4 ms·

Good luck with this one. After spending a couple of years working on something like this, I found the following: 1) A majority of doctors are in small privat

Good luck with this one. After spending a couple of years working on something like this, I found the following: 1) A majority of doctors are in small private practices that reinvent the wheel of how they run their practice. 2) All of these doctors are extremely pressed for time and are practically _always_ behind schedule. #1 means you need to build heavily-configurable software, and #2 means the doctors don't have the time or energy to learn and configure your software. At best you can get the practice managers to force it down the doctor's throats, which doesn't exactly help either. Record keeping is to doctors like text editors is to us hackers. Imagine if a doctor had built your text editor; They're probably very smart and energetic, but they don't really understand your problem and how much you personally need specific things just so.

jpeterson 16y ago
My guess is that this is more targeted to the "hip" crowd among MDs who embrace this sort of thing (of which there are quite a few).
- Skeletor 16y ago
  Over 120,000 doctors in the US own an iPad and doctors (even non-"hip" ones) get immediately that the iPad is the ideal platform to use in the examroom.
  - niels_olson 16y ago
    iPad is not the best. Massive, rapid text entry on an iPad sucks. I took an iPad and a cr48 to the a big orthopaedics conference last week, and the cr48 was the hands down winner, using nothing but qemacs. Fundamentally, on the ipad, character recognition or dictation would be best, but I can barely read my own writing sometimes! The iPad would be a lot better if the input precision was as good as the output resolution. If you've tried any drawing apps on these things, you know what I mean. Wacom tablets have much better input precision, or at least they seem to. I want Pilot G-2 0.5 mm black speed, precision, and reliability. Right now only a keyboard comes close.
    - Skeletor 16y ago
      We are very close to launching an integrated clinical speech to text product in our iPad application that should remove the need for most typing!
      - niels_olson 16y ago
        Dictating the note would be huge.
    - austinshea 16y ago
      Keyboards for the iPad already exist. The future is a touch screen, and an external keyboard (probably should also mention big screens, with gpus, hooked to iPhone docks, in order to offer a fully personalized desktop experience, running off your mobile device.) CR-48 will not be able to detach from keyboard. Everything will be designed to support a touch screen interface; input devices will be external.
    - deleted 16y ago
      [deleted]
  - logjam 16y ago
    Many of us have looked extensively at pads long before this, and concluded that they are not ideal. They may have other support uses.
    - mikeleeorg 16y ago
      I agree, using an iPad's touchscreen is better for information display & retrieval, than for information recording. But I'll admit that speech-to-text has good potential for information recording, as long as it is reasonably accurate and provides an easy way to correct errors & omissions.
    - Skeletor 16y ago
      Before the iPad, the "state of the art" touchscreen was an 11 pound laptop with 2 hours of battery life and a reversible top-cover/"touch" screen that required a stylus to use. The iPad is a REVOLUTION in tablet computing for physicians.
      - logjam 16y ago
        I don't understand your comment. Hardware isn't the issue. Physicians were early adopters of a variety of devices, starting with PDAs, thence to pads quite a bit more sophisticated than your odd and ancient example, all to try to solve the same problem your platform purports to assist with. I have before me a ~1 kg laptop with an actual keyboard on which I can type notes almost as fast as I can speak, hold in one hand as I see a patient, with speech recognition already installed, local secure printing, sensitive data that lives in my office and not on your remote server farms, a hard drive that I own, can copy and share as needed, and can keep as secure as I like, and applications which do not require constant secured access to server(s) whose reliability and security I have no control over. I love the iPad for a bunch of stuff. I own two. I'm an early adopter of all kinds of this type technology. I love toys. But I'm not getting the "revolution" part of this beyond, forgive me, somewhat breathless and vague marketing hype. Tablets have been around a while and not caught on with physicians for a whole variety of reasons that you folks seem oddly unaware of. Sincerely good luck with this, but you're not solving any problems for me or any physicians I've talked to about it.
