In November 2018, Mary Ang and her team won $45,000 in the Department of Health & Human Service’s Easy EHR Issue Reporting Challenge. Then she disappeared…until last week. Almost exactly a year after her Challenge win, Ang debuted a refined, production-ready version of her prize-winning application at the 2019 IHI Forum.
EHRs are a source of frustration for clinical end-users. Unfortunately, most EHRs do not have an easy way for those same end-users to log issues. As a result, most users must resort to attaching screenshots to emails. This is enough of a barrier that many opt not to report the issues they see.
In May of 2018, the Office of the National Coordinator for Health Information Technology (ONC) sought to change this by issuing their Easy EHR Issue Reporting Challenge. The Challenge was a “call to software developers, clinicians, and innovators to create a tool that will make it easier for doctors, nurses, and other care team members to efficiently and effectively report concerns about the usability or safety of EHRs to appropriate parties, such as the hospital or practice’s IT team, the EHR developer and Patient Safety Organizations (PSOs)”.
At the time Don Rucker MD, National Coordinator for health information technology had this to say about the need for the Challenge: “Helping reduce the burden of health IT continues to be a key area of focus at the ONC and we anticipate the winning submissions to the Easy EHR Issue Reporting Challenge will help with those efforts. Once the winning submissions reach production, we expect to see how reporting safety issues can be less burdensome for healthcare providers.”
Having worked in the IT department at Virtua Health for over 17 years, Ang saw the frustrations with EHRs first-hand. Most concerning for her were the patient safety issues that were being caused by EHRs, like alerts not appearing to physicians who are about to prescribe a contraindicated medication. Sometimes these issues were actual product deficiencies and sometimes they were caused by incorrect system configurations.
In either case, Ang saw that these issues were being under reported by staff because there was no easy way for them to notify IT. Instead, it would often be an offhand comment during an IT meeting when end-users would bring up these issues (which the IT team would then scramble to investigate). Ang believed there had to be a better way.
When a colleague told Ang about the Easy EHR Issue Reporting Challenge, she jumped at the chance to build something that could make it better for end-users. Ang and her small team at James Madison Advisory Group created QCapture – a simple utility that ran in the background of a user’s desktop and through a hotkey (or system tray icon), allow that end-user to quickly and easily capture an EHR issue.
Instead of following the standard startup script and leveraging her Challenge win to seek funding and/or occupancy at a brand-name health incubator, Ang bravely chose instead to go it alone. After winning the challenge, Ang took a critical look at her prototype and decided that it needed more work before she brought it to market.
Ang took the prize money and used it to bootstrap her way to a production-ready platform. She hired an overseas development team in the Philippines, pivoted from being a consultancy to a Health IT product company and taught herself product marketing. It took her a year to feel market ready.
By the time Ang signed up for IHIForum, it was well past the exhibitor deadline and as a result, QCapture didn’t make it onto the Exhibitor List. Luckily, the organizers were able to find space in the exhibit hall for them. That would have been stressful enough, but when the day of the conference arrived, parts of Ang’s booth were stuck in transit. She ended up having to go to the local Walmart to cobble a display together.
For a first-time exhibitor (ever) I have to say that she did a fantastic job.
When the IHIForum exhibit hall opened on Day 1, there was Ang, smiling and engaging passers-by in polite conversation. I was one of those passers-by and since I hadn’t heard of QCapture before, I decided to stop and find out more.
As Ang showed me her product I was impressed. It’s simple, straightforward and it works.
When a user finds an issue in their EHR, they simply press the QCapture hotkey or click the icon. When activated, QCapture automatically takes a screenshot of the EHR and displays a form for the end-user to describe/document the issue. The user can draw, annotate and redact patient information on the screenshot within QCapture. When the user is done, they click “Submit” and the issue is automatically routed to the appropriate person or team in IT.
The form that is displayed to end-users is completely configurable within QCapture. Similarly, the routing of issues can be customized to match internal IT workflows.
Ang and her team took a decidedly minimalist approach to their platform and it works beautifully. There is nothing extraneous and it does exactly what you expect it to.
More impressive than her product, was Ang’s answer when I asked how much the platform costs. “$288 per month” she said. Per user? Nope. Per EHR? Nope. QCapture is incredibly just $288 per month for an entire organization – no matter how many users, EHRs or sites an organization has.
“I wanted to set a price that was reasonable,” explained Ang. “I don’t believe software should be thousands of dollars a month when it doesn’t need to be. Plus, I wanted to give back to the community. I won the prize money from HHS and used it to create this product. It seemed like the right thing to do to charge only what I needed for it.”
When was the last time you heard THAT from a Health IT company founder?
Through grit, courage and determination, Ang took a $45,000 prize and used it to launch a product and a company – almost completely on her own. I will certainly be keeping my eye on QCapture in the months ahead.