
Drchrono (YC W11) raises $2.8 Million for iPad Health Record Platform - Skeletor
http://bits.blogs.nytimes.com/2012/01/26/drchrono-raises-2-8-million-to-digitize-doctors-visits/
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zmmmmm
I looked into Drchrono when I was looking for work last year. I turned away
because I found the iPad-centric strategy obnoxious and short sighted. The
iPad is a wonderful device, but any company that builds their entire strategy
around their love of a device has dangerously blurred vision and a horrible
risk (one adverse decision from Apple you're done). Besides which, the last
thing healthcare needs is more walled gardens and information silos.

~~~
naner
_iPad-centric strategy obnoxious and short sighted_

I agree that this is short-sighted. I have worked in the Healthcare field and
am also related to a couple Doctors who built their own private practice. All
the software they use for medical records is buggy as hell and extremely
outdated. (Technically the software is updated frequently but it looks like
something out of 1998.)

An iPad-only (or any tablet) interface, however, would be a non-starter for
every practice I've worked with. It would be a great supplemental device for
some situations, though.

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leak
Healthcare is less about these cool technologies and more about how do they
devices and software interfaces get access to the patient data. I worked at a
startup that launched a tablet application back in 2005 for healthcare
professionals to interface with patient records while walking around the
hospital. Building the software was and still is the "easy" part.

Getting IT to give you access to patient data is the extremely difficult part.
It takes literally years. Lots of proprietary stuff that is very hard to get
into. Maybe Drchrono is tackling small doctors offices and it might be easier
but trying to get into major hospitals is another story.

I wish them luck either way.

~~~
Skeletor
We are going to change healthcare from the ground-up. Small 1-10 doctor
practices can easily make the decision to completely move to a new solution
like drchrono. Once you get every private practice doctor using better tools,
you can start banging on the gates of the hospitals to let you in and adopt
new technology.

It's similar to how Salesforce.com started with small businesses and
eventually broke into enterprise sales from the bottom up.

~~~
samstave
I don't agree.

A little background:

I am a hospital systems designer and consultant. I actually built one of the
first EHR clients for iPhone, before the iPad came out (Rejected from YC in
2009), I was the technology implementation manager for the new El Camino
Hospital build, I was the primary technology designer for San Francisco
General's new 850MM facility. I am consulting on the UCSF Mission Bay project
for technology and transition, and the same for UTSW in Dallas. I am also the
transition planner for a small 100MM facility in Nome Alaska.

In all of these projects I design and or consult on all aspects of technology
implementation, use, training etc..

I even sent an RFP for EHR implementation to Dr. Chrono to see if you guys
could step up to a larger facility ($5MM budget for that piece), I heard
nothing back for weeks until after the deadline when I was then told that you
couldn't respond - and then had a sales guy call me trying to get me to sign
up as a physician.

Anyway -- getting a private practice of ~10 physicians to use your product is
in no way a gateway to hospitals. They are completely different markets.

The EMR implementations in large hospitals are multi-million dollar
implementations and they take ~18 months to accomplish.

The sheer number of workflows needed and the integrations with various systems
are daunting and non-trivial.

You are going after a massively entrenched market with many many millions of
dollars committed by all the customers

I fully hope that there can be a serious shakeup in health IT, but having some
success with 1-10 physicians and then expecting to parlay that to hospitals
with thousands of employees, or even hundreds (like in Nome) is a tall tale.

I think there are TONS of opportunity to disrupt healthcare, and DrChrono is a
great app - it is just not mature enough or on scale enough to compete against
the larger EHR market YET.

EDIT:

I'd like to add - that if you want to continue to build a free product, and
you want to get into the larger scale EHR space - I suggest you partner
with/learn from/attempt to implement on-top-of MedSphere's OpenVista EHR.

DrChrono has some great features - and if you make the capabilities more
robust then you can get into this market more easily.

OpenVista is used widely outside the US as well, and this would be an
opportunity to capture the Asian/Indian market.

Also, if you take some of the features you have (Voice Notes, etc) and offer
them as a stand-alone-ish product - then you can attempt to get physicians
already in large hospitals to use that product - not selling it as an EHR, but
a needed tool, and expand from there.

If you stay away from the EHR/EMR moniker when infiltrating physicians in
larger hospitals you'll more easily get under ITs radar.

Every hospital has iPad users already, and most are rolling out official IT
support for them - so you need to get an app that physicians can use in
parallel to their epic/siemens/cerner/eclypsis solution without pissing IT
off.

