SOAPware Aids Medical Field

Dr. Randall Oates sees only a handful of patients. On a busy day, he might see four. He likes it that way.
Oates says it gives him more time to focus on each patient and research the best options based on the situation. It also allows him time to revolutionize health care.
Oates started DOCS Inc. (Dr. Oates Computer Systems) in 1994 but now does business as SOAPware Inc., which is also the name of his main product.
SOAPware is an electronic health record (EHR) program designed to save doctors time and energy on paperwork and improve patient care.
The result has been outstanding. It’s used in all 50 states and nearly 40 nations, generating “several million” in revenue each year.
“I never intended to be building software,” Oates said. “It was a hobby that got out of hand.”
While Oates loved the medical practice, as a family medicine specialist, he hated charting. In the mid-1980s, Oates bought a Macintosh computer. He taught himself computer programming and turned his word processor into an EHR prototype. He was soon printing out all of his prescriptions.
He began sharing his prototype with other doctors, those he worked with and many at national conferences. Oates saw that doctors wanted to ditch the paperwork, and he continued developing his program.
In 1992, Oates hired Greg Lose, SOAPware’s chief information officer, handing off many of the programming responsibilities. David Powell, SOAPware CEO, was later hired by Oates to cover the day-to-day business operations. Today, these three are the principals of the company.
A version of SOAPware was distributed in 1992, but the first true product was released in 1994.
Since, SOAPware has experienced constant growth. Oates said annual growth has been 10 percent to 50 percent. He said it’s rare that the company has a month that didn’t outperform the month a year before. Sales are in the millions, and don’t look to slow down any time soon.
Oates said only 20 percent of the nation’s physicians have made a move to implement EHR, and no more than 10 percent are fully electronic. That leaves a large open market, and Oates said business is about to take off.
“It should at least double if not quadruple with all the things that are happening nationally,” he said. “The days of paper-based medical records are just about over.”
SOAPware has come a long way. The company now employs 30 full-time employees, plus a number of program developers. It also has a network of hundreds of doctors who provide feedback on the software, helping SOAPware develop the tools physicians want and need.
“I’m a business guy and I just enjoy being able to be a part of a successful business team and help something grow,” Powell said.
SOAPware is now used by about 30,000 physicians worldwide and is in more than 10,000 clinics. The SOAPware program is used by a wide range of practices, from neurology to sports medicine to dentistry.
Software bundles range from $1,000 to $4,000 per license, while annual renewal costs $300 to $600. Oates said the average user spends $1,500 annually.
Clinical Perspective
SOAPware looks much like a paper chart on the screen. It provides canned templates for prescription refills or insurance documents.
One main feature is e-prescribing, requiring no handwriting to fill a prescription. It also includes drug interaction checking.
It supports both wireless and voice-recognition technology. The voice recognition can automatically insert punctuation.
SOAPware will release a new edition of the software near the end of the year, and is now in pre-orders. Among other features, it will allow storage of audio, movies, pictures and text in a medical record. Another option will be the ability to transcribe on wireless tablets and use a handwriting recognizer to digitize notes.
Dr. Terry Turke, a family practice doctor in Watertown, Wis., adopted SOAPware for his practice in 1994.
Turke met Oates at the annual American Academy of Family Physicians meeting in Boston in 1994. He got a chance to see SOAPware and realized it was the future.
“I found SOAPware to be affordable and it met all of my needs,” he said. “Since it was Windows based, it was easy to learn.”
Turke said the system changed his entire workflow.
“Initially, things slowed down a bit while I learned the program and transferred needed information from paper to EHR,” he said. “In a short period of time, the speed was back to normal and subsequently, it greatly increased speed and efficiency.”
Turke said that SOAPware has enabled him to provide better, safer care. He can access patient records from home or while traveling. He can also provide information handouts, on the ailment or medication, with just the click of a mouse.
“I can’t begin to count the number of patients who related that I always told them something but by the time they were in the parking lot, they had forgotten most of it,” he said. “Now, they had a document to refer to.”
Saving Time
Step inside Oates’ clinic in Fayetteville, and you will find a very relaxed atmosphere. He designed the building himself, but one thing patients won’t find is paperwork.
“Eighty percent of my patients do 80 percent of the charting themselves using interactive software that asks questions in a very straight forward, simple way,” Oates said.
His office has a computer room where patients answer questions related to their health.
“It really is more than the clipboard stuff,” Oates said. “It’s the history of what is the issue that brought them in, and branching questions based on that.”
Doctors often take pride in their interviewing abilities and discovering the patient’s issue, but, Oates said, many doctors don’t realize that patients don’t value the 20-question routine. Patients want to know what is wrong and know what the course of treatment will be.
“They spend 80 percent of the face-to-face time doing the 20 questions, and only 20 percent really dealing with, ‘Where do we go from here?'” he said. “We need to reverse that, and that’s what the technology does.”
Once the patient time is over, physicians still have to create and recreate prescriptions. They have a nightmare of paperwork for each visit. An EHR like SOAPware, works so a doctor only has to enter information once, and can create any number of forms from that.
Plus, it’s legible.
EHR Revolution
Oates said the United States is spending too much on health care.
“We’re not getting our money’s worth,” he said.
He believes that health care systems and insurance companies don’t always do what is best for the patient, and sometimes aren’t even aware of the success of other treatment options. Instead, he wants to give the people the power through EHR.
“My bias is that only through information technology and empowering the patient and patients having a medical home to help them sort through the evidence is the only way we’re going to get a handle on health care,” Oates said.
Oates said EHRs will break down information islands. The different systems around the nation can’t and don’t communicate their information with any others.
This leaves health care without a standard for defining conditions, in machine-readable forms, to measure outcome success.
Because there are many treatment options for many diseases, Oates sees the need to create a standard for interoperability and communication between health care providers. Then, based on the evidence of outcome success, give the patient the best care possible.
“That is what we need to get to,” Oates said. “That is my life work.”