The first iPad electronic health record, DrChrono, gets major update, exclusive beta review

We featured DrChrono, the first native iPad electronic health record, almost a year ago on iMedicalApps. Since then, they have made huge changes, not only with their software, but their overall business plan.  When they initially launched on the iPad, they didn’t offer a free version of their EHR, had a quirky user interface, and were betting big that physicians would embrace the iPad.

So far, they bet right. Study after study is showing how physicians are enamored with the iPad, and the number of physicians signing up for DrChrono reflects this theme.  DrChrono told iMedicalApps, they have experienced 30% growth per month, and have had 600 health care provider signups in the last 3 days alone.  In our opinion, these significant numbers can be attributed to four things: The iPad’s popularity among physicians, enhanced user interface of the DrChrono EHR, the quest to attain $44,000 in stimulus incentives, and the recent offering of a free version of the DrChrono electronic health record.

Over the last several months, the DrChrono team has been furiously working on a large upgrade, version 8.0, for the iPad.  We were the first to get our hands on the 8.0 beta upgrade, which they plan on releasing in approximately 2 weeks.

In this review, we’ll go over the main features of the DrChrono iPad electronic health record, and touch on the iPhone and Android versions of the EHR.

Overview:

Dr. Chrono has significantly improved their user interface(UI) over the past year, and the 8.0 upgrade brings another refresh to their UI.  They have done a complete overhaul of their desktop and mobile apps (iPad, iPhone and Android).  Comparing the screen shots from our feature of DrChrono last year with the following screen shots of the upcoming update shows how far they have come.

Within the iPad EHR itself, you are able to do full H&Ps, SOAP notes, e-prescribe, perform patient scheduling, use real time medical speech to text, and more.  The DrChrono EHR is aimed at ambulatory practices, with single to multiple practitioners.  You can manage an unlimited number of patients in the paid version of the EHR offering, and there are four tiers of pricing for the iPad electronic health record: Free, $99 per month, $149 per month, and $199 per month.  This pricing structure is based per physician.

Key Features

Medical Speech to Text:

This is a feature DrChrono began offering just over a month ago — and they are the only native iPad EMR with this feature.  The power of this feature cannot be overstated.  Earlier this month, we wrote extensively on how having native speech to text on mobile platforms allows physicians to be truly mobile.  Inputting text on mobile devices can be cumbersome, and speech to text circumvents this issue.

In the new update, DrChrono will enable speech to text for every portion of the History and Physical, as well as the SOAP note, virtually removing the need to input text by hand.  For this feature, DrChrono is partnering with M*Modal, a company that works with hospital systems to provide medical speech to text.

Below is an example a partial chief complaint I dictated using the native real time Speech to Text on DrChrono.

As you can see, not very accurate the first time around.  The DrChrono team informed us speech to text is currently being upgraded with M*Modal, and will be improving in accuracy with future iterations.

However, when I slowed down a bit, and enunciated my words, I found the medical speech to text worked significantly better:

Faxing

In the 8.0 version of DrChrono, physicians will be able to receive patient records that are faxed to them directly on their iPad.  Those of us intimately aware of how the medical world communicates understand how crucial this is.  Often times, hospitals will fax a patient’s discharge papers to their primary care physician, in anticipation of a follow up visit.  Having the ability for these records to be automatically uploaded to the patient’s mobile chart is huge — saving a physician’s supporting staff from having to individually scan these documents.

Multimedia

Of course, everyone is well aware of the iPad 2’s HD videocamera and image capturing ability.  The DrChrono update will be taking advantage of the new iPad’s features, and allow physicians to add multimedia, in the form of videos and pictures, to their patient records!  If you look at the above pictures, you’ll see a picture button — enabling physicians to add multimedia via this button.  Again, not just pictures, but full video!

Overall, this is a feature that could be a game changer, and make their electronic health record come to life.  Imagine being able to track a patient’s suspicious skin lesion over time, or being able to consult that lesion with another physician, using DrChrono’s sharing capability.

Sharing capability

DrChrono enables you to share your patient’s chart with physicians who don’t have DrChrono.  You are able to send a document to the physician of interest, and they are able to securely login to DrChrono’s online EHR, and view your patient’s chart — huge for curbsides or formal consults.

Integration with Android and iPhone

DrChrono is available for the iPhone and Android.  The apps allows providers to track patient scheduling, and to pull rudimentary patient information.  The DrChrono team has informed us they are currently working on a Android tablet version of their EHR — for Google Honeycomb operating system.

What I liked:

*We are huge fans of the real time, medical speech to text feature — the ability to use this for every portion of the EHR provides huge utility

*Overall, a simple and easy to use User Interface.  Content is easy to access.

*Multimedia features cannot be overstated, and if properly implemented, adding pictures and videos in conjunction with sharing documents could be a game changer for some physicians.

*Automatic conversion of patient documents from fax to the iPad reduces time spent by support staff, and keeps patient’s chart up to date.

*Ability to customize your own H&P templates — very important for specialists.

What can be improved:

*The menu system for the review of systems and physical exam felt cumbersome at times.  In my experience, Epic’s hospital based EMR does a great job of simplifying these types of menus, and makes them extremely quick to go through (ROS image  of DrChrono shown below).

*iPhone and Android versions of app could be made more comprehensive.  Currently you are able to view patient schedules, and basic information on patients, but with the new medical voice to text feature on the iPad, one would naturally think this feature could be put on the iPhone and Android — creating an extremely mobile, keyboard free, mobile EMR.

*Lack of stylus support.  It’s no secret we are fans of using a stylus on the iPad.  In certain settings, having the ability to write freehand is useful — in the case of interacting with a patient.  Typing on a computer or trying to tap on the iPad’s screen while interacting with a patient can be off-putting.  Having the ability to take rough notes with a stylus that can be transcribed later could improve the overall workflow.  The DrChrono team has informed us they are working on this exact type of utility.

Pricing:

DrChrono now offers a free version of their electronic medical record.  The DrChrono team was adamant in making sure we understood they don’t sell ads or share patient or provider data for the free version of their software.  DrChrono generates revenue by offering upgrades in the form of electronic prescribing and electronic billing solutions.

Conclusion:

The DrChrono electronic health record has come a long way since initial launch a year ago.  They have made significant improvements to their user interface, both on their mobile platforms, and their backend online website.  The new implementation of voice to text is absolutely essential — enabling you to avoid typing on the iPad or having a blue tooth keyboard.

Using the photo and video functionality of the iPad to bolster the patient chart, along with physician sharing, could be one of the main reasons why providers would be inclined to try DrChrono.  Until recently, DrChrono did not have forms for filling out full H&Ps, relying extensively on SOAP notes and custom designed templates.  The full integration of H&P templates is an example of an essential iteration that could make providers who passed on DrChrono initially come back for a second look.

DrChrono continues to improve with each successive version, and their early bet on the iPad has paid huge dividends, allowing the electronic health record company to have many “firsts” in the mobile EHR space — and more importantly, deliver quality software in innovative form factors.

Link to DrChrono Website