Hacking Healthcare: Enhancing the Doctor-Patient Relationship with Mobile Technology
A conversation with drchrono co-founder Daniel Kivatinos
Despite all of the noise and innovation in the healthtech world, we’re at a crossroads. Software is eating the world, as Marc Andreessen noted years ago, but healthcare is still lagging behind: expensive legacy systems are costly to maintain, the regulatory environment is difficult to navigate, and, as we all know, people don’t always do what’s best for them.
At BaseHealth, we believe that the developers and engineers behind today’s most promising technology will forge the road ahead, invent new solutions to legacy problems, improve the overall healthcare experience, and, ultimately, create a healthier future.
That’s why we’ve started this series — to recognize and celebrate the people whose behind-the-scenes innovations are driving healthcare toward a brighter future.
In our seventh edition of Hacking Healthcare, we interview Daniel Kivatinos, co-founder and COO of drchrono, a leading mobile electronic health record. Daniel holds an M.S. in Computer Science and a B.S. in Computer Science & Psychology from Stony Brook University. He was a software developer for the Oxford, Stanford, and Yale Online Education Alliance from 2003–2005 and Senior Applications Developer for CommPartners until 2008, when he cofounded drchrono. You can follow him on Twitter at @danielkivatinos.
What are you working on right now and how will it impact healthcare and the developer world? What are you most proud of in your work?
At drchrono, we’re focusing on mobile medical records for doctors and their patients. Most people can’t easily access their medical records, and they certainly can’t access their records on their devices. Parents don’t have access to their children’s records. Sons and daughters don’t have ready access to their aging parents’ medical records.
Our strategy was to begin by focusing on the doctor’s experience. We wanted to build something doctors needed — something they would actually use and would be comfortable sharing with their patients. We became the first Electronic Health Record (EHR) to build a native app for the iPad and iPhone. Now, thousands of doctors and millions of patients use drchrono to easily access their medical records on their devices.
As a developer, I’m really proud of the medical records API we’ve built. Developers generally have a hard time getting access to medical records data, and there’s a lot of data out there that doctors can’t access. Think of all the data being generated by wearables and other devices that isn’t getting to doctors. Our API is designed to help developers share meaningful data with doctors, and to help them easily integrate this data into a physician’s practice. Over 700 developers are building on top of drchrono, and we’re getting 4 million API calls a month.
What have you learned about sharing patient data with doctors? Can you give me an example of how it’s being done well?
A big challenge of having an API is determining what data to push and pull.
As a developer, you don’t want to be sharing all of the data from patient devices with their doctors. If you overwhelm doctors with too much data, they’re not going to look at any of it. For example, imagine you have a heart-rate monitor that integrates with our EHR. One day you have an irregular heartbeat. The data from that day immediately gets pushed to your doctor. You don’t want to send them data from everyday that preceded that moment. You’d overwhelm them, and they’d have to scroll through pages and pages of normative readings before seeing finding what was immediately important. Developers who want to integrate their devices with medical records need to understand the most important aspects of the data they’re working with.
Eko, whose developers built on the drchrono API, is doing this really well. Their FDA-approved electronic stethoscope takes heartbeat readings and integrates this data into medical records. This kind of thing creates a whole new level of connection to the doctor.
You’ve been working as a software developer since 2001. What made you want to get into healthcare?
My co-founder and I both had family members who had bad experiences at hospitals. We’re both developers, so we started thinking about how software technologies could improve the overall healthcare experience. We decided that to positively impact the relationship between doctors and their patients, we had to start by offering doctors something useful and beneficial. If you can improve the doctor’s experience, they’ll want to share the tools and software you developed with their patients.
Certainly healthcare has been less eager to cross-pollinate functionality than other industries, often for good reason. How will APIs eventually transform the healthcare industry?
The incumbent players in a lot of the hospitals are not cloud services, so it’s inherently difficult for them to get data out. Until recently, APIs just weren’t a part of a healthcare IT strategy.
Thanks to the brilliant work in cloud computing across verticals, we’re getting really good at integrating data and tools across users and systems. We’re just beginning to apply the lessons learned in other industries to healthcare.
From our inception, my co-founder and I knew we wanted drchrono to be a cloud service. Once most doctors walk out of their offices, they can’t pull up any patient data, and that’s a real problem. Some doctors can VNC into their EHRs, but that takes time and it’s neither intuitive nor reliable enough to meet most doctors’ needs.
In the past, healthcare development has been very siloed. EHRs that charge for access to their data inhibit developers.
We believe that empowering developers to do what they do best will undoubtedly enhance the healthcare experience.
When smart people collaborate, they innovate, but healthcare has generally stifled collaboration. At drchrono, we give developers free access to our API; they can build on it in sandbox mode using our free EHR.
What is your preferred development stack? Tell me about it. How does it different from other more traditional non-healthcare stacks?
We’ve been working on an open-source stack including Python, Django, and Linux. We also build on top of the iOS platform because doctors tend to really love it, and we want them to have a great experience when they’re seeing patients. We optimized for the iPad and put iPads in the hands of doctors.
We’ve seen technologies come and go. We’ve been lucky and strategic in the technologies we’ve chosen to build with.
What advice do you have for young developers getting into the healthcare world?
Healthcare intimidates a lot of developers, and that’s a shame. Don’t be intimidated! If you want to develop for healthcare, start by engaging with doctors and asking them what they need. You have to understand what a doctor’s day is like, and the best way to do this is to shadow a doctor. Understand the doctor’s experience, and you’ll start to have a sense for how technology can make a real and positive impact on healthcare.
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