Many of you know I’m all about keeping things simple, effective and useful. It’s better to have something simple that does a killer job at what it does than to have something so complex that no one uses it. In fact, that’s really the basis of my simple plan for meaningful use. Of course, this can often be confused as not valuing other items. However, that’s just not the case. You just start with reasonable goals and do amazing things with it. Then, you expand once you’ve conquered something simple, but I digress. The point is that I really enjoy seeing simple systems that just flat out work.
That’s why I was intrigued by an email I received from a reader about their system called ePatientHistory. I think it can best be described as a simple patient portal that tries to do 2 things really well: online patient registration and online patient payments.
I should make a disclaimer that I haven’t used this service other than the demos on their website. However, I really like some of the concepts and I wish more EMR companies would try to create something simple and effective that focus on small goals as opposed to trying to cure the whole world with a patient portal that is so complex no one uses it (man I’m in a ranting mood today). Let’s talk about each function which they call ePatientHistory and ePatientPayments.
ePatientHistory – Online Patient Registration
I tested the demo for this and it was a little buggy and not as intuitive as I would have liked it to be. For example, it didn’t have the standard * next to all the required fields and the pop up that was shown for the required fields didn’t make much since to me. A small thing that makes a big difference. Maybe this just wasn’t shown in the demo, but it would have been nice to had nested questions that were only shown if I’m female for example. That way I can skip the pap smear questions and go straight to the testicular self exam ones.
Also, it was awkward to have to register and then choose the form I want to fill out. Ideally the doctors office could just send me an email that has basically registered me into the system. The email would include a link which I click and get taken to a step by step webpage of what the doctor’s office wants me to do for my appointment. Then, I can’t screw it up as a patient. After I’ve filled out the important paperwork, then let me see the full login and the other features that I may want to use.
Of course, when you’re dealing with a standalone portal like this, the question really is how are you going to get the information out of the system. This system seems to offer a CSV file which can then be imported into an EMR. Ideally, I’d like this company to show me a list of EMR companies that support this type of import. I know that all of them could since CSV is pretty standard, but how many would and if they do would that data be inserted into your EMR in a useful way? Of course, many might just want the health history form to be a nice PDF file that they can upload to their EMR. However, it’s just sad to lose all that data in a PDF file.
The cost structure for this service is interesting. Basically it’s $695 up front and $39.95 per month for hosting. Seems a little pricey to me, but if they can make sales that’s a really good business model to have. You get the up front money and a residual income.
ePatientPayments – Online Patient Payment
This is an interesting module since it’s basic idea is to collect payments. Although, one good part of this system is that it will collect payments over time according to a payment plan. I think this can be really useful in collecting harder to collect accounts. Plus, it can be scheduled to be done automatically thanks to the power of Paypal.
Similar to the other description above, I’m not sure how the patient will know how much to pay. I didn’t see anywhere in the admin that seemed like a place that someone in a clinic could notify someone that they have a bill to pay and come to this portal to pay it. That would be nice functionality. Although, it would be really sweet functionality if it was tied to the EMR where the actual charges arrive. Of course, this is the challenge of using a system that’s not connected to your EMR.
The cost for this is similar to the other one with $395-495 a month up front and then $29.95 per month for hosting. One thing it doesn’t say is how the charges that Paypal charges will be handled. I’m guessing they pass those on to you the end user as well. Paypal is an amazing platform and great for developers since it costs nothing to get started and use it. However, Paypal instead gets paid on the back end with the highest percentage fees of any other credit card processor. I imagine ePatientPayments will want to switch to something other than Paypal as they grow. The savings of using another credit card processor over PayPal will basically pay for the ePatientPayments and then some.
I think we’re going to see a lot more little services like this pop up. I think a number of them could be very beneficial if they’re integrated or used alongside a great EMR. The other good part is that it seems like using stand alone services like this one will still allow you to be considered a “certified EHR” and possibly receive some of the $36 billion of EMR stimulus money.
Now, just to provide some background on this specific company, here’s a copy of the email I received about how ePatientHistory came about:
As a web developer, professionals seeking online solutions that make sense for their particular business often approach my company for advice. A local physician recently asked if I could develop online patient registration and payment services tailored to his medical practice. Since these types of services are commonplace on the Internet, I began to research options that might already exist for his purposes.
What I discovered were complicated, often expensive options for services that appear to take advantage of a basic lack of knowledge regarding web-based application implementation. Advances in technology have resulted in a wealth of web-based software options that companies with in-house IT departments find effortless to implement. It appears that health care providers typically outsource their requirements in this area, often at a very high cost. The requirements to be HIPAA compliant add to the complexity, and thus to the cost.
The physician approaching my company for online services was not seeking an EMR system, but rather a simple, affordable way to accept online patient payments and permit online patient registration. After analyzing and meeting the HIPAA compliance requirements, we accomplished his objectives, providing an online service that involves no hardware or software purchase, and requires no staff training to implement, at an affordable price. Patient history data can now be securely collected and stored electronically for import into an EMR system. Patients may now make online payments.
At the suggestion of this physician, our company has made these services available to any health care provider, as well as other businesses.