Eric Fishman, with EHRtv, speaking with David Lareau, CEO of Medicomp.
Dr. Eric Fishman: This is Eric Fishman with EHRTV and today we have the pleasure of speaking with David Lareau, Chief Operating Officer of Medicomp.
David, you have been with the company for many, many years, 15-16 years?
David Lareau: I have been with the company since 1995
Dr. Eric Fishman: And that’s half of its 33-years history.
David Lareau: Yes
Dr. Eric Fishman: And Medicomp obviously does quite a number of things and in a couple of moments we will be speaking about your most recent offering which is Quippe and it really sounds very exciting but tell us a little bit about Medicomp.
David Lareau: Well, Medicomp was founded by Peter Goltra in 1978 to enable computer systems to provide relevant information to clinicians at the point of care for any situation without having to search for it, without having to look it up, just to present through the MEDCIN® Engine what was relevant given what the physician said they wanted to do at that point.
Dr. Eric Fishman: I was going to ask what is the relationship between Medicomp and the MEDCIN® Engine.
David Lareau: Medicomp’s primary achievement is the MEDCIN® Engine. That’s our core intellectual property. Other things like Quippe, our newest product, are meant to make it more easily integrated with other EMR systems.
Dr. Eric Fishman: Understand and the MEDCIN® Engine, that is being used by a number of different electronic health record companies both in this exhibit hall as well as others at MGMA but you have just recently released the SDK, the software development kit, for Quippe and it’s now being used in the MED3000 Integrate.
David Lareau: Yes, MED3000 is here in booth 1109 and we are excited that they are initial launch partner for Quippe which is a documentation tool, web cloud based, based on the MEDCIN® Engine but much more flexible and customizable by physicians than anything else we have ever had or we have ever seen on the market.
Dr. Eric Fishman: And so, is it customizable by the individual physicians who has implemented MED3000 or is it customizable by the individual electronic health record companies that have integrated in?
David Lareau: That’s where you open up a can of worms. It is customizable by the individual physicians but in an enterprise situation, there is a heavy load if you let individual docs customize as they will. So, it provides the tool to do that but it’s typically done under enterprise guidance so that they achieve their goals as an enterprise, yet accommodate the individual needs of the physicians.
Dr. Eric Fishman: I understand that Quippe is, if you will, agnostic with respect methodology. You could use your keyboards, speech recognition, touch pad. Tell me how many different methods you have seen physicians actually use it.
David Lareau: Well, we have seen physicians use it with speech. We have seen physicians use it on tablets. We have seen it on mobile devices. We have even seen it used with the old ink pen scanners and with the new digital scanners, pens from Scantron and those sorts of things.
Dr. Eric Fishman: And just to put a flavor on it as to what the functionality and I am not wishing this on myself, but if I were to go to a physician’s office and I said I had some chest pain and I had some left arm pain, as the physician were entering that data into their record at this point in time MED3000 as your hope that it will be others, the system would, if you will, prompt the physician with respect to other relevant questions, with respect to all of the other information that is in the patient’s chart at that point in time?
David Lareau: Absolutely. That’s a patented process we call Intelligent Prompting which is meant to present the relevant information to the physician depending on what they say they are concerned about at that particular moment.
Dr. Eric Fishman: And does it go back to the entire historical record or is it only with respect to the information that is being presented in that specific visit?
David Lareau: If they elect in their custom settings to have it include historical information, it can do that.
Dr. Eric Fishman: That’s very impressive.
David Lareau: Thank you.
Dr. Eric Fishman: How is it being received so far?
David Lareau: It’s being received – J. Anders, the Chief Medical Officer of MED3000 told me “Hey Dave get ready to strap it on, it’s going to be an exciting ride.”
Dr. Eric Fishman: That’s exciting, that’s exciting. If you don’t mind, now I am going to play a little game, I call it the acronym game. I am going to say an acronym and maybe you can just tell me the first thing that comes to your mind and what you think about it, how it may affect your company and the industry in general.
David Lareau: Okay.
Dr. Eric Fishman: We have been talking about input devices. Let’s talk about NLP or NLU.
