DrChrono helps small medical practices use iPads for patient records

Michael Nusimow and Daniel Kivatinos were college friends at SUNY Stony Brook on Long Island. Then Michael went to work at Bloomberg, while Daniel studied further before joining New York startups. When Michael took his father to hospitals and doctors, he was frustrated by how inefficiently patient data was handled. In some cases, paper forms needed to be filled out repeatedly. At another site, a doctor had a terminal, but he was so busy typing he hardly had time to look at the patient. Despite recent improvements to document interchange standards, sharing data between different medical institutions can be difficult given incompatible systems, complicated workflows and privacy concerns.

So Michael and Daniel decided that doctors could perform much more effectively with a web-based system. Initially, they started by automating patient communications. Their system would remind people of appointments with text and email messages. Then they added billing and interfaces to existing financial systems, learning requirements as they visited small ambulatory doctors’ practices. They launched DrChrono in 2009.

According to Black Book Rankings, in 2008, only 12% of office practices had even the most basic electronic health record (EHR) systems. By 2014, 51% of office-based practices were using a fully functional EHR systems, and 82% had basic electronic medical records.

In 2010, the iPad was launched. A tablet enables a doctor to face a patient while taking notes. Also in 2010, the government was moving to make Electronic Health Record (EHR) systems more open. So DrChrono decided to build an EHR system from scratch that would work on iPads. They launched their new system in 2010 at a Health 2.0 conference in Florida. It was an exciting time. Instead of struggling to sell a web-based system, Michael and Daniel closed deals at the conference as doctors enthusiastically saw the iPad’s potential.

DrChrono applied to join Y Combinator’s funding program, which Michael describe as being like “a startup’s coming out ball”. The program requires three months intense work in Silicon Valley. So Michael thought he would come to Silicon Valley for about six months. However, the experience was so transformative, that he started raising money and hiring employees in Mountain View. The company is currently based near 101 and Rengstorff.

DrChrono focuses on making small medical practices more efficient. The system manages forms securely, submits insurance claims, schedules patients, enables email correspondence, helps doctors manage inventory, transcribes medical notes, checks for drug interactions and handles prescriptions. The doctor can share diagnostic images, from X-rays, for example on an iPad with a patient.

Patients can download an app, On Patient, to track their health and share information with their doctor. It works on both Apple or Android platforms and is only useful if your doctor has the iPad DrChrono system. On iOS8 devices it works with Apple’s HealthKit, that integrates information from other health-related apps and displays them using Apple’s Health app. If you have a newer iPhone or iPad you might want to check that your fitness and health apps are set to share information with Apple Health.

The company is constantly looking for technologies that can help doctors and tried offering Google Glass. The display in the glasses was useful for certain types of doctors like surgeons, who need hands free information. In general, most doctors found tablets more useful. Wearable devices to track heart rates, exercise and more will transform the doctor/patient relationship as their output is fed into doctors’ systems. Michael quoted Vinod Khosla who notes on his blog that over time 80% of what a doctor does can be replaced by smart hardware, software and testing, with technology also improving a doctor’s ability to perform.

The Electronic Health Records space is crowded and fragmented. DrChrono started by bootstrapping and has been extraordinarily capital efficient, compared with San Francisco’s Practice Fusion, which has raised $134M from investors that include Kleiner Perkins and other big name firms. With major companies like GE, McKesson and Quest Diagnostics in the market, and many fast growing startups chasing for market share, DrChrono is racing to hire software engineers and customer relations staff so it can keep ahead of the game.