Re: Walmart Health: Just had a great dental visit this morning, which was preceded by helpful reminders from Epic, and…
Joseph Cohen, MD is a physician at Cedar Park Pediatrics (TX) and CEO of kiddoEMR.
Tell me about yourself and the company.
Cedar Park Pediatrics began using an EHR in 2005. After nine years of rising cost and limited functionality, we began the funding to develop our own EHR. It had to cater directly to pediatrics and be cost effective. In February 2014, kiddoEMR went live with 2,7000+ imported records and 5,000+ active patient charts. Since that time, we have undergone three major updates that added functionality and implemented bug fixes. We are in the process of launching our HIE to CPP and the 164 practice clients we currently serve. We expect a debug and a HIE release candidate by April. We are also implementing the kiddoEMR portal domain for our patients, which offers them HIPAA-compliant kiddoEMR.com G-mail, and G-drive, further reducing the cost of communication and care for our patients.
Basically, kiddoEMR is the direct result of my experience. The rising cost of business infrastructure is outpacing any rise in reimbursement to doctors. The alarming trend of increased practice closure is a direct result. I owe my patients too much, and I didn’t want to close. Having cancer in 2009 didn’t help my situation either, but my patients stood by me. I owed them another try at keeping their medical home going. When I was sick, I always had dinner, or a card or a crayon picture waiting for me at work. It was a sense of family that overwhelmed me with loyalty to my patients. I knew great developers and we came up with kiddoEMR. It saved my practice and my career as a private-practice pediatrician.
How many customers/site installs do you currently have?
We are at 164 offices nationwide serving over 250 individual physicians and their staff.
What do physicians like best about this particular technology?
They love that it’s super customizable and reliable, and that there’s no more need for support from an IT firm. They also appreciate the BYOD policy that goes with it, and that they get great care value for the cost. It’s built for Chrome, and so secure remote access is key for our physicians.
What have they told you was lacking in their previous EHRs?
No pediatric support, unable to document with photos. They said they had no care value for the price of the platforms they were using. It cost too much for too little. Most of all, physicians said how much they hated the way in which EHRs have forced them to change the way they diagnose, and the way their office runs to satisfy the software. We believe that it should be the opposite, and we started our system with agile architecture to realize that goal.
Is kiddoEMR certified for Meaningful Use?
We are a platform agnostic, thin client, hybrid product using OpenEMR base code through an open-source license. We have applied our proprietary overlay code to make it secure, customizable, and functional for pediatrics. OpenEMR is CCHIT MU1 certified, with the MU2 updates currently being analyzed for certification.
What is your opinion of MU? Is Cedar Park Pediatrics participating?
We do not participate by choice. We found too much red tape to make that a cost-effective project. Our old EHR didn’t even give us the capability of running the right reports, so it would have taken weeks of time.
I call it “Meaningless Use.” It shows in the statistics that only 1.1 percent of EHR doctors have adopted MU2 updates. That speaks volumes to the lack of value MU guidelines have provided for physicians. I know one thing – MU1 and 2 has only raised the price of EHR platforms. I get upset when other industries do a money grab in medicine. There is this impression that we are making loads of cash, and we just aren’t.
Given your enthusiasm for healthcare technology, what is your opinion of ONC’s plans for interoperability in the coming years?
While I tend to be skeptical of government involvement in industry, it is clear that current EHRs have no intention of being interoperable natively. They charge a paywall to physicians to get some limited interoperability. That is unacceptable. KiddoEMR data is granular and processor driven. Our architecture is agile and not waterfall. This gives us the ability to use data across ANY system ANYwhere. We keep our granular data encrypted on the drive level for the privacy of our patients.
How is your practice leveraging Google Glass? How is that experience translating to kiddoEMR product development?
I was invited to the Explorer program in July of 2013, and quickly saw it as important as my stethoscope. I could document visual diagnosis instantly. KiddoEMR supports documentation with Glass natively and allows our doctors to document securely with pictures from Glass in real time. It is an immense time saver and adds tremendous care value to our platform. The notes are brilliant and informative. Think medical atlas and not encyclopedia. There is no going back after supporting the visual diagnosis natively.
Given that you have experienced healthcare as a patient, how have you seen technology such as EHRs improve patient care (or not)?
I am a Stage 4b Hodgkin’s Lymphoma survivor. I went into remission just over five years ago. My original doctors were not using EHRs at that time, but my chemo regimen team and the pharmacist were. I eventually switched oncologists to one who was (for other reasons), and even back then I felt like it was helping me. The nurses, reception, and billing all had their respective access to my chart in real time. It was a time saver.
Since then, I find the patient portal my PMD offers to be lackluster. It is this experience that has spawned our robust HIE. I wanted our HIE portal to be more like a health dashboard and less like DOS.
What are your future plans for the company?
My goal in the end is to provide care for EVERY child, not just the ones that can afford pricey hardware. In addition, I want to relieve the pediatrician of infrastructure costs that are killing private practice and small clinics. If the pediatrician has his few supplies (tongue blades, strep tests, etc.) and a full secure and functional platform behind him like kiddoEMR, why can’t he do house calls all day? Why can’t he see patients on the way home? I do.
Compared to the average costs of implementation of other EHRs, we can do more at one-tenth the starting price for every pediatrician, and in turn provide free access to every child. The result would be a real time, secure, omnipresent platform that has real meaning. Never again will an ER doctor have to practice medicine “in the dark.” With kiddoEMR, his patient’s information is available in real time, immediately. ALL of it. Anytime.
Our current offering is based on an enterprise model to serve facilities remotely. Our final platform will be a cloud-hosted service leveraging HIPAA-compliant, private-cloud architecture and omnipresent capabilities linking all consented and emergency facilities to accurate, real-time data.