. Office-based care model is not seen to be efficient and necessary anymore. The United States will face a shortage of between 40,800 and 104,900 physicians by 2030, according to a new study commissioned by the AAMC. T March 14, 2017, the study found that the numbers of new primary care physicians and other medical specialists are not keeping pace with the demands of a growing and aging population. This is because of the ongoing innovations in the healthcare technology and video-based telemedicine, which allows both patients and the physician to speak face to face. The dual model of face-to-face and in-person approach has narrowed down to only the face-to-face approach. Amidst all the backlash surrounding this model, it still offers a personalized touch with the provider and is much more efficient and cost-effective for both the patient as well as the provider. Hence, there no longer remains the need for the provider to make house calls and for the patient to travel all the way up to the physician’s chamber.

Ashish Mehta CEO Pa entClick

By leveraging the power technology, PatientClick stands out with its EHR solutions that enable physicians to enhance the capability of their facilities and improve patient outcomes. Most importantly, the company helps solve this vital issue surrounding the shortage of physicians and clinicians with its solutions. Featuring as the Cover Story amongst our “Top 10 EMR-EHR Solutions Beyond Disruption,” Beyond Exclamation looks at the journey, the vision, and the rise of PatientClick. An Easy and Efficient Solution PatientClick offers an all-in-one secured, Electronic Health Record, Practice management, & TeleMedicine solution with integrated automation and artificial intelligence built in to manage the workflow of multilocation, multi-specialty clinics. The system offers comprehensive scheduling, document management, and clinical note management capabilities along with the ability to ePrescribe, securely order controlled substances, Lab orders etc. electronically. Some of the unique features of the PatientClick platform includes patient engagement and appointment reminders via SMS, email, and push notifications.

The internal smart engine of the platform takes care of the Physician’s credentialing, current contracted rates with the payers and scrub claims and sends it to the payers upon receipt of the response. The payment auto posts it to the patient accounts and generates patient statements with a simple click! The telemedicine solutions of PatientClick integrated with EHR and Practice management enables office staff to integrate clinical data and financial data along with video-based face to face visit. The technology is built around the fact that there is no fall outs or claims lost through the cracks in the process. The video-based telemedicine also allows the provider to capture remote patient’s vital signs data, as well as any other activity tracking device data! “Our team in Healthcare Technology space have more than 10 years of extensive experience. We understand the need of Physicians or clinical staff, whereas most EHR/EMR companies build their business based on the software developer background,” Ashish mentions while speaking about the company’s competitors. “Affordable Healthcare for All” Healthcare is changing at a very rapid pace. The new generation

Vishal Mehta Founder & President PatientClick, Inc.

needs access to everything and anything without any wait time. Along with the changing face of the healthcare landscape, government rules and regulations are also changing rapidly to accommodate all the changes which are primarily influenced by the technology upgrades. However, amidst all these changes, the key challenge for the team at PatientClick is keeping up with the regulatory requirements, client requirements, and keeps its technology upgraded and up-todate to compete in the marketplace. The team at PatientClick dedicatedly works on what’s coming next into the market and focuses on how they can help providers, clinical staff, to be more efficient, so as to enable them to keep their focus on what they are best at doing. These thoughts and approaches of the company are inversely linked with its overall goal – “Affordable Healthcare for All!” A Leader with a Vision

Ashish Mehta CEO PatientClick, Inc.

Ashish Mehta, the CEO and Chief Visionary of PatientClick, holds a pioneering presence in the company and in the industry owing to his extensive experience and knowledge of the sector. His leadership allows the rest of the team at PatientClick to work on innovative projects such as integrated telemedicine solution

with EHR and Practice management. The inspiring leader boasts more than 18 years of experience in Healthcare IT, Technology, and International business. He serves as the board member of Alliant International University and also serves as a mentor with CONNECT. Ashish has also served as the ambassador for the World Trade Center in Cleveland, Ohio. Making a Mark in the Industry It was back in 2008 when EMR (Electronic Medical Records) had just started out as a digitization of paper-based medical record to electronic. However, as time started to change, by 2011, the first ever certification requirements by the ONC was released as meaning use stage 1 followed by stage 2 and stage 3 requirements. Today, PatientClick EHR is meaningful use stage 1 and stage 2 certified as well as stage 3 modular certified, which is kind of like the Gold Standard in Certification. With all data being digitized, or rather most of the clinics being digitized, the next wave is slated to be data analytics and artificial intelligence in clinical medicines. According to Ashish, “The financial loopholes and claim based challenges will be

eliminated as software can now read the historical data and our applications will have enough intelligence to identify, modify, correct, and/or resubmit medical claims and or get paid much faster than ever before. Better, more efficient medical offices will be coming soon. Patients will get text or push notification reminders from the doctor’s office and before you show up for appointment the doctor’s staff will have complete information about your insurance, deductible and out of pocket limit so you and they can plan in advance on how you can take care of your current visit charges and the collection cycle will hence be reduced to days from weeks or months.”

physicians. The usage of mobile devices also helps assist physicians in geo-locating the patients, as well for keeping track of all the necessary details, like the calls that were made.

An Innovative Integration of Mobile Technology

Since Patientclick is an integrated EHR, Practice management, and telemedicine product, the company helps identify the data point from each segment and runs a report across all components for a specific clinic or even for a specific physician within a group. Speaking about this, Ashish mentions “The decision-making based on Knowledge and intelligent data point would put practices on a different level!”

