An Innovative, HIPAA-compliant Platform for Medical Records Management: DrOwl

Hello and welcome to the Living to 100 Club podcast and another premium episode. Thanks to all of our dedicated listeners for tuning in. I'm your host, Dr. Joe Casciani, and here's today's episode. Well, hello to everyone joining us today on our program. You're listening to one of our premium podcasts on the Living to 100 Club, and I'm your host, Joe Casciani. Each week, our conversations educate, and inspire, helping you get the best out of all the years we are given, regardless of what obstacles come our way. Premium subscribers have access to all episodes, including 2 exclusive episodes per month. Thank you for being a subscriber. Your support allows us to continue this mission without sponsors. We hope you're receiving value from every conversation with our experts, presumably much greater value than the price of a subscription. Our guest for this podcast is Arvind Rajshur in a discussion about his company, Dr. Owl. This is a medical platform that allows you to download and store your medical records, create easy-to-understand language from these records, and easily share these records with your loved ones or caregivers. One of the features of this app is the ability to share your information with others to keep them informed of the latest test results, prescriptions, and other care plans. This information is fully secured and shared only at your discretion and with your consent. Who is this software application best suited for? Who pays for the service? And what do healthcare providers think about this program? Stay tuned. First, a little background. Arvind started his career as an attorney and is a published author. He's been a successful serial entrepreneur and innovator for over 20 years. Avren sold AllLaw.com and AttorneyLocate.com to internet brands in 2010. Dr. Owl is the fourth company Avren has co-founded. He's served on many nonprofit boards, including the University of New Mexico, Roadrunner Food Bank, and West, W-E-S-S-T, a nonprofit that offers consulting and training to small business owners. Arvin, thanks very much for being a guest on our program today. Welcome.

Thank you, Joe. I appreciate you having me on. Great.

Glad to have you. I'm looking forward to our conversation. I always like to open by asking our guests to tell us a little bit about the journey that brought you to where you are today.

Wow, Joe, that's a, that's a big question.

Sure.

Um, but I think what I would say most specifically about this company, and you, you already shared my background, um, and that this is my fourth company. But I will say that I truly believe that this particular company, uh, is my life's work. I have had the opportunity of founding all four companies with my wife, who is the CTO of Dr. Owl, and this particular technology is born in large part out of being a caregiver for my mother until she passed. And I think one of the things that you discover as a caregiver, uh, for a loved one, particularly a parent, is how difficult it can be to navigate the healthcare system without a good understanding of your loved one's medical records. So that's, uh, that's really where the journey for this particular company begins.

So you've been around the corner, around the block several times, and this, as you say, is kind of the culmination of a lot of your experiences and other companies that you've developed. So tell us, what are the problems you're addressing with Dr. Owl? Help our audience understand what you're trying to accomplish with it.

You know, it's a, it's a great question, Joe. And one of the things about trying to build a good and innovative technology that really solves a problem has a lot to do with timing. What I will say is one of the very cool things that has happened literally in just the last couple years is the passage of the Cures Act, not the CARES Act, but the Cures Act. Which was signed into law just a few years ago. And what it does primarily, and what is most important probably to the American people, is it gives them the right to get a copy of their electronic health records from their providers. And the providers really have to provide them with an electronic copy of their health records when they request it through the third-party application of their choice. So sometimes when you're building a technology and then you get a window in time where there's even legislation that furthers that goal, it's extra cool. But what I think Congress was really trying to achieve with respect to this passage, and it's one of the few bits of legislation staying away from the fray of it, that had a lot of bipartisan support because the goal was to make sure that every patient understood what was going on with their healthcare, that there was transparency with regard to our healthcare system. Because I think what is readily understood in the medical community nowadays is that if a patient actually understands what is going on with their own healthcare and health conditions, and if their loved ones and caregivers are empowered with that information, um, that's how you provide the best care, uh, for the patient.

Sure. So is Dr. Au then kind of the interface between the patient and the repository of records, the hospital or medical provider?

Yeah, absolutely, Joe. So, uh, one of the great things about the technology is it's free for the patient. And they have the ability to pull those medical records from wherever they are. In the case of our seniors, uh, in particular, we are connected to CMS, which is essentially Medicare. So again, I think it's something that every American citizen should do. They should know what, uh, Medicare records are out there and available and what those Medicare records say about the patient. One of the other cool aspects of the technology Joe, is when you bring in your medical records, again, everything is encrypted and, and, and HIPAA compliant for the patient. They can review those records, but the records themselves are taken out of the clinical language for the patient and converted into layman's terms so that the patient can actually understand what those diagnoses are, what the medications that have been prescribed are for. Um, all of that information is brought in and presented to the patient in layman's terms. And then we curate out for the patient, if you will, their own personal health search engine based on their own records. Again, uh, supplying them with everything in easy to read and understand language and giving them, uh, physician-curated trusted sources that they can look at to understand.

So a lot of advantages for the patient.

Absolutely. Absolutely.

Let me back up.

