Specialist EMR hosted in the cloud for clinics on the go

Australian developers have launched a fully cloud-hosted electronic medical records system called Clinic to Cloud (C2C) that is aimed at new and existing specialist practices and features full access to the clinical and practice management system on mobile devices, along with a patient portal.

Clinic to Cloud CEO Rafic Habib said he expected the product to appeal to specialists who not only want mobile access to their data but to do without the hassle of buying software upfront – it has a monthly subscription fee per user – or installing and maintaining hardware locally.

Clinic to Cloud is hosted in Microsoft's Azure environment in data centres located in Sydney and Melbourne, meaning patient data doesn't leave the shores, and the company is working on integration with popular cloud-hosted packages such as Microsoft Office 365 and Xero's accounting software.

Mr Habib said the main focus for Clinic to Cloud was on the specialist market. “We believe the market is ready for a true cloud solution and we will be well received from all sides of the spectrum, from existing, well-established specialists through to new ones,” he said.

Mr Habib and his team have been working on the product for several years and say they have built C2C with the clinician’s needs in mind. “C2C has a very clean user interface that focuses on minimising mouse clicks as much as possible to protect the user’s time,” he said.

C2C also includes an integrated voice recognition system using Nuance's SpeechMagic technology, which can be used in both front-end mode and allows the doctor to run a consultation using voice commands, as well as a back-end mode for traditional dictation.

The doctor's scheduler opens immediately upon log-in, with standard features including a holding list, recall lists and an appointment finder. Patients can confirm their appointments through a patient portal that will automatically update in the doctor's scheduler.

Clinic to Cloud also includes checklist and patient portal functions. These allow practices to create a list of questions which are made available to patients to fill in online prior to their appointment, as well as to register their full demographic details.

“As far as I am aware, the patient portal is something that no one else has in private practice in Australia,” Mr Habib said. “It provides a medium for communication between the patient and the practice.

“At this initial stage, when someone calls to make an appointment the practice manager will ask the patient some basic details; they are then sent an email with a secure link and a password. They will then log in and complete the registration, filling in their own demographic details prior to their initial appointment.”

The scheduler uses colour codes to show the different appointment types and C2C has an in-built alert system that can show warning messages such as 'Do not disclose my condition to my usual GP' or 'This patient suffers from Alzheimer’s disease' – in every interaction with that patient’s record.

“C2C encompasses some intelligent workflow, for example, when the consult is over and you save and exit, the system will prompt you to send a message to your reception staff about the item numbers and rebooking the patient, which will show up in the calendar,” Mr Habib said.

The consulting screen itself has been designed with a clean interface. It is divided into a white area for the current consult and a grey area for historical data that allows the doctor to quickly and easily review the patient’s history and previous consults, order investigations or create letters and more.

Consultation notes can also be controlled by voice commands from SpeechMagic, which is owned by Nuance Healthcare and was designed from the ground up for the medical industry. Mr Habib said SpeechMagic uses a medical-grade UK English dictionary and is phonetic-based so it can handle accents as well being gender-specific.

Mr Habib's team has been working with the SpeechMagic engine and related solutions for a number of years and has supplied it to many major hospitals. C2C has speciality specific dictionaries for doctors and while it is easy to train for an individual profile, it doesn't require the doctor to train it themselves, as the system learns in the background in a number of advanced ways.

“In the back-end dictation mode, when the doctor sends the dictation to the typist for typing, the system will take that typed text and match it to your voice and learn from it,” Mr Habib said.

One of the concerns when dealing with cloud-based solutions is how to manage advanced scanning of documents into the patient files. C2C has dealt with this by developing two small pieces of software known as C2C Middleware and C2C Printing to be installed locally on a computer in the practice.

One piece receives and uploads pathology and radiology results that come in as HL7 files from the labs and scanned documents as they are scanned in, and the other is to manage multi-tray printing so users can choose which tray they want a particular item to go to.

“You configure your scanner to send PDF documents to a folder and the C2C Middleware will probe that folder, pick up the scanned documents and push it up to Clinic to Cloud, ready to be labelled and linked to a patient,” Mr Habib said.

For photos, it can handle JPGs or PDFs. “You can just attach the photo to the patient file, but soon we'll give clinicians the option to link a photo from their smartphone.

“Our smartphone applications, Android and iOS, are quite advanced, but will soon also have the option to take a photo with a smartphone and securely link it directly to the patient file without having to keep a copy of the photo on the doctor's phone.”

As C2C is cloud-based, users can access the system from anywhere and on any device with an approved browser as long as it is internet enabled. One of the most popular features for the system is eTasks for the smartphone, which allows users to create a task and assign it to someone in the practice or link it to a patient all while on the move.

“You can bring up a task like 'call your insurance broker' or 'call patient X', complete it, delete it, respond to it, all from a smartphone. Doctors can also make a phone call to the patient directly from the smartphone or even dictate letters that are directly linked to a patient file and the voice recognition system will transcribe them either real time or in the back-end.”

There is also great potential with the patient portal to allow patients to better interact with the practice, as well as self-manage some aspects of their visit such as rebooking or re-print invoices or quotes. He plans to add further functionality to the portal, but will ensure that it is the doctor who controls what can and can't be done through the portal.

Clinic to Cloud also features a simple way to add a new practice or a new location for a practice. Clinic to Cloud also has an enterprise-level Medicare integration that allows users to add new locations or practices without needing tedious local certificate or HIC certificates installations. It is all built in as long as you have a location ID from Medicare.

“To get software ready for a new practice is usually quite a mission, but in Clinic to Cloud, if you want to add in a new location, you just type in some core details and set up the scheduler for that location, enter your Medicare location ID, click a button and you are ready to go,” Mr Habib said.

Posted in Australian eHealth

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