Aside from virtual visits, the patient portals of PatientClick oﬀers individuals with the capability of intuitive scheduling, attaining informational materials concerning the current medical conditions of the patient, and providing e-visiting billing. The solutions of PatientClick are compatible on multi-devices and can be accessed with ease through both an Android as well as an iPhone mobile device. This enables the patient to identify and select the medium of interface that they would prefer for communicating with the

A Step into the Future Moving ahead, PatientClick is slated to come up with artificial intelligence built into its medical record software. This would allow providers to predict the expected patient inflow for a day in advance as well as the likeliness of the patient following the medication plan, and finding the patient medical adherence score, clinical decision-making process, etc.

physicians. The usage of mobile devices also helps assist physicians in geo-locating the patients, as well for keeping track of all the necessary details, like the calls that were made. A Step into the Future Moving ahead, PatientClick is slated to come up with artificial intelligence built into its medical record software. This would allow providers to predict the expected patient inflow for a day in advance as well as the likeliness of the patient following the medication plan, and finding the patient medical adherence score, clinical decision-making process, etc. Since Patientclick is an integrated EHR, Practice management, and telemedicine product, the company helps identify the data point from each segment and runs a report across all components for a specific clinic or even for a specific physician within a group. Speaking about this, Ashish mentions “The decision-making based on Knowledge and intelligent data point would put practices on a different level!”

Online Health Care - Challenges Faced and How We Can Make a Win-win Situation

Dr. Atish Laddad Pediatrician & Founder Member The Pediatric Network

ndiaâ&#x20AC;&#x2122;s noticeable beneďŹ t is the huge pool of online medical specialists and experts working round-the-clock and the comparatively lower medical costs as equalled to other western and Asian countries. The way internet penetration and alertness about health care is growing in India, ehealth care services would mature at a very healthy rate.

comparative upsurge in incomes and extra importance on awareness of health and other such factors contribute to this advance. Not just this, there is a noteworthy demand in the quality of healthcare services in Tier-II and Tier-III cities, indicating the fact that people are identifying the necessity for specialty-care. The healthcare industry recently has become highly controlled. The range and intricacy of healthcare regulation has made it extremely tough for organizations to embrace novel know-hows. As a result paralleled to other industries, the healthcare segment has been fairly slow to accept technological revolutions. When thinking about technology in the healthcare segment, and more precisely embedded communications, there is a gamut of vital factors to be considered. Despite its massive growth potential, the healthcare industry faces challenging situations that hamper invention.

Digital Healthcare The fact that we barged into the digital healthcare space is enough evidence that healthcare will leave no stones unturned to join forces with the World Wide Web, exploring enhanced ways to attach with probable patients. E-health in current times has witnessed a volatile market evolution and shows no sign of slowing down. The Indian healthcare division alone is projected to touch $160 billion in the year 2017, which is crudely double from what it was in 2012, leading to a progress rate of about 15 per cent.

So Where Does the Real Challenge Lie? Online medical professionals interact with the masses through a gamut of hashtags, likes and shares. However, this technologically savvy trend can also result in misunderstanding. Patients might take to self-

Factors That Made Movement Possible This movement is made possible due to a group of factors like easy access to good healthcare facilities,

diagnosing and treating themselves. Although social media has its own doles, it’s vital for patients to get themselves checked by a doctor in case of any emergency medical issue. The only solution to this situation is that online healthcare portals should make it accessible for people to browse online through quality doctors, read through feedback provided by patients and must be able to book their next appointment with just the click of a button. Ÿ

Secondly, India comprises a major portion of people who are introduced to doctors by family and friends or by word-ofmouth. Getting these people to trust that their medical issues can be solved through the podium of internet is a real challenge. Instilling trust factor among these people can deﬁnitely bring in great victory for healthcare portals. Another challenging situation would be online healthcare is not at all accessible to the

community of people who are not technologically savvy. The rural classes are not at all familiar with receiving online medical care. Language barrier is also another impediment that creates a challenge for many. There is a need to create a more aﬀordable and accessible platform to cater to all the strata of the society Ÿ

Security is a major concern while dealing with online health applications since it involves conﬁdential and sensitive health data of the patients. The healthcare industry has very rigid requirements around cryptographic security that commands how and when the data should be translated, conveyed and decrypted.

Many healthcare professionals are still very unwilling to modify their current approaches and systems that they’re familiar to. The worth of current technologies needs to be rapidly accepted and proven to surge

competency and customer satisfaction. Ÿ

For the healthcare portal to emerge victorious being high in performance and oﬀering high quality service round the clock becomes mandatory. For example a chronically ill patient must receive the required online help at given time of the hour.

While there’s no looking down for the healthcare industry, online healthcare is undoubtedly emerging as the real hero. Studies have revealed that there will be about 550 million users of internet by the year 2018. Online healthcare has improved communication amongst various people by not only making doctors and hospitals more reachable to patients, but is also aiding patients bond with other patients. These podiums are not just informing people but are also encouraging and inspiring them.

