CEO of E-Health Records, Dan Smith, left, and his developer Kiko Taganashi work from their startup's new headquarter in Sebastopol on Tuesday, December 17, 2013. The startup builds and deploys low cost Hospital Information Systems (HIS) and Electronic Health Records (EHR) for hospitals and clinics in the developing world. (Conner Jay/The Press Democrat)

Sebastopol startup brings e-health records to developing countries

The idea of marketing electronic health records to hospitals in impoverished developing countries may seem somewhat of a head-scratcher.

How can you go from paper records to electronic medical records without the powerful computer network systems that for decades have been part of hospital infrastructure in wealthy nations?

By using the powerful world of mobile technology to bypass the desktop computer age.

The same technology teens use to send emoticons, play "Minecraft" or watch videos is being used by a Sebastopol-based startup to help doctors and nurses in Africa, Asia and the Philippines join the electronic health records revolution.

Founded barely two years ago, E-Health Records International, or EHRI, offers hospitals in developing nations an affordable electronic health records platform that can be used with cellular networks and cloud-based computer servers.

In many places such as Haiti and Africa, cellular networks are more fully built-out than land-line communications systems, and a mobile phone is the primary form of communication, said Dan Smith, EHRI's CEO.

"Cellphone networks are more complete in the third world than in some parts of Sonoma County," said Smith, a well known Sebastopol entrepreneur and philanthropist.

The company primarily does business with hospital networks operated by religious organizations such as the Adventist Health International and Presbyterian Church U.S.A. The electronic health records platform is just one of the products it offers to medical professionals in developing countries.

The company also offers hospital management and administrative software that can work independently of its electronic records software or link up to it.

EHRI recently landed a contract with the Philippine Department of Health to use EHRI software to help screen newborns for hearing problems. The software collects and manages the results of newborn hearing tests, referring certain infants to audiology clinics.

EHRI is a spin-off of OffSiteCare, a firm founded by Dr. Jim Gude that provides tele-medicine services to hospitals throughout Northern California. EHRI and OffSiteCare share the same small office, which is actually a former pathology lab, on Palm Avenue in Sebastopol.

Electronic health records have only recently taken off in the United States. Most local hospitals and local community clinics have made the jump from paper patient charts to electronic records in recent years.

Smith said his platform differs from existing records in two crucial ways: cost and ease of use.

The system features an intuitive touch-screen user interface on inexpensive tablets, which use the Android operating system and cloud-based servers (operated by Sonic.net or Amazon.com). That allows EHRI to bring down the cost of the platform from millions to thousands of dollars.

"It brings us into 21st Century health care at an affordable price," said Dr. Elie Honor? president of Adventist Healthcare Services - InterAmerica, an association of all the Seventh-day Adventist Healthcare institutions in the Carribean.

Honor?said EHRI is currently conducting a pilot project at some of the association's hospitals using the cloud-based electronic health records system. He said the high cost of traditional electronic health records systems has previously been prohibitive.

Smith says ubiquitous cellphone towers and powerful tablets that cost as little as $140 dramatically change the equation.

The tablets, equipped with WiFi, mobile connectivity and auto-focus cameras, allow doctors and nurses to monitor a patient's condition, prescribe medication, or document injuries with a photo. The camera is also used to scan QR codes on a patient's wrist or a patient card.

Security features include system firewalls and the use of encrypted data. The software also verifies both the users who enter the system and the device used to log in.

In some cases, where a stand-alone hospital cannot afford the system, EHRI has donated its lowest cost product.

"If you're a small hospital in Zimbabwe, and your annual budget is $10,000 and you get most of your payments in goats and chickens, we're not going to charge you anything for our system," said Smith, adding that EHRI has "done about 10 freebies" as a cost of between $3,000 to $5,000 to get a hospital up and running.

Smith, a former president of the Palm Drive Healthcare District

and the owner of French Garden Restaurant & Bistro in Sebastopol, has been working in the software business for more than three decades.

In 1980, he wrote the first iteration of a construction management system called Master Builder, which he sold to Intuit in 2001. He is EHRI's primary investor and chairman of its board of directors.

The company employs 20 full-time employees, including 12 in Sonoma County, seven in Manila, Philippines, and one in Grenada. The company has completed a round of Series A funding that raised $1 million, and is likely to conduct a round of Series B funding in the second quarter of 2014 that's expected to raise between $1 million and $2 million.

Though the company has yet to turn a profit, it is generating a modest revenue. Conservative financial projections show the company becoming profitable in 2015 at the latest.

You can reach Staff Writer Martin Espinoza at 521-5213 or martin.espinoza@pressdemocrat.com.

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