Two men, including a Long Island native, are working to make the iPad as vital a tool to the doctor as a stethoscope.

Michael Nusimow and Daniel Kivatinos developed a Web-based electronic medical record, or EMR, system in January 2009, which they made compatible with the iPad after that device debuted in early April this year.

DrChrono software helps modernize the traditional medical office by streamlining multiple systems."We are bringing a whole new level of health care, giving health care professionals an all-in-one solution, because the traditional tools don't interoperate like they should," said Nusimow. "We are putting the digital world into doctors' hands."

Chrono is Latin for time. Nusimow named the EMR application for its primary purpose: to help overworked physicians manage their schedules and billing, thereby saving time and money.

The EMR software allows practitioners to review all of their patients for the day and view the patient's photo next to his or her chart. They can access the patient's complete clinical history directly on the iPad. "We are trying to remove all the manila shelves," said Kivatinos, who grew up in Floral Park.

During an appointment a physician can enter the patient's vital signs and use dictation for documentation with the iPad's built-in microphone. The mobile platform can display X-rays and show videos of procedures to be performed on the patient. Once the appointment is over, the doctor can enter in the billing information.

"The program allows much more interaction, and the iPad is more convenient for physicians who get very distracted by turning away from the patient, which would be required by a laptop or computer," said Kivatinos. "The patient can feel engaged and have a better outcome."

Less than 10 percent of physicians use any sort of EMR program, despite the $44,000 per physician tax incentive offered through the American Recovery and Reinvestment Act. The Centers for Disease Control's National Center for Health Statistics said the use of fully functional EMR systems, such as DrChrono, went up from 3.8 percent in 2007 and 4.4 percent in 2008 to 6.3 percent in 2009.

DrChrono has about 350 offices testing the system on a trial basis. Twelve offices have signed up with DrChrono; they pay a start-up fee and then DrChrono makes a 3 percent commission on each billing transaction through the office's system.

Dr. Hayward Zwerling, who practices internal medicine and endocrinology in Massachusetts, explains that many physicians are apprehensive about introducing EMR systems into the office because of costs in time and money. "In health care we test a new drug against a placebo, but we are not doing that with EMRs," said Zwerling, who began distributing the EMR software ComChart in 1999. "We don't know if it's saving. It may improve the quality of health care, but we really don't know."

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