iPhone Life magazine

iChart EMR

Edward M. Zabre...

iChartPatientListDo you need help moving into the 21st Century of Electronic Health Records? iChart EMR ($139.99) claims to be able to help you with that. Developed by Caretools Inc. to be an all-in-one tool for the busy physician or health care provider (PA, nurse, chiropractor, etc.), iChart helps you track patients and manage what they call the “Chart, Bill, and Fill,” process.

iChart iPrescribing featureAll patient data is entered on the iPhone app, or from a desktop computer via the bundled Web application, and a data synchronization feature makes sure that data is securely synced between both. This allows you to use the iPhone app in the absence of an Internet connection, to access and modify patient data. (Tip: You’ll be carrying sensitive patient data on your iPhone, so be sure to activate the iPhone’s password lock to protect it—and to avoid huge HIPAA fines and other penalties.)

The health care professional starts by selecting a patient from a list based on the location of the user’s practice, the encounter type (clinic visit or inpatient), or by a specific patient identifier. Once you have a patient selected you can then access their medical records via tabs at the bottom of the screen. 



To access medical records in iChart, select the individual
from the Patient list (above left and right images Figs.)


The iPrescribing feature lets you manage drug lists, check ADR’s,
and electronically transfer prescriptions to the pharmacy (right).


Chart, Bill and Fill


The Notes tab allows the user to create various types of documents, including SOAP notes, H&Ps, procedure notes, consult notes, etc. iChart NEWhen a note is created on the device, it pulls in what’s known about the patient so it can create med lists, recent labs, currents problems, and past medical history automatically. You can then select a section of the note and add information to it using various forms of input. You can create a narrative description using a set of menu trees. These menu items list common questions and responses to a specific problem or complaint. The existing library of templates can be modified and new templates created on line using the bundled Web application/account that is furnished to each user.


You can also enter data using real-time voice recognition, which displays results in a matter of seconds! The system uses a third-party voice recognition engine that runs across the Internet. It is speaker independent and highly accurate for medical jargon. You can also create dictations and transfer them to the Web at a later time for transcription, which is returned within 24 hours. This is a huge advance over any mobile app and device I have used in the past. Notes can also include preset images that can be annotated on the iPhone such as body maps and diagrams. You can also include ad hoc photographs taken with the iPhone camera. Images and annotations are all included in the final note.


iChart lets you can create chart notes
using complaint-specific “picklists” and/or voice input.


The iBilling component of the app uses a built-in billing code capture tool. This allows you to capture billing codes from a Favorites list or from the entire library of CPT4 or ICD9 codes that are loaded on the device. All billing codes are transferred to the Web application for reporting and/or export. Caretools also offers a billing service option that will seamlessly check for correct coding, submit, and manage the electronic billing process via the bundled Web application


iPrescribing is another key feature of the app. It allows you to manage medication lists, and create new iPrescriptions, and have them electronically transmitted to the desired pharmacy with a few taps. Drug interaction checks, drug dosing options, and drug monographs are all integrated and preloaded.


iChart labiChart also has an iLab feature which allows you to review recent labs in the convenient “stick” form. You can enter in any new labs directly, or receive electronic lab feeds as an add-on option.


The cool thing about this application is that it takes advantage of the iPhone touch user interface and is quite simple to use without complex screen navigation.


Connectivity to the Internet


Once you have added new information to a patient’s record on the iPhone, this information is stored locally on the iPhone database and is then synchronized to an iChart Internet account using HIPPA compliant technologies. At the same time any updates entered to the Web account are downloaded into the users device. These items include any new patient information, scheduled visits, or in box items such as prescription requests, lab alerts, or patient call back requests. Management of the Web account information is enabled through a Web application written for use by the physician or his front office staff. This Web application has similar features to the iChart iPhone application and includes an Outlook style scheduler, message inbox and screens for reviewing and printing patient prescriptions, chart notes, and uploaded billing codes. In essence, it’s a Web based lightweight EMR that synchronizes to the iChart iPhone application.


The iLab feature lets you review labs, enter new labs,
and receive electronic lab feeds as an add-on option.


Robust, reasonably priced solution


Everyone is struggling in these difficult economic times, including health care professionals. iChart is a very robust solution for medical offices looking to transition to a very reasonably priced electronic health record with options for billing and prescribing tools included. The basic product is priced at $139.00 for the first year with an annual renewal subscription fee of $99. Optional add-ons are available for electronic lab retrieval, electronic prescription transmittal, and electronic transcription. More information can be found the developer’s Web site (caretools.com).