Kazutaka Yoshinaga, M.D., CEO of Flixy, Inc.
Melp is a web-based questionnaire that can be linked to all EHRs, developed by Kazutaka Yoshinaga, a physician himself. In the case of EHRs and paper medical questionnaires, the receptionist looks at the scanned paper medical questionnaire and retypes it into the EHR. We wondered if this work was really necessary and if it could be made more efficient, so we developed a web-based medical questionnaire that can be linked to all EHRs.
The trigger was the inefficiency we felt in outpatient clinics
- Why did you launch Melp questionaire services?
The trigger was when I was working as an internal medicine doctor in my third year after completing my initial training. At the time, I was working as a part-time physician at a night clinic. The clinic operated with an EHR and paper questionnaires, and I noticed some issues with the questionnaires.
The first is that it does not make sense to fill out the questionnaire when the patient is feeling the worst in the waiting room. In fact, many people with colds would only write "cold" in the questionnaire. I once asked a patient, "Why do I have to fill out a questionnaire in the waiting room when I don't write down my symptoms in detail on the questionnaire because I'm too tired to do so, and then tell the doctor right away in the examination room? I was once asked.
Second, the process of transcribing the medical questionnaire into the EHR is surprisingly time-consuming. The paper medical questionnaires filled out by patients are first scanned by the medical staff and imported as PDF data into the corresponding folder of the EHR. I would open the PDF and transcribe the text into the EHR, and then call the patient into the examination room. I would also shred the completed medical questionnaires after the consultation was over. Since we were short on staff in the early days of the clinic, I often had to shred the paper medical questionnaires of about 40 patients and take them out to the garbage after the clinic.
Third, we could streamline our practice by formulating questions for doctors. Doctors generally have a set of questions they ask patients based on their symptoms. For example, if a patient is suspected of having the flu, the doctor asks "Does your throat hurt?", "Do you have a cough?", and "Has anyone around you had the flu?" We thought that if these questions could be formulated in advance and answered by the patient, it would improve the efficiency of medical treatment.
I thought that if I could solve these issues that I felt I wanted to streamline in my practice, other doctors would be able to accept it, so I started developing it.
- In 2017, there were many companies offering electronic medical questionnaires, weren't there?
That's true, there were already about 10 companies offering tablet medical questionnaire services, and ever since the iPad arrived in Japan in 2008, there have been companies offering tablet medical questionnaires for clinics. However, I thought that there were some issues with the existing services.
The first is that the content of the questionnaire to be captured is shallow. Many of the tablet medical questionnaire only asked for basic information about the patient, the main complaint and the symptom history. However, the questions that doctors ask for each symptom are generally fixed, so we thought that supporting them to that extent with web-based medical questionnaire would be an added value.
Second is the linkage to EHRs. There are many EHRs that are not linked to tablet medical questionnaires, in which case you have to view the content of the questionnaire on the tablet's management screen and post it to the EHR. Therefore, we thought it was important to increase the number of EHRs that can be linked.
The third is price. Many companies were offering the initial installation cost alone at around 10,000 dollars, or 4,000 - 5,000 dollars at the lowest. We thought that with EHRs becoming increasingly cloud-based and price competitive, people would not adopt them at this price.
Finally, the service until now was only designed for filling out medical questionnaires in the waiting room. For some reason, all the companies were offering a service where a tablet is handed to the patient in the waiting room and the patient fills it out on the spot, and I thought that if we could have the patient fill out the questionnaire on their device from home with the web-based questionnaire, it would reduce the waiting time before the patient sees the doctor.
Service expansion and future prospects
- How did you go about your sales activities?
At present, the service has been introduced to more than 1000 facilities in Japan, and trying to go overseas. Recently, the number of sales agents has been increasing, and we are seeing more and more contracts being signed through referrals from doctors who have introduced Melp.
ーWhat do you hope to achieve through Melp?
We would like to be able to "deliver medical care at the optimal timing". For patients, we offer a symptom-checking service that allows them to easily find out which department to go to and at what time when they feel sick through a chat-style questionnaire.
Also, we are speedily developing the functions requested by the doctors who have introduced Melp Questionnaire. "Multi-Language Questionnaire"and"Melp OCR" are services that were born that way. We have received requests to make the medical questionnaire multilingual because there are many Vietnamese and Nepalese people in the area, or to import text information from referral letters and medication handbooks into the EHR, and we are actively responding to these requests, as shown in the future development schedule on the website. We would like to continue to make Melp more and more convenient in the future.