Physician Entrepreneur of the Year

Jonathan Bertman, M.D., is the CEO of a rapidly growing $3 million software company. But he isn't trained in software engineering, and he didn't go to business school. Bertman went to medical school and opened his own family practice.

After finishing his residency at Memorial Hospital of Rhode Island, Pawtucket, Bertman started his own family practice in Hope Valley, R.I. While he enjoyed treating patients, Bertman says he quickly became frustrated with the demanding schedule. He says that to make a decent living, he had to see 25 patients a day and log extra hours during evenings or weekends to keep up with administrative tasks such as managing charts.

"I said to myself, 'I either have to quit medicine or find a way to supplement my income and address some of these things,' " Bertman recalls.

He decided to research electronic health-record software, hoping to find a product that would make the administrative side of his business—from scheduling and intraoffice messaging to maintaining charts and refilling prescriptions—more efficient. He was not impressed with the available options. Bertman says he found most of the systems to be too complex and too expensive.

"If you have to click 10 times to write a prescription, when you can write it on paper in two seconds, of course that is not a solution that makes sense," he says.

Because the EHR he was looking for did not appear to exist on the market, Bertman decided he would create his own. Nearly 10 years later he has a thriving EHR company, Amazing Charts. For his achievements, Bertman has been named Physician Entrepreneur of the Year for 2010 by Modern Physician. To learn more about how Bertman was chosen, please read this issue's editorial.

Because Bertman had no software engineering experience, at the beginning of his venture he bought Visual Basic for Dummies, and taught himself basic computer programming. In 2001 he began building an EHR that included all of the features he wanted, without the bells and whistles he believed only made his job harder.

Bertman drew on his own day-to-day experiences as a practicing physician to add elements that he thought would be most useful to family doctors trying to run small practices. In what little spare time he had while juggling a thriving medical practice and a growing young family, Bertman labored over every detail to create a customized EHR.

"I started working through the night to add all of these new features," Bertman says. "In between patients, I would literally run back to my office to write code."

There were plenty of naysayers along the way, Bertman says. Some friends and colleagues thought he was foolish for spreading himself so thin and taking a big financial risk by self-funding the software development.

"The biggest hurdle was ignoring people who called me selfish, stupid or ridiculous, while knowing there was a very real risk that it would end up a complete failure," Bertman says.

But after nine months of fine-tuning the software and testing the program by putting it to work at his own medical practice, Bertman had a product he was ready to share with other doctors. He launched Amazing Charts and sold the EHR online the way he would have wanted to buy it—at a low price with a free trial period. Slowly but surely, physicians started buying Bertman's software, which costs $995 for the initial licensing fee—thousands of dollars less than most other EHR systems.

"I have always thought if I make a great product, people will buy it, and everything else will fall into place," Bertman says.

It turns out, Bertman was right. A little less than a decade later, he has a thriving EHR business with 30 employees and more than 3,500 customers.

In the results of the 2009 EHR User Satisfaction Survey published by Family Practice Management, Amazing Charts was ranked highest out of 19 companies for ease of use, easy and effective documentation, cost and overall satisfaction. Amazing Charts also earned Best in KLAS Awards for Software & Professional Services in 2008 and 2009.

Martin Sechrist and his two physician partners purchased Amazing Charts for their Los Angeles-area medical practice in 2007. Sechrist says he and his partners were eager to implement an EHR in anticipation of changing federal regulations that may require electronic charting. Sechrist concedes that he didn't think Amazing Charts could provide a permanent solution for his 7,000-patient practice.

"I didn't think initially that Amazing Charts was the right one for us," Sechrist says. “It seemed too easy and too cheap.”

Three years later, Sechrist and his partners are still using Amazing Charts and he says it has "revolutionized" their practice. Routine tasks such as filing and refilling prescriptions now take a fraction of the time they previously required, he says. Sechrist says he appreciates Amazing Charts' simplicity, and says it is obvious the system was created by a doctor who understands how doctors work, rather than by software engineers.

"We looked at another system that was $20,000 per license, and it doesn't even show vitals on the same page where you are doing the patient encounter," Sechrist says. "Most systems just are not structured the way you practice medicine."

Even as his business has grown, Bertman has remained steadfast about keeping the price of his EHR low. He says the licensing fee will increase to $1,995 in December, but only to account for additional costs the company is incurring for federal meaningful-use certification. Amazing Charts doesn't have a sales force and doesn't spend significant amounts of money on marketing. Instead, Bertman says, he lets Amazing Charts sell itself through word of mouth among physicians. Because the company's overhead is low, Bertman can pass that savings on to his customers.

"I like having a car and a house, but I don't think you need to extort money from colleagues just because you can," Bertman says. "This philosophy has worked well and allowed me to sleep at night."

Margalit Gur-Arie has more than 10 years of experience in the healthcare IT field, and currently operates a St. Louis-based consultancy that helps healthcare providers evaluate different EHRs. She likes Amazing Charts because it enables doctors who otherwise would not be able to afford an EHR to adopt the technology.

"What I like about Amazing Charts is that for $500 a year you get all of the updates and service. There is no nickel and diming," Gur-Arie says. "It's a very simple product; it doesn't have all the bells and whistles, but most people don't need that, and certainly most primary-care doctors don't."

For Glenn Lopez, M.D., Amazing Charts has been a key component in enabling him to provide healthcare to hundreds of uninsured people in the San Fernando Valley of Los Angeles. Lopez operates a mobile clinic that makes twice-monthly stops in 10 communities. He provides primary healthcare and chronic disease management for conditions such as diabetes, thyroid disorders, hypertension and asthma. The goal, Lopez says, it to empower people to take an active role in their own healthcare.

A visit with Lopez costs only $15, making preventive healthcare possible for low-income people who cannot afford insurance or higher out-of-pocket medical expenses. The mobile clinic is funded by a grant that requires Lopez to use an EHR, so he knew from the start that he would need to implement a system. Amazing Charts appealed to Lopez because of its low cost and high level of customer support.

"Amazing Charts' technical support has been great, I feel like we have become friends," Lopez says. "Knowing my situation was unique, they were patient and helpful with my technical ignorance, and even helped with aspects that weren't directly related to Amazing Charts itself, like setting up a network in the mobile clinic."

Unlike many other EHRs, Amazing Charts does not require an Internet connection, which makes a big difference for Lopez given that he is on the road and often unable to access the Internet. And Lopez says he may not have been able to stay within his grant's budget if he had to buy one of the pricier EHRs he researched, all of which required an upfront licensing payment of $10,000 to $30,000.

"Frankly, I don't think I could be doing the work I do without Amazing Charts," Lopez says.

Bertman, currently on sabbatical from his medical practice, says his goal is to get Amazing Charts on as many desktops as possible. Once enough physicians are using his system, Bertman says he would like to offer additional low-cost components that would enable doctors to better serve their communities without a lot of extra administrative work.

For example, he hopes to one day add an e-medicine feature to Amazing Charts that physicians could use to exchange e-mails with patients for a flat monthly fee.

While some insurers will pay doctors for practicing e-medicine, Bertman says they often require physicians to "jump through hoops." His system would give doctors the same capabilities and opportunities to generate additional revenue, but without the bureaucratic hassle, he says.

"My ultimate goal is to defeat what I see as the main cause of unhappiness with medicine—involvement of all these third-party payers," Bertman says.

Meghan Streit is a freelance writer based in Chicago. Reach her at meghanstreit@gmail.com.