This article is part of our HIMSS 2010 coverage. It includes an overview of the MacPractice EHR and its iPhone interface as well as a conversation with Mark Hollis, CEO of MacPractice.
One of the key’s to Apple’s success has been the reliable, simple, and fun UI it has designed for every one of its products. Part of the reason that this feature has stood out is because the Microsoft-based PC world has become known for essentially the opposite. The same is true for many electronic health record platforms built for Windows, where the same security vulnerabilities, networking complexity, and famed “blue screen of death” plague the slightly-less-than-tech-savvy average physician. For this reason, Mark Hollis – CEO of MacPractice – offers a system that runs entirely on the Mac. I had the opportunity to check out the iPhone platform tied to this EHR and also to chat with Mr. Hollis about his vision for this platform and some of the challenges it faces.
The iPhone Platform – From the start, the interface looks pretty slick. There are a number of different functions built in including a calendar of appointments, patient contact information (with a simple touch allowing you to call or email them), charge capture, patient prescription history, and referral management.
The appointment calendar (pictured here with the Rx history) basically consists of the patient’s name, appointment time, and picture. This last feature, a simple picture, is great for two reasons – it could help jog your memory so you remember who this person is (rather than just the diseases they need followed up) and it does wonders for morale (its a lot harder to be unhappy with a packed afternoon schedule when you have those smiling faces looking at you). Honestly though, I was underwhelmed with the remainder of the features. I expected more in terms of ability to view a problem list, recent notes or labs, or other information that would be useful in caring for a patient. This app, at least at this stage, seems to be geared more toward the administrative side of a physician – planning a day, getting all the charges in, etc. I hope that future versions of the iPhone interface improve on the clinical utility of this app.
In addition to this iPhone platform, there are a number of other features that make the MacPractice EHR pretty cool. Among them are the UI which Mr. Hollis noted was designed so that pretty much any office personnel can be up and running with minimal training. It can also be used by patients via a special interface to make appointments, send messages, and so on. For the tech-wary among us, it runs on networked MacBooks/iMacs without a server, which means a far simpler system to manage – according to Mr. Hollis, its not uncommon for a practice to go years without ever needing corrective service of any kind. And if they do, its often fixed with a trip to the Apple Store, thus leveraging Apple’s customer service infrastructure. Finally, its a highly customizable system – this is a particularly useful feature for small specialist practices who often require very different kinds of patient records. In fact, the basic system has been customized for dentists and optometrists as well.
While there a lot of cool features here, MacPractice also faces a big challenge from web-based EHR’s. These systems provide similar benefits – minimal setup and maintenance for example – with very low price points (as low as free). And they too are directed at small-medium sized practices that don’t want or need a complicated, in-house EHR. Mr. Hollis raised a number of very interesting points as to why he believes web-based EHR’s will join the same market space that MacPractice occupies rather than dominate it.
First, most web-based EHR’s come prepackaged, and that packaging is largely defined by the “meaningful use” criteria that will allow clinicians to get stimulus funding. However, those criteria are basically geared to primary care – specialists could be left out on this one. That’s an opportunity for customizable, simple EHR’s like MacPractice.
Second, Mr. Hollis notes that the development possibilities are far more rich using Apple’s XCode, giving him opportunities he wouldn’t have with a purely online platform. Finally, there’s the issue of reliability – what happens if your internet goes down? Clinicians who adopt web-based EHR’s will not only need high-speed connectivity, but they may also need some sort of redundancy and managing that could be a headache.
All that being said, Mr. Hollis doesn’t dismiss cloud functionality as unimportant – in fact, its likely to be essential to meet meaningful use criteria. MacPractice is exploring ways to bring data in aggregate onto the cloud for analysis and take that essential step to contributing to population health management. Additionally, they have been engaged in the development of the Stage 1 criteria, being released in June, and plan to be certified as well. I certainly look forward to seeing how this EHR evolves in the coming months.