News 3/11/09

Physicians will expand range of mobile activities to include administrative and patient care tasks by 2012. This bold statement is courtesy of Manhattan Research’s announcement of a new report – “Future of Physician Media”. Among other things, the press release (because I’m sure not buying the report) restates the prediction that physician smartphone adoption will reach 81% by 2012 (originally announced in October)… In all seriousness, while the highlighted take-aways are ridiculously obvious, the report is based on interviews conducted among 1,900 US physicians. I’m sure they’ve been able to uncover some insightful gems.


M*Modal partners with Intelligent Medical Objects (IMO) to improve ease of use of electronic medical records. Combining M*Modal’s speech recognition and understanding technology with IMO’s clinical terminology interface, the two companies aim to improve physicians’ ability to create, review, reconcile, and update clinical diagnoses, problem lists, and medical histories in electronic health records using physician narrative dictation… I missed this release amongst the HIMSS hubbub, though I did spend a bit of time with both Nuance and 3M, where I learned quite a lot about the various methods of both capturing and transcribing dictations. In the next couple of weeks, I’ll try to provide a comparison of the different companies and technologies and where they each “play.” 

Glide Health

Glide Health Corporation announces unified platform for EMR and PHR, new mobile PHR application for the iPhone and new board members… I was going to try to give you a highlight of the press release, but it has to be the most convoluted one I’ve ever read – it also includes the announcement of a major customer win in Integrated Medical Professionals PLLC. I’ve mentioned the company in the past and think their cloud-based OS looks promising. Their technology is definitely enough of a paradigm-shifter as to require clear, concise and delicate messaging. This ain’t it.

Practice Fusion

I receive periodic product update announcements from Practice Fusion (btw… can anyone tell me why their landing page is identical to Though I would generally defer to Inga to cover such matters, I feel compelled to comment about the most recent. Not that I have anything particularly interesting to say about the release – it looks like they did a major overhaul to their scheduling system. My comment is really just that building an EMR looks like such a “tar baby.” I actually worked with a start-up over the last year and a half or so, exploring whether we should build a hosted, integrated EMR and PMS. We were interested in giving the technology for free but using it as the platform to provide critical services, beginning with revenue cycle management… Similar to the AthenaHealth model before they went public.

On the surface, building an EMR appears to be achievable. If it didn’t, there wouldn’t be 1,000 vendors clamoring for the same business. Unfortunately, each feature becomes a solution unto itself, bringing along its own enormous overhead – in terms of product development, support, integration, usability, etc… Then, just when you think you’ve got it all covered, a new requirement or feature comes out that you have to support. And, if that weren’t enough, your users will NEVER be satisfied. According to the Practice Fusion product update email, “Our VP of Engineering, Matthew Douglass, reports that a whopping 80% of all feature requests from our users make it directly into the EHR.” I find that just plain scary.

I tend to think the only way to be truly successful in the small office environment is to not let the EMR become a “tar baby.” For starters, if you’re going to compete in the small office space, stay there. While bigger business is nice to have, it also requires changing the solution in some profound ways, generally to the detriment of your smaller customers. Another thing, just because your customer has an opinion does not mean that you should listen to it. This is true for every vendor, not just EMR, or healthcare, but everyone. The smaller the footprint, the better. Clearly the solution needs to do what it was designed to do. Once it is doing that, whatever “that” is, fight the urge to add. Every little subsequent bell and whistle will diminish the usability and the value of the solution.

Maybe this is just my pitch for “Hire a mobile solution developer.” While we all agonize over form versus function decisions, the ultimate test is proving yourself on a 3 1/2” screen. The more I think about it… maybe this is just about making myself feel better because it supports what those of us in mobility have always known – smaller is better.

In other random thoughts… At HIMSS, someone asked me what I thought of the term “mHealth.” To be honest, I’ve deliberately avoided it. I think it sounds really cheesy. It reminds me of all those i-, e-, and m- companies that emerged during the dot com era (most of whom have gone away). It makes the whole sector sound like a fleeting fad. What’s more, those using the term most vociferously are among its newest advocates. I much prefer the words “mobile” and “mobility”, though I must confess that the resulting “mobile healthcare” is more suggestive of mobile clinics or mobile radiology units than nifty little devices that mobilize health information. After much deliberation, I have personally accepted mHealth to describe the use of machine-to-machine (M2M) devices used in remote monitoring and various telehealth applications, such as glucose monitors that transmit information to a cell phone, which, in turn, relay that information to a back-end disease-state application. mHealth suggests a well-defined package. After interviewing approximately 40 companies over three days at HIMSS (and missing many others), I can assure you that just about every healthcare IT vendor participates in mobility on some level, or in some fashion. A much smaller number engage in mHealth.

  • Novadoc

    Practice Fusion currently requires Flash, not quite mobile friendly.

  • I think it’s fair to say that the software development philosophy at Practice Fusion traverses a significantly more user-centric orbit than the majority of our competitors in the EHR universe. We spend a nontrivial amount of time thinking about real-world workflow considerations and true impact on end-user experience. This is why we encourage our users to send us their feedback throughout the entire EHR planning, adoption, and implementation processes.

    Of course, some of the requests that come from our users are ill-conceived, too narrow in focus, or just don’t make sense from an implementation standpoint–but that’s why we don’t implement 100% of our users’ requests. Were we to do that, we’d most certainly be entering non-functional software territory.

    Believe it or not, I still personally read and seriously consider every single inbound feature request coming from our 30,000+ users. The vast majority of our users are perfectly content with how our EHR and PHR software applications currently function, but that doesn’t mean we rest on our laurels. My personal goal is to improve that contentedness factor from “vast” to “complete”. A lofty goal, for sure, but as long as there are things to improve upon, we’ll be listening to our users to make the experience better for them.

  • Stay tuned, Novadoc! 🙂

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