David Lareau: Okay, Natural Language Processing or Natural Language Understanding are typically viewed by most people to be the same thing; they are not. Natural Language Processing is turning speech into text and getting some meaning out of it. Natural Language Understanding is actually understanding the clinical implications of what’s being translated from sound to text to actual clinical data. We are excited about that because given that, you can feed that through our clinical data engine and we can provide intelligent filtering of the rest of the record or whatever the physician says, “These are the important things I want to focus on” and the MEDCIN® prompting engine can accommodate that.
Dr. Eric Fishman: It’s nice to hear somebody understand the difference with respect to NLP and NLU and the understanding is obviously there; you are not really processing. How do you expect that entire industry to change Quippe over the next few years?
David Lareau: We would like to see and we were talking to some of the speech recognition vendors about it to actually use MEDCIN® with the Quippe interface as the target of natural language and what some people call political language understanding they’re getting more specific. So, given that, we want to take and dynamically find the MEDCIN® concepts which are then mapped to all the reference standards, so the physicians can use any input method including speech they want and still meet all the data requirements they do for HIEs, meaningful use, ICOs, etc.
Dr. Eric Fishman: Let’s get to another acronym – PHI.
David Lareau: That’s related to security and if the information is there, we make it easier to get the information there but we don’t really address security issues because we are not the EMR, we are the acquisition engine for the data itself.
Dr. Eric Fishman: So, the PHI and some people call it Protecting Health Information is not particularly…
David Lareau: Yea, luckily we get to focus on clinical users and clinical use and people like the vendors in the hall have to worry about security.
Dr. Eric Fishman: Okay. Now, let’s go to something you probably know a lot about – CDS.
David Lareau: Okay, Clinical Decision Support – Clinical Decision Support means to us giving the clinical information to the physician that they need to do their job and that job may be documentation, that job may be treatment, that job may be coordination of care with somebody in the ACO world. So, clinical decision support for us doesn’t mean making clinical decisions. It means actually supporting clinical decisions which we do by providing the relevant information out of the mountains of data that the HIEs are about to send to physicians.
Dr. Eric Fishman: You read my mind – HIE was going to be one of them. Let’s skip it. Let’s go to ICD-10.
David Lareau: ICD-10 – International Classification of Diseases, Syndromes and Other Conditions. It’s going to be ridiculous, the degree of change that’s going to be required in some of these systems…
Dr. Eric Fishman: A lot of codes…
David Lareau: It’s a lot of codes, it’s codes like drowning or submersion, from burning, from falling water skis – initial encounter. We don’t expect anybody to have a coded concept for that. So, it’s going to be important for software to be intelligent enough to realize what additional information is needed to get the right code. We have just released our Alpha version of ICD-10 coding. The beta goes out in February. The general availability release will be out next August.
Dr. Eric Fishman: May I ask how many people your company has on this project with respect to ICD-10?
David Lareau: We have about five people working on it both internally and consultants. That doesn’t sound like many perhaps but because we already have coded data, 280,000 coded data elements and an unbelievably powerful knowledge editing system, I think we have an advantage over most people who are going to have to do deal with this issue.
Dr. Eric Fishman: I understand. This is fun. Let me do ask you about HIE.
David Lareau: Okay. Health Information Exchange – sounds like a good thing and it will be if the recipient of the data coming through this health information exchanges can deal with the tsunami of things that they are going to have to because they are going to be expected to be able to deal with that data, they are going to need some intelligent processes; that’s what our prompting engine will provide. So, we are excited to see it and we are anxious to see how people actually deal with the flood of data that’s about to be unleashed on them.
Dr. Eric Fishman: We have been talking about these interoperability issues for a long time. I think we are finally here.
David Lareau: We are finally here, we are finally here.
Dr. Eric Fishman: David, I thank you very much. It has been a pleasure chatting.
David Lareau: Okay.
Dr. Eric Fishman: This is Dr. Eric Fishman with EHRTV. We have been speaking with David Lareau, Chief Operating Officer of Medicomp.