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

Author:

Iltifat Husain, MD

Founder, Editor-in-Chief of iMedicalApps.com. Emergency Medicine Faculty and Director of Mobile App curriculum at Wake Forest School of Medicine.

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

  1. Drjenna April 19, 2011 at 5:40 am #

    I have repeatedly been impressed with DrChrono’s EHR.

    My practice is streamlined. I have ready access to accounts receivable, and my bottom line has increased. My notes are professional, searchable, accessible when i travel– yet secure.
    can do more with less staff, and the support team at drhchrono is incredible.

    As a subspecialist, the ability to readily customize my notes has been invaluable.

    I have beta tested the new launch and find that it has incorporated many suggestions that we, the users, requested in our uservoice forum. It gets better and better, and I am happy to be using this system. I cant wait to utilize the integrated fax system.

    • Iltifat Husain April 19, 2011 at 1:39 pm #

      Drjenna-

      How you input text with the app. Do you enter H&P and SOAP notes on the back end side, do you type the text with a keyboard, or do you use the voice to dictation feature?

      I’m sure our readers would be interested to know,

      Thanks!

  2. Matt April 19, 2011 at 9:00 am #

    Dr. Chrono has something special and I truly think they will be one of the top choices in the next few years for small medical practices. I applaud their efforts and think the world of this SMALL GIANT! Keep up the great work Dr. Chrono team and thanks for the a great article.

  3. Bob April 22, 2011 at 3:49 pm #

    I would caution physicians looking at systems like this to consider carefully where your patient data ends up living. Privacy concerns are rampant with cloud systems like this, and with very recent debacles like Amazon’s cloud meltdown, you should look carefully before trusting “the cloud” for your HIPAA data.

    • Iltifat Husain April 22, 2011 at 5:18 pm #

      “the cloud” is where all healthcare data is stored and is actually
      significantly safer than storing it on personal devices.

      Even in large hospital systems, everything is accessed via the cloud
      – it would be unsafe to have all the information to be stored on
      computer hard drives. It’s all stored on servers, and when you access
      patient information on a computer at a nursing station you are getting
      information from the cloud. If that information was stored on that
      computer permanently, someone could easily take it, along with all the
      patient info. The cloud prevents this scenario.

      You bring up a great point though, we should always be aware of security.

  4. Drgin April 23, 2011 at 11:05 am #

    Is this system certified for the hi tech act? Anyone not associated with the company have any verification that this emr will qualify for sure??

    • Iltifat Husain April 23, 2011 at 11:28 am #

      Per their website, they state it qualifies.

      • Drgin April 24, 2011 at 4:08 pm #

        There is an independent certifying agency called The Drummond group that HHS uses to lable ehr systems as passing certain criterion for meaningful use. To my knowledge, dr chrono is Not Drummond certified. I would be very careful in adopting a system that claims incentives without actually being certified by the appropriate authority. Initially I was thinking of using dr chrono but decided against it. Also, questionable whether this is a serious ehr YET, as I don’t think a lot of actual doctors are using it. When I did the demo it seemed a lot of chiropractors and acupuncturists were adopting it for use. Sure this system looks pretty, but be sure that you are buying into something legit. It’s very important.

        • Hong Li April 24, 2011 at 11:36 pm #

          Drchrono is following the government Meaningful Use guidelines on security and encryption standards and we are getting certified by a 3rd party government approved lab. Rest assured that Drchrono is committed to addressing every concern a doctor has and we do everything at a very quick pace.

          The Drchrono EHR is being used by a variety of specialists, with the majority of our userbase being doctors. Our fully customizable templates allow specialists from different fields to use our system, but all the core features are designed to be use by physicians.

          While we are on the iPad with a cloud-based backend, our EHR is completely legit and we are not stopping until we have the best EHR in healthcare. The new release will ensure that we are giving doctors the best user interface with the substance and great features they expect from an EHR. And because we are native on the iPad, we have features and are planning features that you won’t find anywhere else. If you have any questions, send us a message from our website and we’ll be happy to answer it for you.

        • Rich May 25, 2011 at 3:39 pm #

          In order for it to be eligible it needs to be on this list: http://onc-chpl.force.com/ehrc

          In order for my office to use it, it needs to be on Android. We will be implementing an EHR soon, what is your time frame for being certified and for the Android release?

        • Daniel June 10, 2011 at 9:05 pm #

          Hi Rich,

          Certification will happen this month.

          We have been focusing on the iPad, we do have an Android app, but it doesn’t have all of the fancy features the iPad does currently.

          Daniel

  5. Siritalk April 26, 2011 at 10:38 pm #

    It is a wonderful detailed review. Very helpful in giving me a good idea of the pros and cons. I will definitely try the free version before I think about paying for it. I just wonder if I can take my records with me electronically if I change my mind.

    • Daniel April 27, 2011 at 1:57 pm #

      The latest version has just been released, feel free to download and try it! http://itunes.apple.com/us/app

      Daniel, cofounder of drchrono

  6. Michael Laccheo April 27, 2011 at 6:28 pm #

    It seems like they’re moving in the right direction and the new update is a big improvement, but unless I’m missing something, it seems to be missing some basic functionality of an EMR such as the ability to make a telephone note, which is even more surprising since it’s a mobile EMR.

  7. Kimberly Blozie May 6, 2011 at 10:46 am #

    I liked your review so much, I posted it over at my blog CureTalk where we take an innovative, fun and down-to-earth approach when discussing medicine and health care: http://trialx.com/curetalk/201

    • Daniel June 10, 2011 at 9:03 pm #

      Thank you Kimberly for the support!

      Daniel from drchrono

  8. Khobbs June 16, 2011 at 12:33 pm #

    If someone switches from another EMR to Drchronos, is there an easy way to get the files out of the old system and into this one?

  9. R. Shipon September 2, 2011 at 9:30 am #

    Question: Is this a viable tool for psychologists? There appear to be several things I would not need as a psychologist. All I really need is patient information and a SOAP note.

    Thanks.
    W

  10. Deborah Allison October 11, 2012 at 8:12 am #

    Sounds good!

  11. Dr. Dennis February 5, 2014 at 11:21 pm #

    Is this medical app working in UAE?

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