Chocko Valliappa CEO & MD Vee Technologies

Delivering Extraordinary Outcomes

associate with one of the top ranked insurance companies, in the United States of America, as its ﬁrst client. The insights and experience gained from this association, inspired us immensely and boosted team’s conﬁdence to move into health information management outsourcing industry. With an extensive understanding and knowhow of the healthcare sector in the US, Vee Technologies has the expertise to meet any challenges, arising from both, payers and providers which gave us the momentum into the healthcare sector.

he process of digitization has created a wave of success amongst many leading industrial sectors and so Healthcare industry too has been a major beneﬁciary. Going in tune with the paperless and online transactions, EMR-HER has played a pivotal role, in taking operations to the next level. Though EMR-HER has eased out many a complex processes which were hitherto very time consuming, there is a need to always keep the process, compliant, with the ever changing technology trends, at all times. One company, which has been keeping up with the ever changing trends in the healthcare industry since 2000 is Vee Technologies.

Vee Technologies extends its services equally to both Healthcare payers and Healthcare providers, in the USA. By associating with the company, healthcare providers can look forward to a range of services which include end to end healthcare information management and revenue cycle management. Similarly, the healthcare payers sectors are also at an equal advantage as medical coding, risk adjustment optimization, independent clinical reviews, DRG

Providing formidable services to every client Vee Technologies, today, excels in providing a complete healthcare solution. Its ambitious journey was started by venturing into revenue cycle management. Vee Technologies was privileged to

Validation, claims management, member management, contact center services, and network data management, complete a list of formidable services on oﬀer. For both, the healthcare payers as well as the healthcare providers, Vee Technolgies extends its quality services in the IT and Analytics sectors too.

youngsters, who are keen to contribute to the growth of the organization. In addition, Sona University’s acclaimed R&D center is a value addition to all the ﬁrm’s clients. Vee Technolgies, to its credit, has a well-established quality of service that results in extraordinary outcomes for its clients every single time. The presence of an onsite operation team to coordinate and be a Single Point of Contact (SOP) for the clients in the US, and domain experts with a technical knowledge in the latest platforms, have resulted in establishing longstanding partnerships with clients, spanning 7-10 years, which is rare in the industry.

Fearless approach to meet the goals The emergence of the cloud platform has given a new dimension to many ambitious projects. Vee Technologies, through its continuous and meticulous research, is abreast with the changes in technology. In addition, Vee Technologies is proud to have the continued support of its own University, The Sona University, which serves the company with exquisite talent to choose from, in the form of ambitious

Being the ﬁrst choice amongst the choicest of clientele Accuracy, competency and teamwork, resulting in

extraordinary outcomes, have been the hallmarks of success in the journey of Vee Technologies. Fearless approach to meet its goal irrespective of any quantum of challenges makes Vee Technologies, the first choice amongst the choicest of clientele. Vee Technologies has continuously focused on giving quality rich services to all its global clients, by embracing new technologies and developments. The healthcare industry, today, is surrounded with innumerable challenges. Persistent amongst them at various levels are the fee-for-service and population health schemes. Vee Technologies knows that with a majority of payers and ACO’s focusing more on analytics to study the risk factor in patients to keep them hopeful and confident as well as the induction of Artificial Intelligence, to make the processes, more automated, there is an immediate need to clearly and completely understand the technologies behind

process automation, like, NLP, Machine Learning etc. Realizing the same, Vee Technologies now plans to enter into Robotic Process Automation (RPA), Machine Learning (ML) and Artificial Intelligence platforms, which are much in demand and include these technologies towards developing value added, quality rich, products for its global clients. A dynamic leader with great business acumen Chocko Valliappa, the great grandson of visionary freedom fighter, industrialist and philanthropist, Karumuttu Thiagaraja Cheittiar, has been a leader par excellence and a true inspiration to Vee Technologies family. Combined with a passion for using technology, in niche development areas and a vision of an entrepreneur, he has been able to establish a link between the market requirements and the capabilities of Vee Technologies. Since the last two decades, Chocko Valliappa’s contributions have been unparalleled, in helping Vee Technolgies, serve the top ranked hospitals and insurance companies, in the United States, with quality services. Chocko has held key positions in administration, international business and operations, corporate affairs, strategic planning and marketing, and planning of corporate policies. He possesses an in-depth knowledge of European, Asian, & Pan American markets and a comprehensive expertise in forging alliances and joint ventures of strategic importance. Furthermore, he is one of the founding members of the YEO Bangalore chapter. Chocko also has a great passion for empowering the community. With this aim in mind, he established Sona Yukti Pvt. Ltd., which provides skill-based training with a strong industry focus. He is also the Vice Chairman of Sona College. With his varied experience in education, industry-focused skill development, technology, and a traditional industry background, he is guiding Vee Technologies to reach the heights of success on a global scale.

Eric Hoell Founder & CEO eTherapyDocs

Making Practices Thrive

development and regulatory/HIPAA experience. And the cornerstone of eTherapyDocs was laid as they worked closely with many small to medium sized practices, speaking with physical, occupational, and speech language pathology therapists to ensure their product met the needs of pediatric practices. Today physical, occupational, music, mental health, and speech language pathology practices across the country use eTherapyDocs.

he EMR-EHR industry’s focus is quickly moving toward the ability to interconnect diﬀerent systems together in order to share data. With new meaningful use requirements, healthcare practices will be forced to participate in the health information exchange in order to receive payment for services. Today, there is very little sharing of data among hospitals, clinicians, and other healthcare providers. The HITECH act begun to change that in 2009 and many hospital systems adopted basic EHR systems, but true data sharing is still limited.

