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A Q&A with Dr. Sam Gharbi, physician and co-founder of Arya Health
How does the healthcare industry compare to other industries in terms of technological innovation and what are some of its problems?
I remember back in 2006 during med school going to the local telecom company and saying, “Hey I would like to buy a pager”, and the guy looked at me like I was insane. He said; “Sir, may we suggest something called a cell phone”, and I was like; “no, you don’t understand. I need a pager.” Back then we had to buy pagers when starting med school because you were not allowed cell phones in the hospital because they believed that they would interrupt or disrupt the technology there (of course that wasn't the case). Even now, we still can't use text messages when it comes to communicating with patients or even our colleagues, and we can’t even use email because there’s all kinds of privacy and security regulations. It's amazing how far behind we [healthcare industry] are; somehow fax machines and pagers are considered safer for patient care. First of all, you don't even know if the other person received your fax, you definitely don’t get confirmation in any meaningful way, or if you’re even sending it to the right person. Furthermore if you have seen a fax come through, it’s not very legible half the time. Then you have people scanning that document to put it into an electronic health record (EHR) which only further deteriorates the quality and hence legibility of that faxed document. Oh, and then another person has to go ahead and shred that original faxed document. So the whole process is just nuts.
Another space where the industry is behind is medical records software. Many of them were designed in the 90s and haven’t been updated in decades. They have so many pop-ups, so many buttons, so many clicks. It’s death by a thousand cuts. One of my first days in the clinic using one particular software, I couldn’t figure out for the life of me how to make a prescription in the EHR. You would think that a guy who’s not a complete idiot (although that fact is debatable), equipped with 12 years of university education, that something so essential and basic to the medical workflow would be easy enough to figure out intuitively. I have seen time and time again doctors and nurses having incredible issues using technology that should be making their lives easier, but is instead creating more headaches and in fact slowing them down in their usual workflows. Technology is supposed to make physicians' lives easier, but most EMRs are doing just the opposite. Why should it take days and days of training to be able to use what should otherwise be very simple technology. This is where my co-founders and I saw an opportunity.
Can you walk me through how Arya Health came to be?
In my experience working with these dated EHRs I noted that the most basic functions were not simple and intuitive. Doctors were struggling to do the fundamentals of their job (prescriptions, referrals, billing) due to poorly designed workflows. I saw my colleagues getting frustrated, and saying stuff like “I hate this [EMR], this is so difficult”, and then these colleagues either give up and go back to paper, or just do things however they wanted on these electronic systems. They would do shortcuts that compromised the validity of the information, which ultimately would compromise care. This giant ubiquitous mess of complicated and messy healthcare software is from where the idea for Arya Health was born. I thought, “We can build something better, and it’s going to kill me inside if I don't try!”
However, as I started to get into the work, I went through what most new entrepreneurs experience; it can be intimidating and difficult. So I went and called up one of my best friends and colleagues, Dr. Richard Sztramko. I said Rich I have this idea, I want to create our own electronic health record. Rich’s initial reaction was of course to think I was crazy. He asked me what the heck do we know about this? And I said, well what do these other guys know about it? We couldn’t screw it up much worse than they already have. Look at the existing vendors, nobody has really built anything that makes sense.
Later on we got our third co-founder, another one of our good friends, Dr. Richard Vandegriend, with whom we had also trained with during residency. Rich had also been frustrated by the healthcare system and was looking to innovate, so he was a perfect fit to join us on our mission. The three of us started putting together some ideas, we hired some developers, leveraging contacts, and we built out the backbone. We started fixing a lot of issues in terms of basic workflows; how is the user is reviewing info, then inputting new information at a fundamental level, how is that information flowing, how are we using and sharing that information to the entire healthcare team to provide better care in a way that is smooth and designed for the way healthcare professionals actually work.
Too many software companies are focussed on sexy buzz words; big data analytics, predictive analytics, artificial intelligence. Although those things are amazing, you have to start with the backbone and basics. For an EHR this includes how do you enter in a note, how do you enter in patient information. When building Arya EHR, we started with the basics and from there we built out things like telehealth and a patient portal, a patient reminder system, patient self-booking, billing and integrated eFax.
“The core of Arya is a group of doctors who saw a fundamental problem in health tech and said you know what, let's fix it.”
Dr. Sam Gharbi Co-founder of Arya Health
Lots of doctors feel like they do not have a creative outlet within their practice, how do you manage that in your experience?
When you’re enrolling in science and healthcare, creativity may not necessarily be the highest thing on your priority list. There is not that much creativity in medicine, depending on what kind of medicine you do. You often just follow protocols, pathways, and guidelines in medicine. But there are those of us who need that creative outlet, including myself. With Arya it's very fulfilling where I can identify a pain point for me in the clinic and then I can go back to the team and say what do you guys think about this, what will our users think about it, can we make this better. We also take feedback from users and colleagues about Arya Health, and then we assess it to see what we can keep building, and what we can keep introducing. You can’t stay static, there’s a million and one things that you can do to improve these systems. Prior to starting Arya, my frustration with the existing vendors was that they had not made any improvements in their systems in many many years. Everything looked like it was designed in the 90s, ugly interfaces, poor designs and workflows, just painful stuff. I actually went to several vendors and offered to work with them for free to help improve their systems. I was turned away by all of them and essentially told their products were perfectly fine. Now with Arya, we make it our mission to listen to our colleagues, to our users, to keep examining our pain points, and to keep making things better. It's an amazing creative process that way.
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Dr. Sam Gharbi, co-founder of Arya EHR, was hosted by Gelan Nuttal on A Clean Bill of Wealth Podcast where he talked about technology innovations in medicine, how Arya EHR started, and reaching beyond your practice to bring creativity into your medical career. The questions above are an excerpt from that conversation.
Apart from being a Co-founder at Arya Health (www.aryaehr.com), Sam practices Internal Medicine in the Vancouver Coastal Health region, and is a subject matter expert (SME) for Cerner Corporation. Dr. Gharbi was previously the Medical Director and Advisory Board Member at Medeo and he is an author of five published textbooks.
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Interested in learning more about our co-founder Dr. Sam Gharbi;
Twitter: https://twitter.com/gharbidr
Personal Website: https://www.samgharbi.com/
Sam’s full interview with Galen Nuttall, can be listened to here on Spotify:
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ARYA EHR;
Arya EHR is an electronic health record system built by physicians for physicians and it helps manage your patient records simply, intuitively, and efficiently. The technology used in providing healthcare is antiquated, slow, overly complex, and overpriced. Arya’s philosophy is to build technology for physicians that is beautiful, intuitive, easy to use, saves you headaches and saves you money. Interested in a demo, book one here: https://go.oncehub.com/AryaEHRDemo
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