Re: Walmart Health: Just had a great dental visit this morning, which was preceded by helpful reminders from Epic, and…
DOCtalk by Dr. Gregg 2/3/12
Hey, You, Get Onto My Cloud
Singing “I can’t get no satisfaction” last week must have set off some sort of cosmic karmic coincidence collision thing, because just after bemoaning the current general state of EHR techdom, I was given a jolt of inspiration sufficient to stop my sagging satisfaction sadsack soliloquy.
Thank you, Inga. Inga was my “scoop” source. She had recently heard of, and just finished interviewing, the chief executive officer and the director of marketing for the software that provided the aforementioned jolt for my EHR psyche. She had read my Jagger-infested article and e-mailed a simple, “Looked at CareCloud?” I hadn’t, but I soon did.
I Googled them and saw enough to more than pique my interest. Thanks to Inga’s introduction to Mike Cuesta, the marketing man mentioned above, I was able to hook up with Juan Molina, CareCloud’s director of biz dev/“Chief Evangelist”, and Nicole Trueba, events and outreach manager. They undertook some very kind squeeze-me-in scheduling and enabled a short, but quite enjoyable demo of CareCloud’s new Charts EHR software, along with a fast overview of their Central, Concierge, and Community solutions. (Central is PM, Concierge is back office/RCM stuff, and Community is a business-facing “social” community. The patient-facing version is coming.)
I could sense my satisfaction shooting up from the first page view. Their EHR component was just officially released January 20 of this year and it is, in a word, spectacular, in both look and feel.
Designed from the ground up to be “one platform” and browser agnostic, it is smooth, seamless, and fast. Starting with new technology allowed for technological design considerations that are simply impossible when trying to layer newness onto old code (e.g, Windows on top of DOS still has DOS-related issues that are virtually impossible to eliminate. I’m sure you can think of other such examples.)
Perhaps most apparent is the design excellence. Even before hearing that it is true, you can tell that they started out with user experience (UX) experts doing the human/computer interface design layout. The Web site says their UX folks spent hours studying provider workflows with their UX expert eyes. It comes through. Handing a beautiful design off to the programmers for them to then construct the actual mechanics beneath led to a UX that is truly “Apple-ified.” It is enjoyable to look upon, easy to navigate, and extremely workflow-friendly. It is vastly different from the typical experience you get when programming is core and design is secondarily considered.
I’ve said it for a long time: “App me, baby.” Well, they did. Apps are both a core element of the design and smoothly integrated so that you can add the apps you need as you need them and pocket them when you don’t.
Built on open architecture (Ruby on Rails and Adobe Flex), it is designed to be future-friendly. Instead of locking into current standards, these guys have learned that evolving technology means that great answers for today are the leg-irons for tomorrow’s development.
Another thing that really caught my attention was CareCloud’s social side. Their implementation of certain social aspects into the design creates huge workflow advantages. It struck me as almost the Facebook of EHRs. I’m not a huge Facebook user, but I nonetheless appreciate the value and power it provides in connecting people and facilitating interactions. Apparently these designers understood that from the outset, because the functionality for office use is extremely integrated and also appears to be extremely well-considered.
I’ve seen somewhat similar “digital ecosystems,” but never one as well thought out and as well implemented. Though as I mentioned, we had to sort of squeeze the first demo in and thus it was a limited overview, it was still one of the most impressive systems I have ever seen. Sure, it has some warts and needs to continue to evolve, but its starting point is so far down the path to greatness that it should make other developers shudder. It’s kick ass, to be sure.
In case you’re wondering, it is Drummond -certified as a Complete EHR and SureScripts-certified for ePrescribing. Not unimportantly, especially to small guys like me, they offer a pay-as-you-go plan or a comprehensive RCM version. Plus, they provide 24/7 real person support via phone, chat, or e-mail.
I’ve told the tale before that when I first saw Bond Clinician back in 2004, I almost told the rep to stay quiet, as it looked so nice and so straightforward that I thought I could probably start using it without any instruction. I mean, that’s exactly what iPads are: great-looking technology with tons of power that don’t even come with instruction manuals. I may learn differently as I dig deeper into it, but I’m thinking the CareCloud folks took a page from that playbook and have come as close as anyone to date in creating a truly iPad-ized EHR – one that is friendly, gorgeous, and (my personal favorite) stupid simple to use.
I’m also thinking I may now have to reconsider this whole “can’t get no satisfaction” thing.
From the trenches…
“Why is Cloud 9 so amazing? What’s wrong with Cloud 8?” – Mitch Hedberg
Dr. Gregg Alexander, a grunt in the trenches pediatrician at Madison Pediatrics, is Chief Medical Officer for Health Nuts Media, directs the Pediatric Office of the Future exhibit for the American Academy of Pediatrics, and sits on the board of directors of the Ohio Health Information Partnership (OHIP).
Based on your description, the 49-second animation and the brief video demo available on their website, the CareCloud user interface seems to have been specifically designed to be significantly more intuitive and usable than the ambulatory EHR products of the ten vendors that now control 75% of this segment of the rapidly evolving United States market. The October 2011 report about this is here: http://www.americanehr.com/Libraries/documents/AmericanEHR-Partners-Market-Share-Top-10-Products-Oct-2011-Final.sflb.ashx and it is summarized on page 15 of Circle Square’s December 2011 HIT Trends Year in Review issue.
The emerging focus on maximizing EHR usability, defined as easy to learn and use by both physicians and support staff, is long overdue as indicated by the IOM’s November 2011 report (“Improving Patient Safety Through Health IT” here: http://iom.edu/Reports/2011/Health-IT-and-Patient-Safety-Building-Safer-Systems-for-Better-Care.aspx and the NIST’s development of a standardized industry format template for EHR usability testing as described here: http://www.nist.gov/itl/hit/upload/LowryNISTIR-7742Customized_CIF_Template_for_EHR_Usability_Testing_Publicationl_Version-doc.pdf .
As you know, the 1,704 ONC-certified EHR products listed at: http://onc-chpl.force/ehrcert/cphlhome are not currently tested for usability, but CCHIT did begin using a 5-star usability rating system last year. Their 35-minute rating process uses usability questions CCHIT developed in consultation with User Centric, Inc., experts in the field of usability testing and is integrated into the clinical portion of its MU Certification inspection. The Comprehensive ambulatory EHR applicants were required to participate in 2011, but the usability rating does not yet affect the certification outcome.
With the total number of ambulatory EHR products increasing from about 400 in January 2010 to 1,146 today, the usability-focused design of the Care Cloud product may help differentiate this brand new entrant from many of the market leaders and other incumbents and help catalyze what all physicians and their patients will greatly value, consumer-centered EHR product competition based on both price and quality.
All the best,
What’s your thoughts on them a year later? Have you implemented them in your office?
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