A simple to use pediatric focused system Focused on adding features and functionality to resolve real problems that small to medium sized pediatric therapy practices experience, eTherapyDocs has continued to create ‘a simple to use’ pediatric focused system since its foundation. Treatments are easily and eﬃciently documented within the system using any internet enabled device, pulling information from discipline speciﬁc patient goals. Complete treatment notes, plan of care, progress notes, and other uploaded patient documentation can be exchanged in a secure HIPAA compliant way via integrated messaging and secure faxing. eTherapyDocs’

Two years before the HITECH act began to change, Dr. Denise Hoell DPT expressed her frustration with practice management systems in the market to her husband, Eric Hoell. Denise found the existing systems to be extremely complicated, not pediatric focused, and didn’t allow for the full narrative documentation that she and many other members of the NDT community commonly utilize. Together, they brainstormed combining Denise’s years of pediatric experience, with Eric’s background of software

integrated calendar provides visual feedback to help remind therapists of appointments that still require treatment notes, and provides appointment reminders to patients via both email and text messaging. The company combines its functionality with outstanding client services, to ensure the best service possible.

Eric started his career in customer service and software development in the 80’s with a large Fortune 500 company, where he learned the customer and process skills he leverages today. He has helped to lead a number of healthcare start-up and holds several hardware and software patents. Eric was invited and participated in a healthcare roundtable at the White House, and has worked closely with the FDA to deploy thousands of healthcare kiosk across the nation. Today Eric is focused on his true passion, eTherapyDocs.

Committed to remain focused on pediatric practices The biggest challenge in the market according to eTherapyDocs is to remain pediatric focused. The large practice management systems disregard the fact that the goals and approaches to therapy are different for pediatric clients; the tools the therapists need must match their treatment approach and documentation preferences. The majority of adult orthopedic & rehabilitation practices are much larger than independent pediatric practices, therefore big practice management systems focus their efforts of their product development on the larger, and often more profitable, market of adult rehabilitation.

Continuing to improve the product ease of use Going ahead, eTherapyDocs is committed to invest and provide enhancements to the eTherapyDocs product. Annually, they conduct a survey to all of their practices presenting new ideas for product improvements, and working together with the practices they, prioritize new functionality. eTherapyDocs will be also continue to improve product ease of use by leveraging the latest technologies and enhancing data integration with other products.

Be that as it may, eTherapyDocs’ commitment to remain focused on pediatric practices combined with its constant involvement in the pediatric and NDT community allow the company to remain connected to its practices. eTherapyDocs continues to work closely with its practices in developing new features, and focuses on providing excellent customer service. It receives feedback from its practices regarding how easy eTherapyDocs is to use; Therapists want to focus their time and eﬀort on treating patients, not trying to ﬁgure out technology.

For more information, visit https://etherapydocs.com/

Making passion, a profession What makes Eric, founder and CEO of eTherapyDocs, diﬀerent from other CEO in the industry, is that Eric personally has over 30 years of experience in software development, focused on user experience, customer service, and the regulatory aspects of healthcare. His technical and customer skills, combined with his passion for his wife’s pediatric therapy ﬁeld of practice, makes Eric passionate about eTherapyDocs every day.

Cherry on cake eTherapyDocs has, over the years, worked with numerous clients and has provided them with the best practices in the industry. Let’s take a look at what the clients have to say about eTherapyDocs’s service. “eTherapyDocs is so easy to use. I am the biller and have to pull charges every week to enter into Medisoft. This is the easiest program I have ever seen. It takes me about 60 seconds to pull the charges and print them out. How much easier can you get?” “User friendly program, the calendar with patient text reminders have significantly cut down our number of “noshows.” The view today’s schedule gives a quick easy to see overview of the day’s schedule. The ability to upload scanned documents and to print notes to a PDF file simplifies the prior authorization process for insurance companies.” “e-Docs has provided a system for scheduling and documentation that facilitates treatment planning for individual sessions as well as across time. The staff has been extremely supportive and assisted us to transition us from individual documentation to more electronically documented and tracked notes. There are many aspects of the notes that are completed automatically that allow the therapist to focus on the critical aspects of treatment planning and noting changes across time. We have clearly saved time and money by using this system. I would highly recommend e Therapy Docs.” “We have been using E-therapy docs in our practice for several years now, and it has been fabulous! The therapists love the flexibility of accessing their patient notes and contact information on the web. Our billing manager is off-site, and can retrieve notes and evaluations for insurance companies in an electronic format which saves time and money. Our in-house costs for printing have also significantly decreased since we transitioned to electronic data.” “Using e-Therapy Docs has made my job as an assistant billing specialist simple and efficient. When filing for Medicaid PA’s, I can quickly and easily select the patient, all of their clinicals and most recent notes, and have the PA filed in mere minutes.” “eTherapyDocs allows me to focus on what is really important, the rehabilitation of these children. It’s easy to learn, allows me to expand on my note documentation, keep up with quarterly reports and improves communication between therapists. I really appreciate the text reminders to help remind patients of their appointments.”

Dr. Eric B. Larson Executive Director

Access, electronic health records, and the ecology of care

igital technology provides increasingly more ways for patients to connect with their providers. And many primary care physicians appreciate the convenience patients now have via systems like web-based portals and secure messaging. At the same time, many physicians feel challenged to manage a new, 24-hour cycle of incoming requests for information and advice.

