Skeletor's comments

Yesterday.

drchrono cofounder here.

I spoke with Dr. Dal on the phone and we worked out his issues. We try to make all of our users happy, but from time to time things don't work out. The drchrono team and I are working to change healthcare doctor by doctor and healthcare is a hard space to fix.

Dr. Dal was using our RCM (Revenue Cycle Management) service where we do all of the staff work for billing for the Doctor in exchange for a percentage of all of the insurance collections done in a month. There is a monthly minimum fee for the first few months the service ramps up, but for all of these contracts the percentage of billing fees is designed to exceed the monthly minimum in a steady state. In all the months Dr. Dal was using our RCM service he was paid on all of his medical claims in our system, but his account still never exceeded the minimum fee.

We raised rates for all of our RCM customers whose contracts weren't exceeding the minimums across the board. We gave customers several months notice about these rate changes and helped any customer that wanted to do their own billing or port to another service do so.

All of our users have access to download all of their data at any time. Users can also synch all of their data on an ongoing basis to Box's Enterprise HIPAA compliant storage. We put up a blog post to highlight these features and give instructions for users with links to our knowledge base: https://drchrono.com/blog/backup-records-outside-drchrono/

I think it's important that users always have access to their own data to use with other services at their convenience and to have for their own safety and peace of mind.

This is Michael, CEO of drchrono. It's definitely a rude awakening to wake up to see a post on top of Hacker News from an angry customer.

I've reached out to Dr. Dal to have a phone call today to see how we can resolve his issues. Me and my staff have attempted to have a phone call with him for the past several weeks to address his issues.

Rather than try to dig into the issues he brought up publicly, we'll do our best to contact him directly and resolve the issues he has.

Why do you say that?

drchrono: iPad Electronic Health Records YC Winter 2011 Alum

Fulltime in Mountain View, CA

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That's the exact way the market looked to Salesforce.com when Seibel system only went after large markets and told their salesforce to "run" not "walk" away from smaller customers. Salesforce.com definitely killed Seibel in the enterprise space after building a better product with feedback from smaller sales forces.

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.

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.

Also covered on techcrunch: http://techcrunch.com/2012/01/26/drchrono-raises-2-8m-from-y...

You are a napping genius!!!

Patient records can be given to patients in .pdf format (human readable) and also one of two government specified HL7 formats (CCR and CCD.) The MU certification makes all vendors give patients/doctors the ability to download one of the format (CCR or CCD), but all vendors have to be able to read both formats.

The MU guidelines did a great job of forcing all of the vendors to adopt one of these two standards and to understand them both.

Your fear is understandable, but I feel you would have less doubt if you knew more about the EHR space.

The government is laying out strict regulations on how EHR's should work and what data can be used (and by whom).

Access by patients to their own records is mandated as part of the certification and we already see widespread use of patients accessing their data from EHR systems via our patient portal and iPad app for patients.

The legal FUD you bring up would have some basis in fact if the government weren't mandating that all US physicians use EHR systems and passed laws/regulations defining their use and liability under HIPAA and the security rule.

The #1 source of patient data theft has occurred from stolen laptops which contained locally stored records. A cloud based solution with mobile access is much more secure since even if an iPad is stolen there is no loss of data.

Evernote primarily makes money from paying customers (by charging paying customers. I don't think they give money to their customers.

That worked! Thanks! +1 for you!

One aspect of getting government certification is that all vendors are required to support government approved standards like HL7/CCR/CCD for the exchange of health information.

So forcing all vendors in the space to get certified has forced all of us healthcare IT vendors to cooperate and adopt a fixed set of standards for exchange of data. Without the government stepping in and forcing vendors to adopt these standards, the disparate vendors would never have agreed on any standards and followed them.

drchrono runs on the iPad and on the cloud backend of drchrono.com. So drchrono can and does integrate with other vendors and systems to share data and take actions. For instance we transmit billing data to insurance companies and order electronic prescriptions over the Surescripts network.

Yes, companies that sell data about their doctors and patients are doing something dishonest in my view and we will never do it.