Thread by @scanman

@Gautaamm @aparanjape @ngkabra @anandesh @ksprashant @Girbane @neeran @MCCIA_Pune I'll reply from the perspective of being a co-founder who's been involved in building, deploying & developing an EHR for outpatient medical practice (@slashdr) for the last 5+ yrs.

When we started back in 2014-15, we were well aware that dentistry was primed for such a product.

@Gautaamm @aparanjape @ngkabra @anandesh @ksprashant @Girbane @neeran @MCCIA_Pune @slashdr We chose to stick to the medical OP side because the co-founders had the most experience in that side.

Knowing how our product has evolved, we are well aware now that we can deploy this to outpatient dental practices after building in the necessary features.

@Gautaamm @aparanjape @ngkabra @anandesh @ksprashant @Girbane @neeran @MCCIA_Pune @slashdr Coming to the points that you raised, when we initially started approaching doctors, one of the most important points of resistance that we met was similar to the one that you mentioned in your first few tweets. That of a software vendor selling out to big corporate chains.

@Gautaamm @aparanjape @ngkabra @anandesh @ksprashant @Girbane @neeran @MCCIA_Pune @slashdr I don't suppose I have to mention names for you to understand who the doctors are accusing. It started back when those fellows became the darlings of medical apps.

It's a breach of trust that is still difficult for doctors to digest. I'm not surprised it happened to dentists too

@Gautaamm @aparanjape @ngkabra @anandesh @ksprashant @Girbane @neeran @MCCIA_Pune @slashdr We overcame that by being honest and committing upfront that we would never do something like that. It is built into our company's policy.

This obviously is fundamentally about data ownership.

This is where I and my fellow co-founders of SlashDr differ from your POV.

@Gautaamm @aparanjape @ngkabra @anandesh @ksprashant @Girbane @neeran @MCCIA_Pune @slashdr Our view is that the patients own their data.

The doctor (or dentist) and the EHR vendor are just custodians of that data.

This is in line with the Govt of India's health data privacy policies.

@Gautaamm @aparanjape @ngkabra @anandesh @ksprashant @Girbane @neeran @MCCIA_Pune @slashdr How that patient data is protected and shared should be governed by governmental policies which are already published and available online.

Some legislation is yet to be enacted by parliament, but I believe it's only a matter of time before these policies become law.

@Gautaamm @aparanjape @ngkabra @anandesh @ksprashant @Girbane @neeran @MCCIA_Pune @slashdr Next, there is some inherently conflicting stuff in your "should & shouldn't have" lists.

First: local servers vs cloud. Obviously this relates to the concern about data theft.

EHR developers worth their salt will tell you cloud is easier & cheaper especially for OP practices.

@Gautaamm @aparanjape @ngkabra @anandesh @ksprashant @Girbane @neeran @MCCIA_Pune @slashdr When we talk about a cloud-based EHR which supports users on multiple platforms (desktop/tabs/ mobile) we can't insist on these being "one-time fee only."

From personal experience as a doctor (not an EHR co-founder) I'll tell you to beware of such single payment solutions.

@Gautaamm @aparanjape @ngkabra @anandesh @ksprashant @Girbane @neeran @MCCIA_Pune @slashdr Any EHR sw that "doesn't require constant upgrades" is a loser right off the bat. But I get your point about upgrades not being chargeable to the customer. Ideally, they shouldn't be. At least not the minor tweaks that keep any sw nimble.

@Gautaamm @aparanjape @ngkabra @anandesh @ksprashant @Girbane @neeran @MCCIA_Pune @slashdr This is connected to the other points of single fee vs subscription.

From personal experience and from being involved in EHR development, I feel that a subscription model serves the interest of both the vendor and customer. This is, of course, my personal opinion.

@Gautaamm @aparanjape @ngkabra @anandesh @ksprashant @Girbane @neeran @MCCIA_Pune @slashdr I would actually love to hear the views of my fellow SlashDr co-founder & our CEO, @rgokul, who has interacted with the most number of doctors during the development and deployment stages and has faced similar questions from them.

Also copying @afterdark0600 and @VaradhKrish.

@Gautaamm @aparanjape @ngkabra @anandesh @ksprashant @Girbane @neeran @MCCIA_Pune @slashdr @rgokul @afterdark0600 @VaradhKrish One other guy who can opine far better than me on these technical matters, is another fellow co-founder @kmathan.

But he is too busy doing important #Covid19 work for @icmr_nie. If he has the time, he will also chime in.

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