Discussing this with colleagues recently, I mused that access has been a challenging issue for decades — at least as far back as 1962. That’s when Kerr L. White, MD, published a paper in theNew England Journal of Medicine(NEJM) describing “the ecology of medical care,” quantifying rates at which adults typically seek medical help. He found that during a typical month, about 68 percent had symptoms of illness or injury, and 23 percent consulted a physician. Fast forward to 2001 when Larry A. Green, MD, published a similar study inNEJM that showed little had changed. Each month, 80 percent of people had symptoms, and about 22 percent visited a physician. So despite how communication technologies evolved between 1962 and 2001, our care-seeking behavior remained much the same. Most people felt bad fairly frequently and many sought care. (Interestingly though, the majority didn’t contact their providers when this happened. As Green explained, about 33 percent thought about seeking care, but only

22 percent actually had an oﬃce visit. What happened to the one-third who considered a doctor visit but then didn’t go? His study didn’t say, but we know from decades of primary care research that most probably got better on their own.) Think of all that’s possible Should we be surprised that careseeking behavior changed so little over four decades? Maybe not. While society changed dramatically in the intervening years, most people still experienced their sense of well-being as people always have; they had physical complaints and illnesses; they looked to doctors and nurses for comfort and relief. And what about today? I’m not aware of recent studies updating the work of White or Green. But I do know that 17 years later, digital technology has continued to evolve — creating more challenges for primary care providers who aim to keep pace with patients’ expectations for convenient access. Think of all that’s now possible with smartphones, text messaging, interactive video, personal health monitoring devices, social networking sites, and more. In an editorial accompanying the Green piece, Thomas H. Lee, MD, wrote, “Patients today are increasingly unwilling to live with the perception that their needs are going unmet.” Faced with such pressures, how will dedicated primary care providers achieve high standards in meeting patient demands? As a researcher practicing internal medicine for the past 40+ years, I don’t pretend to have the answers. But it helps to take the long view: The “access problem”

is not new; what’s new are digitally based channels of access, as well as technologies that could be better designed to more efficiently and effectively meet patients’ needs. Take, for example, the tools we’re now using for collecting, storing, sharing, and analyzing information about patient-provider encounters. It’s no secret that many physicians are quite dissatisfied with the current state of the electronic health record (EHR). Heralded more than 15 years ago as a way to provide reliable patient data at the point of care, the EHR has dramatically changed how providers work, taking time and attention away from valuable patientprovider interactions. In a 2016 study by Christine Sinsky, MD, in the Annals of Internal Medicine, observers documented that for every hour of direct clinical time with patients, physicians spent 2 additional hours on EHR and deskwork. EHRs have been linked to higher physician burnout and safety concerns. A 2017 patient safety review published in the Agency for Healthcare Research and Quality’s Patient Safety Network reported that adoption of the EHR may lead to decreases in medication errors and improved guideline adherence, but usability issues are also contributing to medical errors. It doesn’t have to be this way I don’t raise these concerns out of nostalgia for the “good old days” of paper records. Rather, I’m calling for a better future when health information technology can be as efficient and customer-centered as we see in other industries. Think banking, retail, aviation — and all the efficient tools workers have to predict

and meet customer demand. To match these realms, however, we must be committed to designing the EHR as a tool to serve high-quality patient care and create efficiencies for providers, not extra work. Unfortunately, today’s EHR systems are designed for other purposes, primarily to improve billing and regulatory compliance. It doesn’t have to be this way. Given all the skills and knowledge that today’s computer scientists are amassing in fields of predictive analytics and user-centered design, we should be able to develop something better for our patients. Providers should have an EHR that serves health care’s entire quadruple aim: improving the experience of care, improving the health of populations, reducing per capita costs, and improving provider experience. (Note that improving revenue generation in a fee-forservice system is not on this list.) Designing a better EHR will require a very different focus, one that centers on our mission to provide high-quality, affordable care to improve the health of our members and the communities we serve. This mission is the reason most of the Kaiser Permanente physicians I know came to medicine. As highly skilled professionals, we have a calling and a belief in our work and our model of care. None of us want to experience burnout — and especially not from using tools that require excessive bean-counting and tracking irrelevant metrics. There is an alternative and that is to create a tool that better serves our patients and our mission.

Kumar Subramaniam Founder & CEO Kaaspro

Bringing Doctors & Patients Together

Assisting and empowering the medical professionals

MR/EHR adoption has been growing in a big way during the recent times, thanks to various factors such as easy and timely access to patient medical data, more efficient data capture, and improved interoperability. With advancement in technology becoming more wide-spread, healthcare industry has been embracing software solutions such as EMR and EHR on a large scale, as these solutions have the potential to make the lives of patients and providers better. Driven by potent forces such as Meaningful Use and incentive programs, there’s no doubt about the increased adoption of health information technology solutions in the future. Recognizing what would future hold for the healthcare landscape, one firm started building the most reliable and affordable services and solutions to clinicians and healthcare facilities – Kaaspro, the exclusive health information technology services provider.