~~~
brudgers
> _"The EMR implementations in large hospitals are multi-million dollar
> implementations and they take ~18 months to accomplish"_

This is approximately one and a half revisions to Apple's product line and
developer agreements, and this creates serious uncertainty for a large
organization on the scale of a US hospital which needs needs to plan changes
to its operations well in advance.

Unfortunately, Apple does not provide a technology roadmap around which
organizations can make the sort of serious decisions that affect health,
safety, and welfare.

~~~
samstave
Exactly. The iPad can only be an access device for an EHR - it cant be the
core of the product.

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Nat0
I am very excited to see what Drchrono will do in the medical field. The
industry is overdue for a smart company to come in and innovate.

I don't have any hands on experience with the app yet, but it seems to address
one of the biggest hurdles to adoption, the physicians' reluctance to
learn/use the cumbersome interfaces of the existing systems.

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Kadrith
How is this iPad app any different from what Canto provides from Epic for
physicians and MyChart for patients?

Disclaimer: Where I work we use Epic as our EMR and have been on it since
2005.

~~~
Skeletor
For starters, drchrono offers a completely free version (in a freemium model)
with the free version being a full EMR that qualifies doctors for $44,000 from
Medicare in Meaningful Use incentives.

drchrono has also been building on the iPad exclusively since the iPad was
first launched in April of 2010 (much longer than any other company). So
drchrono on the iPad is more advanced with features like realtime speech to
text, customized templates, and automatic note generation and billing features
that have evolved over the last 2 years.

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taurussai
Congratulations! If private practices are willing to use Ipads and meet some
of the criteria for the $44k, why not then? Was at a recent healthcare event
and met a random med student from John Hopkins, enquired about the exact same
problem and a solution that his advisor was asking him to build. Question
though - if doctors are already using something for EMRs how will drchrono
convince them to switch?

~~~
Kadrith
I don't think that is their target market right now. There is a land rush on
for people that do not have an EMR and do not want to join with a larger
facility that already has an EMR.

~~~
taurussai
Sorry I didn't see this earlier. We are actually working on making HIPAA
compliance easy in the cloud by providing a platform where developers can
easily encrypt/track/audit their data and establish compliance to auditors. We
plan to do this using a custom-built stack + a centralized management console.
Do you have any feedback on something like this, or would it be okay if I
could contact you offline? My email is in my profile. Thanks

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Skeletor
Also covered on techcrunch: [http://techcrunch.com/2012/01/26/drchrono-
raises-2-8m-from-y...](http://techcrunch.com/2012/01/26/drchrono-
raises-2-8m-from-yuri-milner-and-others-to-help-bring-medical-records-to-the-
ipad/)

~~~
chubs
Keep up the good work. Wow - i just read all the comments here - there's a lot
of 'can't be done' negativity. All that means is that you'll have few
competitors. To be honest, i'm thinking of not bothering reading HN comments
any more.

Keep making a difference - if you guys succeed in improving the efficiency of
US hospitals, that's something MAJOR to be proud of :)

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gshayban
Exciting, inevitable news. Healthcare needs a shakeup. How does drchrono
interoperate with medical systems? Other than SureScripts. Does it support
regional labs or just LabCorp/Quest?

Disclaimer: I am writing a modern interface engine.

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blasdel
Is the screen capture used in the announcement an "I didn't know I was
pregnant" joke?

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csallen
Congrats guys, awesome!

