1. The first comprehensive communication
system for on-call healthcare providers
Dave Wortman, CEO
Copyright © 2011 Allscripts Healthcare Solutions, Inc. 1

2. Solution Overview – 1 of 2
Ø High Level Solution Description:
• Conveniently connects patients to on-call providers via telephone,
connects doctors and nurses to on-call providers via telephone or
secure text message.
• Automatically identifies patients and retrieves critical patient data
from the EMR in real-time for delivery to the on-call or recipient
provider’s smartphone.
• Enables immediate and thorough documentation of encounter
activities directly from the smartphone, supporting continuity of
care and reimbursement requests.
• Manages on-call schedules, alerts and notifications.
• Provides comprehensive encounter logging and performance
monitoring through an interactive dashboard for improved
practice management.
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3. Solution Overview – 2 of 2
Ø Healthcare/Business problem addressed:
• On-call medicine is conducted “in the dark”:
• Lack of complete and accurate patient medical history (14% errors in calls)1
• Lack of secure and convenient mode of communication (>$50,000 text fines)2
• Lack of efficient tools for follow-up and documentation (<5% documentation)3
• This leads to severe costs (left) and risks (right) including:
• Unnecessary ED visits • Suboptimal or erroneous diagnosis/treatment
• Higher readmission rates • Compromised quality or continuity of care
• Lost reimbursement opportunities • Increased liability and malpractice risk
• Inefficient use of provider’s time • Greater HIPAA compliance risks
Ø The application developed addresses the following category:
q Applications that improve management of high cost chronic diseases.
q Innovative approaches to addressing value-based care imperatives.
q Both
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4. Usability and Design
Ø The Diagnotes system is comprised of two main components:
Ø Diagnotes Mobile – a slick smartphone application that enables
providers to conveniently interact with patients and other providers,
quickly review patient medical history and recent provider activity, and
thoroughly document all encounter actions.
Ø Diagnotes Manager – a powerful web-based application that allows
practice managers to track activity logged in the Diagnotes system,
manage on-call schedules, generate reports and review performance
metrics in an interactive dashboard.
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5. Diagnotes Workflow
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6. Development Stage
Ø Please indicate the development stage as of the Phase 1
Submission Date:
q Idea
q Prototype
q Code development in progress
q Code complete
q Code complete, tested and approved by Allscripts.
Ø Additional Information: Diagnotes is a fully-developed
product that is currently deployed and in use in multiple clinical
settings. Remaining development efforts for the Open App
Challenge will center on integration with one or more of the
Allscripts Electronic Health Record Solutions.
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7. Integration Description
Ø Diagnotes requires two primary integrations with Allscripts
Electronic Health Record Solution(s):
Ø 1. Patient Search
Ø The Diagnotes IVR performs searches for patient records based on patient phone
number and first name.
Ø Diagnotes Mobile allows healthcare providers to search for patients by patient ID
number, phone number, first name, last name and/or date of birth.
Ø 2. Patient Record Retrieval
Ø Diagnotes integrates via Continuity of Care Document (CCD) exchange, giving
healthcare providers an “abstract” of a patient’s health record—providing only the
most pertinent information needed at the point of care.
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8. Go to Market Strategy
Ø Beachhead market focus
Ø High mobility needs (frequent on-call duty) and high information needs
(complex or high-risk patients)
Ø Cardiology, Pediatrics, OB/Gyn, Internists, Neuro, Orthopedics, Emergency
Ø Strong economic case
Ø Hospital-owned and large independent practices, ACOs
Ø EMR system in place
Ø Direct sales to secure initial reference accounts
Ø Channel partners to accelerate growth Pricing
Ø Healthcare software companies (Allscripts) • SaaS subscription model
• Effective monthly cost of
Ø Healthcare consulting firms
$75-150 per provider
Ø Value-added resellers • Based on customer scale
Ø Answering and transcription services and configuration
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9. Video Demonstration
Ø Diagnotes - Video Demonstration (YouTube)
Ø This video demonstration shows just one of several potential
use cases for the Diagnotes communication system.
Ø In it, an Emergency Department nurse uses Diagnotes to
conveniently and securely share patient information and
consult with an on-call cardiologist via text message; the
encounter is immediately documented.
Ø Other use cases include but are not limited to:
Ø Patients calling after-hours to reach the on-call provider
Ø Other clinicians calling to reach a specific, known provider
Ø Other clinicians calling or securely texting an unknown on-call provider
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10. Compelling Benefits
Benefit Provider Practice Patient
+ + +
Colleagues System Caregivers
Improved Care
Added Convenience
Lower Costs
Reduced Risk
Better Documentation
Additional Revenue
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11. Why Diagnotes?
Ø Convenient, easy to use, secure and effective
Ø Automatically, securely delivers patient record to smartphone
Ø Supports follow-up actions, including encounter documentation
Ø Facilitates secure text messaging among providers
Ø Alerts providers and staff of pending or completed encounter actions
Ø Clear compelling need
Ø Over 50 million on-call encounters after regular business hours alone
Ø Errors and noncompliance create health and liability risks
Ø On-call activities currently not reimbursed, despite incentives
Ø Ready to go, ready to grow
Ø 3rd party security audits passed – fully HIPAA compliant
Ø Multiple pilot studies completed – excellent user satisfaction ratings
Ø Experienced team spanning IT, healthcare and early-stage companies
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12. References
Ø 1. Anna B. Reisman, MD, Karen R. Brown, MD. Preventing Communication Errors in
Telephone Medicine – A Case-Based Approach. Journal of General Internal Medicine
2005; 20:959-963
Ø 2. Andrew A. Brooks, MD. Healthcare Texting in a HIPAA-Compliant Environment.
American Association of Orthopaedic Surgeons Now 2013; 7:2
Ø 3. Katz HP, Kaltsounis D, Halloran L, Mondor M. Patient Safety and Telephone
Medicine – Some Lessons from Closed Claim Case Review. Journal of General
Internal Medicine 2008 May; 23(5):517-22. Epub 2008 Jan 29
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