To assist and empower the medical professionals to achieve providing the most optimal healthcare to their patients through varied health information technology products has been motto of Kaaspro since the foundation. The firm has developed, in partnership with clinicians and IT professionals, innovative products such as 75Helath EMRs, 75Health EHRs, 75Health Personal Health Records, and 75Health Practice Management System. Moreover, the team at Kaaspro has ensured that by adopting cloud technology, its clients-clinicians and hospitals, are enabled to provide improved levels of services and care than what would have been possible by using their internal IT efforts. Kaaspro is able to facilitate clients to accomplish flexibility and scalability, bring down operational costs, and achieve reliability and security, thanks to our exclusive cloud-based solutions.

Similar to other industries, the global healthcare industry is also experiencing a period of innovation and growth that is based on information technology. One of the options in the modern era is leveraging the capabilities of cloud systems to develop and accomplish eHealth goals. “At Kaaspro, we help medical practices and providers to reap the exclusive economic beneﬁts and information management advantages oﬀered by the cloud,” Kumar Subramaniam, company’s founder and CEO.

governmental policies and standards have proven to be particularly difficult to adapt with,” Kumar adds. Fulfilling unique client needs while adhering to all statutory and individual compliance needs has been one of the biggest challenges that Kaaspro faced. But Kaaspro has surmounted these issues by fine-tuning the company’s products according to the specific client needs and making the essential changes to meet all compliance needs. Also, the company has always included its clients, employees, and all stakeholders involved in its projects. By ensuring that they are all actively taking part in the various stages of creating products, Kaaspro accomplishes the capability to face any challenge that comes up.

Dedicatedly striving to satisfy the varied requirements of the clients Storing, sharing, and processing critical patient health information has been one area of concern for medical professionals since long. Thanks to the modern Cloudbased Electronic Health Records (EHRs) and Electronic Medical Records (EMRs), clinicians are now able to manage patient records in a convenient and secure manner. The once paper-based medical records have been rendered robust and accurate with the entry of cloud-based systems in the health information technology front. As cloud-based EMRs and EHRs were found to be the most optimal solutions for taking medical data management to the next level, Kaaspro has devoted time and eﬀorts to come up with the best and most reliable cloud-based systems. Kaaspro has germinated the idea of developing cloudbased health information technology to assist hospitals and doctors considering the various advantages such as eﬃcient and integrated patient care, better patient data management, secure and accurate information, and increased care quality and productivity.

An industry veteran striving for better future Kumar is an electronics engineering graduate from the prestigious PSG Institute of Technology, Coimbatore. Motivating leadership and technological foresight that helps the healthcare fraternity with solving their unique needs are his strongholds. Having an industry experience of over 20 years, he has gained the expertise and capability to drive the company ahead. Kumar encourages innovative ideas and assists developers in coming up with their dream projects in a manner that not only brings out the best in them but also satiates the client needs effectively. Having identified and understood the immediate needs of the medical professionals with their hectic activities, and the demand of patients and individuals with regard to the most optimal healthcare and safety, he has conceptualized the most reliable and efficient health information systems and worked along with the team for successfully building the same.

With several vendors and service providers pitching for market share and the medical industry constantly evolving, it has not been a smooth sailing for Kaaspro. “We have been dedicatedly striving to satisfy the varied requirements of our clients in the everchanging medical ecosystem. Huge changes such as the value-based reimbursement model and

Unmatched and reliable services Kaaspro’s ﬂagship software, 75Health EHRs and EMRs are the modern real-time electronic version of

patient medical data that describe all necessary information in minute detail. By making its products patient-centric and doctor-friendly, Kaaspro has ensured that users ﬁnd them unmatched and reliable. Enabling managing and exchanging critical patient data in the most reliable and fast manner, the company’s EMRs and EHRs convey accurate information to the intended destination.

motto of any medical practice, namely, providing the most optimal care to patients under the most economical manner, products such as 75health EMR/EHR lend reliable assistance. Kumar believes in customizing his products according to the specific needs of each of the client. Medical practices of all sizes and different specialties will be able to get their needs fulfilled with Kaaspro’s products.

“We have ensured that our health information technology products unfold case-specific solutions, thus increasing patient safety and patient outcomes. Our products help healthcare facilities and clinicians in bringing down redundancy and improving efficiency, while ensuring that patients are empowered to cut medical expenses and encouraged to take active part in their care. We have taken care that all stakeholders are involved in the crucial development stage of our health information technology products, ensuring that all possible requirements of clients are met with effectively,” Kumar asserts.

Kaaspro envisions cloud technology and mobile integration to be the factors that are going to impact the healthcare industry in a positive way in the coming years. The company has a few innovative and sophisticated medical information technology products in the developing stage. “We aim at providing software solutions to the medical professionals and healthcare facilities that enable them to oﬀer the most reliable and safe care to their patients. Our vision is to help the medical fraternity with the most reliable and eﬃcient systems that facilitate improving the health of the entire society,” Kumar concludes.

Any technology solution, to be able to satiate the client needs on a long-term basis, must be updated on a regular basis. “We are particular about providing follow-up on implementation, continuous customer support, and long-term updates. This way, we make our clients feel at home with our products regardless of time period. This also ensures the busy medical professionals are never stuck with any hindrance at any stage after having adopted our products. We take responsibility of tweaking the product according to their requirements at any point of time,” he further adds. Enabling clients to achieve the best care quality possible Kaaspro has been striving to oﬀer the clients the most economical and eﬃcient solutions that make running their practices smooth and achieving the best care quality possible. To be able to accomplish the primary

Medical App Development: How to Build a Logbook App for Electronic Health Records

iewing, storing and exchanging health data in an eﬃcient way is one of the biggest challenges that app developers have to deal with when designing medical apps.

