IconoPsych reduces paperwork, increases patient access

Dr. Jason Cafer is a bit frustrated with work. As University of Missouri psychiatry resident, he has been struggling with the huge stacks of medical records lying around his office. Cafer finds that these unmanageable records force him to spend too much time poring over the paperwork of each patient he sees, leaving less time for patient care.

But if all goes well, the problem won’t last long. Two years ago Cafer started developing IconoPsych, a system for placing mental health records online in an easy-to-use format more streamlined than many of the electronic records systems that already exist. The system should be launched late this summer.

Cafer formulated plans for the project during his free time—which was in short supply. A DJ for KOPN, the owner of the local recording label Painfully Midwestern, and the father of a son, Jack, Cafer managed to complete medical school with a grade point average higher than 4.0—back when MU had a weighted GPA system—and now adds patient care and record keeping to his busy schedule.

Michael Schrader, an MU instructor and business consultant whom Cafer recruited to work on plans for the electronic medical records system, described Cafer as a visionary and a true entrepreneur.

This entrepreneurial spirit drove Cafer to invest his own money in the initial planning stages of the project. Over the following months, Cafer assembled a team including Shane Bradley, a fellow psychiatry resident; Tim Trull, a tenured psychology professor; and Ali Hummos, a computer programmer. The group met on weekends and during lunch hours to discuss ideas. They saw problems with the current methods for maintaining medical records, and they also recognized the growing psychiatrist shortage, which made it difficult for patients to find available doctors.

The group’s brainstorming, fueled by Cafer, lead to the system’s two components: IconoPsych, a system for maintaining electronic mental health records, and Telepsych, which allows for doctor-patient visits online via Web cameras.

With IconoPsych, patients can enter their medical histories and schedule appointments in the online system prior to their visits. Doctors then access these records in a streamlined format, allowing for more efficient organization and review of medical records.

“The major advance is quality of care,” Cafer said of IconoPsych. “The patient’s medical history is put in context on a timeline, instead of just scattered here and there throughout a chart.”

Any computer can support the program’s iconic dashboard and will allow access to all records from one central screen. Doctors can review patient information, including medication and evaluations from prior sessions.
Bradley said this system will allow doctors to spend more time with patients and less time with paperwork.

“A picture is worth a thousand words,” he said. “We are putting everybody’s life into something that is recognizable in seconds. This leaves more time for education, for therapy—and more time for building rapport. It also prevents a doctor who has been trained for 10 years from working as a clerk.”

To further demonstrate the inefficiency of current medical records, Bradley conducted an informal time analysis study at a psychiatry office in Columbia. He found that about 20 percent of manpower in the office was devoted to direct daily care; he said he thinks IconoPsych can easily increase this number to 60 percent.

Electronic medical programs exist in the industry, but the group said that many doctors have not found these records to be beneficial to their practices. Current systems have failed due in part to their inability to adapt traditional thinking to the modern electronic environment, Cafer said, adding that while such systems have been monetarily successful, their approval ratings with doctors are generally very low.

“They’re worse than paper,” Bradley said of established electronic medical records. “Almost all of them essentially take paper and put it on the machine, so instead of shuffling 300 pieces of paper, it’s usually shuffling 300 screens of text.”

Making electronic medical records easier to use can give psychiatrists time to treat more patients, which is important, considering the growing need for mental health providers.

“The typical waiting list in Columbia for child psychiatry is three to four months, and the typical waiting list for an adult is one to two months,” Bradley said. “People are in distress, and it is hard to wait that long.”

IconoPsych and Telepsych not only will reduce waiting time but also will grant patients easier medical access when they are in emergency situations or cannot get to a doctor, Bradley said. He identified rural emergency rooms, correctional facilities and nursing homes as target beneficiaries of Telepsych.

Telepsych users need Web cameras and computers that support a Web-based system using Flash technology. Through Telepsych, a patient can log on and place his or her name on a list to see the next available doctor. Also, people in correctional facilities and nursing homes who are unable to go to a doctor’s office can make online appointments.

There are many potential benefits and uses of IconoPsych— if the group can get doctors to use the program. Toward this end, Cafer and his group have been working on business planning.

Schrader, a business consultant with The Hedgehog Consulting Group LLC, said one of the first steps was acquiring loans to get IconoPsych up and running. With a late-summer launch deadline looming, the next step is seeking equity financing and venture capital through outside investors, Schrader said.

Jake Halliday, Missouri Innovation Center chief executive officer, is helping the group with the equity-financing aspect of the project.
“We’re in the thick of things,” Halliday said. “We’re working on raising capital to take the company to the next stage.”

Without investors or an affiliation with MU, the project relies solely on the efforts of Cafer and his partners. Although they are not earning revenue now, the group is hopeful that the time investment will pay off in the future.

“We have done market projections, and if we succeed, this is hundreds of millions of dollars,” Bradley said. “IconoPsych has the potential to transform patient-doctor interaction with an ultimate value that is tremendous.”
Most recently, IconoPsych has been awarded an $80,000 phase one Small Business Innovation Research grant from the USDA to begin establishing a rural Telepsych network. If phase one goes well, phase two is renewable for about 10 times that dollar amount.

In addition to finding finances, developing a secure system for the electronic records was a priority for the IconoPsych team from the beginning.

The video conferencing technology is double encrypted, and the electronic records are accessible only by the author and authorized staff (a system much more secure than other current systems), Cafer said.

Quilogy, the company working with the IconoPsych team to develop the software, assures that patient data will be stored securely.
IconoPsych will be offered on a subscription basis. Providers will pay to use the service in their offices, and then a small percentage of the patient visit fee will go to IconoPsych. Bradley said he sees a large part of the company’s revenue coming from hospitals, though large offices and private practices can use IconoPsych too.

Though the group expects some traditional doctors to be reluctant in adopting the technology, Schrader said he sees a lucrative market of forward-thinking doctors.

The group is starting small by focusing on mental health, but they also acknowledge the bigger picture. In theory, any medical professional could adopt the user interface, which makes IconoPsych’s potential, according to Bradley, “just mind boggling.”