A Central Iowa electronic medical record startup finds opportunity among small practices and university education
A Central Iowa startup built its business helping speech-language pathologists and audiologists communicate effectively with their patients’ health care insurance providers. Now, ClinicNote’s management of electronic medical records is reaching private practitioners and medical students alike to influence the future of medical record-keeping.
ClinicNote, founded in 2015, developed software intended to streamline the progress report process for speech therapists and audiologists. As one of the first graduates of the Global Insurance Accelerator in Des Moines, ClinicNote’s initial product simplified the development of patient progress reports being shared between therapists and medical insurance providers.
A team of three full-time staff members has expanded ClinicNote’s electronic medical record system over the past few years with the help of external tech developers, said President Lana Fox. In 2017 ClinicNote piloted its first software version designed for medical residency students — today, the company’s services are expanding through new disciplines at universities and private clinics, and ClinicNote is identifying where it can expand documentation services for clients, Fox said.
“We are going to continue focusing on university therapy teaching programs and ensuring they are getting the best possible EMR system for their students to work with, and teach them how to use an electronic medical record, and make sure that the students are prepared for advances in technology,” Fox said.
The Business Record spoke with Fox, who was named the 2020 Emerging Technology Leader of the Year by the Technology Association of Iowa, about where ClinicNote expects EMRs to grow in the next few years.
How do you explain ClinicNote to newcomers?
An EMR is an electronic medical record, which is just a fancy way of saying electronic documentation for taking patient notes, scheduling their appointments, billing to insurance. It’s like if you were to walk into a clinic and look for a case with a person’s file — it’s all that information that would be in a person’s file, but stored in the cloud. … Initially we started for speech therapists, but now we’re really focused on helping university teaching clinics that are teaching up-and-coming therapists of the U.S. Our main [market] is speech and audiology; however, we have our first occupational therapy [program], universities, athletic training and physical therapy. We’re expanding into other disciplines now, which is really exciting.
I think the first idea of electronic medical records was in the late 1970s, so a long time, but the tech boom [in the 2000s] really made it realistic — hospitals had them first, but the smaller clinics couldn’t afford it. When the technology boom started, that’s when it really took off for the smaller clinics.
There are certainly some smaller private practices who are still using pen and paper … but I think the more efficient and easier to use EMR systems get, the more it will become common. It’s the smaller practices, 20 providers or less, that are still looking for a super efficient way to do their documentation and physical therapy.
Usually every EMR system is written a little differently, or on a different tech stack. That makes it a bit complicated when talking [between] different EMRs so they would just load information. You can certainly email between the EMR systems, but it doesn’t just automatically load the patient record.
How has ClinicNote grown?
When I came on to the team in 2016, we were really looking to gain traction and trying to make sales. What we found was that we needed a more robust system, more than just some notes and progress reports. We needed to expand and make the platform have scheduling, billing, all the things that are kind of expected with EMRs now. What changed was we had to build more products before we can really get that big data. I think there’s still opportunity down the road where we can analyze more of the record and go back to insurance companies with that, but right now I’m just focused on providing the very best documentation process for our users.
The way [COVID-19] affected us was that some contracts got delayed another year because they wanted to see what was happening. But on the other hand for some universities, they needed something so that they could have their students work on documentation from a remote space. [ClinicNote] made it much easier to do that, along with sending documentation to the patients that made it a lot easier for them.
What are the challenges in storing health care documentation into a cloud-based system?
From the inception of ClinicNote we’ve been very careful and conscientious, knowing that it needs to be a HIPAA [Health Insurance Portability and Accountability Act]-compliant space because it’s dealing with really sensitive information. We work closely with our developers to ensure that they were planning for both growth, but also make sure that everything is secure and in compliance. I’ve been lucky to have great advisers and mentors. We found a company that we utilize called HIPAATrack to help with HIPAA compliance — you really have to focus on your processes and improving them, documenting what you’re doing to be compliant. Creating all of those policies and procedures has been really important and imperative.
How is patient access to their own medical records changing through this process?
I think it’s becoming more and more readily available. With the patient portal access, patients then can see finalized documents that the provider wanted to share — they can see their scheduled appointments, they can message their provider if they need to, and I think that is something that will continue to be easier and more streamlined.
What are your predictions in the next few years? What will ClinicNote look like?
I think COVID-19 has made using the internet more of a necessity, especially if you think of remote Iowa — it’s not easy to access good therapy unless you have someone who came to live in your small town and that’s their expertise. Otherwise you have to drive and see your therapist. I think a trend we’ll see as the internet continues to improve is our ability to seek service that’s exceptional will become easier and easier. It’s really important that EMRs match that. You’ll see some telehealth exploration, such as Doctors on Demand, that sort of thing. I could see telehealth being integrated with EMR systems.
One of our main goals is just to get a foothold in the other disciplines, occupational therapy, physical therapy and athletic training, and continue to grow in speech and audiology. If we do that, we’ll be happy as a company because we’re helping serve more people.