There used to be a time when working with medical records required a serious amount of paperwork and all records (as physical copies) were stored at the hospital. With new technologies appearing the situation changed, but even though electronic records are indeed more convenient, they are not perfect. Many challenges and opportunities remain for medical app developers. What is an electronic medical records app? Medical apps that store and exchange personal health information most often come in the form of a logbook that contains all medical records that a particular patient accumulates over the course of time, and can be viewed by both a patient and a doctor. Some apps are designed to be used by only one person at a time, while others allow users to store several people’s health data in one place. For example, it is possible to save the records of all family members in a single app. A medical records app should be able to keep different types of information in a convenient and secure way. The types of data that a user might want to store in a medical logbook app may include medical records, patient-added information (discussed below), and reminders. Let’s see what each of these types of data may look like. Medical records: 1. Test results and lab work which can be stored in the form of a chart or graph. An ideal logbook would offer some pre-made templates that could be used for common lab results such as heart rate, blood pressure, red or white blood cell count, cholesterol level, and urine test results. It would also be desirable to offer customizable features that would allow users to create templates for rare medical tests. 3. X-rays and scan images (e.g. CAT scans or MRI scans) 4. Prescription/ medication descriptions including photos of drug packaging, pills, and leaflets provided by pharmaceutical companies.

Kate Abrosimova CEO & co-founder Kaiiax

Additional records: 1. Emergency contacts can offer contact information for family members, and information about caregivers and local emergency departments. It’s important to add a list of medications that a patient is taking to the screen with emergency contacts. 2. Doctors’ contacts with hospital info, working hours, and a log with the patient’s previous appointments. 3. Health insurance information including a copy of the insurance card, policy number, and contact details. 4. Immunization schedule. Possible reminders may include appointments with doctors, vaccination calendars, and various medication reminders. How do users upload all this information to a medical records app? There are two different approaches: 1. A logbook that requires manual input of all data (typed, scanned, or in some other way uploaded by the user). 2. A logbook that automatically receives medical data from sources such as a hospital or clinic’s database to the mobile app. Type 1: Apps that require manual input The first type of logbook app

requires manual input of data. In this case, only users are responsible for updating their information, whether it be a CT scan image or an appointment reminder. It is also possible to develop such a logbook in a way that allows users to upload data from certain types of wearable devices. It is important to note that we are talking about fitness trackers and smartwatches here, because medical sensors are in a totally different category. An app that exchanges data with advanced medical sensors must comply with HIPAA requirements, as discussed in one of our previous articles. When data is uploaded by patients themselves, and doesn’t involve health care providers, then apps are less prone to privacy breaches. Type 2: Apps that automatically receive data The second type of medical records app relies on automatic updates from different types of medical devices and other apps on a user’s smartphone (for example Google Fit or HealthKit). Automatic upload of medical records is far more convenient for users than manual input. But on the negative side, attaching an app to any piece of hardware is a security concern, meaning that app developers must make sure that all personal health data is protected at all stages.

Furthermore, developing a medical app that shares personal data is complicated and raises a number of ﬁnancial and legal concerns for both clients and developers. Legal requirements an app should comply with often depend on a particular country’s laws and regulations. In the United Kingdom, for example, medical information protection is regulated by the Data Protection Act of 1998 (DPA), and if an app is developed for the US market, then HIPPA requirements should be taken into consideration. How can a logbook share diﬀerent types of data? A good medical records app should provide a number of options when it comes to sharing personal health information: Ÿ Generating health data reports and sharing them via email or cloud. Ÿ

Uploading existing records from other sources onto a device.

Sharing data easily among devices (through wiﬁ networks or via Bluetooth)

The type of data that a user can share in an app will deﬁne which security measures medical app developers must implement in their product. The only more or less secure way a medical logbook app can operate is

if the user is fully responsible for uploading and updating all healthrelated information. In this case, an app does not need to interface with any outside servers, and data can be stored locally and securely on a user’s phone. Complying with industry standards of formatting If you make up your mind to develop a medical records book, another thing you should take into account is data formatting standards. A logbook will be of little use for patients if the format of the medical reports and documents in the hospital is critically diﬀerent from the one oﬀered by the logbook. Modern hospitals use electronic health record systems (EHR) which allow their physicians to access patient records. This means that a medical records app that is designed to provide a hospital with records should use the same format that the EHR uses. The Continuity of Care Record (CCR) exists in the US as a format for personal medical records transmission. It’s an industry standard that allows for the creation of e-records, and reduces medical errors by making current information available to physicians. Like any personal health record (PHR), the Continuity of Care Record operates with patientrelated information, such as patient

demographics, insurance and health care provider information, medication lists, allergies and recent medical procedures. Under the United States guidelines for the meaningful use of electronic health records (EHR) technology, a certiﬁed EHR system must be able to receive documents formatted in either the Continuity of Care Record or the Continuity of Care Document standard and display them in a human-readable format. For medical records app developers this means that any logbook designed in compliance with these standards will be able to exchange patient data with US hospitals, as well as with large health and ﬁtness platforms that keep user records (e.g. HealthKit and Google Fit).