      - 16y ago
  - alphaoverlord 16y ago
    13% of physicians have iPads? And 1.5% of all iPads went to physicians? Can you give us a citation of how you got that number? The estimate is that there are less than 1 million doctors in the US. http://online.wsj.com/article/SB10001424052702304506904575180331528424238.html http://online.wsj.com/article/SB1000142405270230450690457518... And before October 2010, about 8.25 million iPads were sold - that number is probably way outdated though. http://www.tuaw.com/2010/10/07/estimates-vary-on-number-of-ipads-sold/ http://www.tuaw.com/2010/10/07/estimates-vary-on-number-of-i...
    - niels_olson 16y ago
      > 13% of physicians have iPads? anecdotal evidence from the conference of 30,000 orthopods in San Diego last week, that seems very plausible.
- minalecs 16y ago
  after working in a hospital and seeing older doctors hire people just to answer and reply emails.. I think this market assumption may be correct.
  - Skeletor 16y ago
    Hospitals and private practice healthcare offices are two entirely different worlds. In a small healthcare practice the doctor will be paying each staff member as an employee.
Skeletor 16y ago
This is great feedback! drchrono has a really customizable form builder tool that lets users build out their legacy paper clinical forms on our website and then have those forms recreated on the iPad to be filled out as the doctor sees patients. This lets the doctor move from paper to an EMR with a very similar workflow, but still gives the benefits of having the data stored electronically and getting clinical benefits like having drug-drug interaction checks on the patient's medication list.
- niels_olson 16y ago
  I'm a doctor. I failed to use a special character in my password during signup so my domain/username got reserved but it wasn't obvious until I was informed of failure, tried again, and was told not once but twice that my username was already taken. I decided to try reseting my password, and then found two emails in my inbox, one to confirm, and one to reset my password. All on my iPad, but through the website. Very confusing. Frankly, with a full-size keyboard I can't type fast enough or click fast enough to keep up with my mouth and ears and fingers and eyes, so dictation would be awesome, but I don't see how to get that started in the iPad app. I still haven't figured out the forms...
  - Skeletor 16y ago
    Please email support@drchrono.com and someone can help you with that issue right away! We have an amazing support team ready to help!
mikeleeorg 16y ago
My wife is an ER physician and I went down the path of a similar idea as well, because I saw how awful her life was in trying to maintain meaningful records for her patients. #1 is very true - especially when you take into account all the various medical specialties in the industry. As I did my research, I reasoned that a Dragon Dictation-esque solution may be best. However, such a solution already exists. And built by Dragon Dictation too, coincidentally. It's a very efficient solution for doctors in case #2. They can just dictate their patient notes to an audio recorder, and the software is intelligent enough to sort it out appropriately, with perhaps 80-90% accuracy. However, for patient records, you need to have it at 100% accuracy, otherwise you could face medical malpractice. So the current products require doctors to review their notes on a confirmation screen on their handheld tablet devices (yup, it's on a tablet device much like an iPad). The result? Most busy doctors just hit SUBMIT without reviewing their notes, and their 80-90% accurate patient notes get recorded. Medical groups saw this behavior and have been moving away from these types of products. I'm gleaming over a lot of details, but this is the gist of what I found. This is definitely a problem begging for a solution, so I wish DrChrono a ton of luck in solving it.
- Skeletor 16y ago
  Speech to text is one cool feature we are integrating now, but is still just one feature. Hospitals and doctor offices are two completely different markets with very different needs and scales. Speech to text doesn't address managing a doctors appointment book, communicating with patients, giving drug-drug interaction checking, etc.
  - mikeleeorg 16y ago
    True, hospitals and doctor's offices are completely different animals. I was only looking at hospitals at the time, which has the added disadvantage of requiring long sales cycles. Doctor's offices should be a much easier sell. Good luck with the speech-to-text feature! I agree with niels_olson that text entry on a touchscreen is painful. I'm glad to hear you've already got a solution in the works. Best wishes!

jpeterson 16y ago

My guess is that this is more targeted to the "hip" crowd among MDs who embrace this sort of thing (of which there are quite a few).

Skeletor 16y ago
Over 120,000 doctors in the US own an iPad and doctors (even non-"hip" ones) get immediately that the iPad is the ideal platform to use in the examroom.
- niels_olson 16y ago
  iPad is not the best. Massive, rapid text entry on an iPad sucks. I took an iPad and a cr48 to the a big orthopaedics conference last week, and the cr48 was the hands down winner, using nothing but qemacs. Fundamentally, on the ipad, character recognition or dictation would be best, but I can barely read my own writing sometimes! The iPad would be a lot better if the input precision was as good as the output resolution. If you've tried any drawing apps on these things, you know what I mean. Wacom tablets have much better input precision, or at least they seem to. I want Pilot G-2 0.5 mm black speed, precision, and reliability. Right now only a keyboard comes close.
  - Skeletor 16y ago
    We are very close to launching an integrated clinical speech to text product in our iPad application that should remove the need for most typing!
    - niels_olson 16y ago
      Dictating the note would be huge.
  - austinshea 16y ago
    Keyboards for the iPad already exist. The future is a touch screen, and an external keyboard (probably should also mention big screens, with gpus, hooked to iPhone docks, in order to offer a fully personalized desktop experience, running off your mobile device.) CR-48 will not be able to detach from keyboard. Everything will be designed to support a touch screen interface; input devices will be external.
  - deleted 16y ago
    [deleted]
- logjam 16y ago
  Many of us have looked extensively at pads long before this, and concluded that they are not ideal. They may have other support uses.
  - mikeleeorg 16y ago
    I agree, using an iPad's touchscreen is better for information display & retrieval, than for information recording. But I'll admit that speech-to-text has good potential for information recording, as long as it is reasonably accurate and provides an easy way to correct errors & omissions.
  - Skeletor 16y ago
    Before the iPad, the "state of the art" touchscreen was an 11 pound laptop with 2 hours of battery life and a reversible top-cover/"touch" screen that required a stylus to use. The iPad is a REVOLUTION in tablet computing for physicians.
    - logjam 16y ago
      I don't understand your comment. Hardware isn't the issue. Physicians were early adopters of a variety of devices, starting with PDAs, thence to pads quite a bit more sophisticated than your odd and ancient example, all to try to solve the same problem your platform purports to assist with. I have before me a ~1 kg laptop with an actual keyboard on which I can type notes almost as fast as I can speak, hold in one hand as I see a patient, with speech recognition already installed, local secure printing, sensitive data that lives in my office and not on your remote server farms, a hard drive that I own, can copy and share as needed, and can keep as secure as I like, and applications which do not require constant secured access to server(s) whose reliability and security I have no control over. I love the iPad for a bunch of stuff. I own two. I'm an early adopter of all kinds of this type technology. I love toys. But I'm not getting the "revolution" part of this beyond, forgive me, somewhat breathless and vague marketing hype. Tablets have been around a while and not caught on with physicians for a whole variety of reasons that you folks seem oddly unaware of. Sincerely good luck with this, but you're not solving any problems for me or any physicians I've talked to about it.
    - 16y ago
- alphaoverlord 16y ago
  13% of physicians have iPads? And 1.5% of all iPads went to physicians? Can you give us a citation of how you got that number? The estimate is that there are less than 1 million doctors in the US. http://online.wsj.com/article/SB10001424052702304506904575180331528424238.html http://online.wsj.com/article/SB1000142405270230450690457518... And before October 2010, about 8.25 million iPads were sold - that number is probably way outdated though. http://www.tuaw.com/2010/10/07/estimates-vary-on-number-of-ipads-sold/ http://www.tuaw.com/2010/10/07/estimates-vary-on-number-of-i...
  - niels_olson 16y ago
    > 13% of physicians have iPads? anecdotal evidence from the conference of 30,000 orthopods in San Diego last week, that seems very plausible.
minalecs 16y ago
after working in a hospital and seeing older doctors hire people just to answer and reply emails.. I think this market assumption may be correct.
- Skeletor 16y ago
  Hospitals and private practice healthcare offices are two entirely different worlds. In a small healthcare practice the doctor will be paying each staff member as an employee.

Skeletor 16y ago

This is great feedback! drchrono has a really customizable form builder tool that lets users build out their legacy paper clinical forms on our website and then have those forms recreated on the iPad to be filled out as the doctor sees patients. This lets the doctor move from paper to an EMR with a very similar workflow, but still gives the benefits of having the data stored electronically and getting clinical benefits like having drug-drug interaction checks on the patient's medication list.

niels_olson 16y ago
I'm a doctor. I failed to use a special character in my password during signup so my domain/username got reserved but it wasn't obvious until I was informed of failure, tried again, and was told not once but twice that my username was already taken. I decided to try reseting my password, and then found two emails in my inbox, one to confirm, and one to reset my password. All on my iPad, but through the website. Very confusing. Frankly, with a full-size keyboard I can't type fast enough or click fast enough to keep up with my mouth and ears and fingers and eyes, so dictation would be awesome, but I don't see how to get that started in the iPad app. I still haven't figured out the forms...
- Skeletor 16y ago
  Please email support@drchrono.com and someone can help you with that issue right away! We have an amazing support team ready to help!

mikeleeorg 16y ago

My wife is an ER physician and I went down the path of a similar idea as well, because I saw how awful her life was in trying to maintain meaningful records for her patients. #1 is very true - especially when you take into account all the various medical specialties in the industry. As I did my research, I reasoned that a Dragon Dictation-esque solution may be best. However, such a solution already exists. And built by Dragon Dictation too, coincidentally. It's a very efficient solution for doctors in case #2. They can just dictate their patient notes to an audio recorder, and the software is intelligent enough to sort it out appropriately, with perhaps 80-90% accuracy. However, for patient records, you need to have it at 100% accuracy, otherwise you could face medical malpractice. So the current products require doctors to review their notes on a confirmation screen on their handheld tablet devices (yup, it's on a tablet device much like an iPad). The result? Most busy doctors just hit SUBMIT without reviewing their notes, and their 80-90% accurate patient notes get recorded. Medical groups saw this behavior and have been moving away from these types of products. I'm gleaming over a lot of details, but this is the gist of what I found. This is definitely a problem begging for a solution, so I wish DrChrono a ton of luck in solving it.

Skeletor 16y ago
Speech to text is one cool feature we are integrating now, but is still just one feature. Hospitals and doctor offices are two completely different markets with very different needs and scales. Speech to text doesn't address managing a doctors appointment book, communicating with patients, giving drug-drug interaction checking, etc.
- mikeleeorg 16y ago
  True, hospitals and doctor's offices are completely different animals. I was only looking at hospitals at the time, which has the added disadvantage of requiring long sales cycles. Doctor's offices should be a much easier sell. Good luck with the speech-to-text feature! I agree with niels_olson that text entry on a touchscreen is painful. I'm glad to hear you've already got a solution in the works. Best wishes!