Mobile technology is rapidly developing and modern smartphones are increasingly able to sync up with electronic health record systems, allowing physicians to access patient records from remote locations. Yet there are a lot of challenges when it comes to using mobile platforms for storing and sharing electronic health records. Data has to be accurate, private and secure, and well-integrated with existing healthcare systems. Once devices and apps become truly connected, they will be able to store and share immense volumes of data with valuable insights with doctors and other healthcare professionals.

Sebastian Kurian Co-founder & CEO Medgre

Providing Guaranteed Ease of Use

technological know-how, and extensive business and managerial expertise. With more than six decades of combined industry knowledge, the founding team has brought their visionary passion and technological innovations to the healthcare market segment, with a vision to bring transformational technology products to physicians and health care professionals.

hen it comes to talking about companies building products that physicians want, the first name that pops up is Medgre (Green Apples MedSystems, LLC) – a West Virginia based technology company inventing, producing and selling products for the Healthcare Sector. On a mission to help physicians give better care to their patients, Medgre has made itself a renowned name in the EHR landscape. The name, Medgre has two parts, Med, the first 3 letters of Medical and Gre, the first three letters of Green. Being an Electronic Health Records (EHR) software for Medical providers, Medgre promotes & facilitates the medical providers to move away from the paper, hence promoting a green environment.

Today, Medgre solutions include an easy to use and feature-rich Electronic Health Records (EHR) software, Practice Management and Billing Software. Medgre EHR (Medgre V3.0) is certified as ONC-HIT 2014 Complete EHR (Ambulatory). Moreover, the company also offers end-to-end Revenue Cycle Management (RCM) solution to take care of clinic’s billing service needs. Additional products from Medgre include Charge Capture & Rounding (CCR) system, Appointment Reminder System and Waiting Room Module that give the clinic an overall control over effective patient management, improved patient care and enhanced revenue.

Building what Physicians want The company was founded by three highly experienced professionals, with a unique knowledgebase in end to end product life cycles, in-depth

At the core, Medgre is an easy to use software made by keeping in mind the lack of time medical providers & the other clinic users have while providing patient care. Ability to get to any area of the software quickly cuts down the time that they spend to get a task done and availability of dropdowns & templates to do the repetitive tasks easily brings in eﬃciency and customer satisfaction.

Sebastian Kurian is the Co-founder & CEO, responsible for business strategy, program management & operations. Sebastian brings more than 28 years of experience in a number of technical and managerial roles in various ﬁelds of technology. Prior to founding Green Apples, he headed the product delivery, manufacturing & operations of Tech Mahindra’s iPolicy Networks and eDRM product lines. He was one of the four founding employees of the Silicon Valley start-up company, ‘IOSpan Wireless’ that was acquired by Intel Corp. He is a coinventor of 25 issued US patents in the ﬁelds of data communication & wireless technologies.

The Three Pillars of Success Medgre is founded and run by the three passionate Co-founders; Sebastian Kurian, Rajendra Prasad and Mohd Rehan. The three Co-founders have made it a point to make ‘Ease of Use’ the key aspect of the company’s software products and have successfully driven it down to every member of the team.

Rajendra Prasad is the Co-founder & CTO, responsible for product development & technology. Rajendra has more than 21 years of experience in

Mohd Rehan Co-founder & CIPO Medgre

Rajendra Prasad Co-founder & CTO Medgre

software development & management that spans into a complete product development lifecycle. His expertise extends into embedded systems, networking and network security systems. Prior to founding Green Apples, he headed the product engineering group at Tech Mahindra’s iPolicy Networks.

Fostering, supporting and Rewarding Innovation & Integrity The founding team has made it a point to enable a working environment that fosters, supports and rewards the virtues of integrity and innovation. “Clarity of purpose, integrity in what one does as a member of a team that delivers a world class product and solutions around it can sustain its edge only when innovative ideas are valued and given its right importance throughout the organization. The founding team considers these virtues as the pillars on which an organization can be built and grown,” asserts Sebastian Kurian, the CEO of the company.

Mohd Rehan is the Co-founder & CIPO (Chief Innovation & Product Oﬃcer), responsible for product management, validation, sales engineering & customer support. Rehan brings close to 17 years of experience focused on software product management and network security products, doing security consultancy, product validation, sales engineering & customer Support. Prior to founding Green Apples, Rehan was a Senior Architect at Tech Mahindra Ltd.

Accurate and Dependable Solutions The journey of Medgre, since the foundation, has seen its fair share of struggles and successes. Talking about the journey, Sebastian says, “There were ups and downs throughout the journey with that ultimate satisfaction of bringing out a product that can compete with other bigwigs of the industry. The biggest challenge has been the fact that you are pitted against the masters of the industry with many years of standing and financial backing. We were able to benchmark our product with series of Meaningful Use Certifications that were needed legally to compete and yet keep our main focus of “Ease of Use” in the product.” Ease of Use has been Medgre’s prime focus since the very beginning. “We have been able to embrace that idea very well in bringing that successfully into Medgre. Initial years of EMR/EHRs were driven by the incentive dollars that the US government has pumped in. But once that time is passed by, Ease of Use, efficiency and time saving aspects of EMR/EHRs are paving the way,” Sebastian adds. Going ahead, Medgre is working hard towards maintaining the usability & ease of use aspects of the software while trying to find solution to the big problem of InterOperability.

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