Yeah, if I may, Joe, one other thing. It's not just CMS. We're connected to the VA. The patient can pull their record from numerous other sources, everyone from, you know, Epic's MyChart, Cerner, you know, the various, you know, Humana. It doesn't matter. You know, we're connected to over 1,000 EMRs out there. So the patient can pull in their records. And we're adding more and more EMR systems every day because there are just tons of them out there. But I do think that ultimately, and I think a lot of experts out there in the field would agree with me, probably within the next 5 years, everyone in America will have the ability, uh, to have their medical records on their phone, and the majority will have done so.

Yeah. Yeah, so you really kind of create the pathway for ease, simplification, streamlining the process of obtaining these records. I want to back up to the Cures Act. Prior to that, we always had access to our records, right? I mean, Cures made the electronic records more accessible. Is that the difference?

Yeah, I think that's the case. And I, you know, Joe, I'll just speak from a real-world experience going through this not that long ago with my mother.

Sure.

I can tell you very honestly, you know, without naming the specific position, going in with my mother and my sister, you know, for my mother's appointment, a fairly big important appointment for her where decisions had to be made. We asked for a copy of the records at the end of the discussion just to make sure we understood everything and to go over it. And the physician at that time, and this is not that long ago, said, no, no, those records are my notes on, on the patient. They're not for you. Uh, I'll give you a separate summary of what's going on for you to think about. And I think that I'm not the only one— I, not I think, I know I'm not the only person that's ever experienced that where a physician or a provider went, no, no, I can't give you a copy of that. That's our internal notes and records, but I'll give you something else so that you understand what's going on with you. That's really not the intent. And I think one of the things that we've understood and come to realize is those notes belong to the patient. There is no reason you should be making any note on a patient that the patient is not allowed to see. And I think that's, that's the big change. And I think there is a, there is a big understanding now that if you empower the patient with that knowledge, uh, you're only going to get better outcomes because no one cares more about the patient's health than the patient and their, their loved ones and family members.

Sure. Yeah, I agree. I agree. We can make much better decisions, more informed decisions when we have the full picture in front of us. So is there no distinction then now between providers' notes and the public notes? I mean, don't physicians still keep their notes private electronically?

Well, that's the whole point, right? If they've put a progress note in, the patient's entitled to see that note.

Okay.

Whatever they've put in there. And I think that's a good thing. I think that, I think you're going to get much better outcomes with it. I think the other thing that's very unique about our system, Joe, is if you think about a person who's going through any healthcare situation, or particularly our senior community as they get older, they tend to have a half a dozen, maybe a dozen doctors, different kinds. In the case of my mother, she probably had a good 9, 10 doctors. She, had a number of things going on before she passed. She had one kidney. She was dealing with a bout of cancer. She had had multiple heart attacks. She was dealing with dementia. You know, we were seeing everyone from an internist to an oncologist to a cardiologist to a pulmonologist to a nephrologist. And they were all prescribing different things. And most of them were on different EMR systems. So if you think about that, and I'm sure we have plenty of people out there in your audience listening who may go, well, I do get a copy of my electronic medical records from my doctor. But the problem that we see is oftentimes these patients are forced to have 7, 10 different apps just to view their records. And then they're like, wait, are my records in this app or are they in that app? Or Is it over at this doctor or no, wait, it was this doctor that prescribed it. The beautiful part about the technology that we've developed is that it reads all the records. They can look at one app, get their Medicare records, get their primary care doctor's records, get that hospital, uh, you know, uh, records. If they went and visited a specialist, maybe at the Mayo Clinic, they can pull records like that in too., and they can view it all together in one place, understanding all of it, looking at all their medications, all the procedures, all the diagnoses, all at once.

Wow.

And then share those records as they choose, as you gave in your intro, with their loved ones. Again, remember HIPAA applies to the providers and the payers. HIPAA does not apply to the patient. There is nothing that restricts the patient from sharing their medical records with whomsoever they choose. A spouse, maybe a child who's helping them, you know, adult child who's now making— helping them make medical decisions. If they are a parent and taking care of a young child, certainly they need to be able to see their records, maybe their spouse's records, and their children's records at the same time. So I think it's a really good thing when you have the ability to see those records and understand them.

Yeah, yeah, there's beauty in that, that simplicity and consolidating all of these different providers in one place. I, I think that's the real upside here. So who is your— who's the patient or population that's best suited for Dr. Al? Any particular group or audience that you think benefits the most?

You know, uh, Joe, being very candid, uh, and, and sharing my backstory, this was really born out of being a caregiver for my mother. And I think that a lot of the design of this is for our older seniors out there. They tend to have a lot more medical records. They tend to be dealing with multiple conditions from multiple doctors and providing them with that understanding is a powerful way for them to have better health and better outcomes. The ability for them to share that with maybe grown children or their spouse who are helping in their decision-making process really aids in the outcome and really benefits the patient overall. So I would say that that's, that's really who benefits a lot from this. Not to say that anyone at any level couldn't benefit from it, but if you're in your 20s and you're not yet dealing with a parent who needs your help with regard to their medical decisions, and you don't yet have young children that you're taking care of their health, you may not be looking at it nearly as closely. But that's how I think about it.

Yeah, yeah, that makes a lot of sense. More providers, more practitioners, more healthcare individuals working with the older adults. So I can see that, especially the consolidation, putting all of these records in one place. I think that's great. So you mentioned translating or kind of reducing some of the medical jargon for the reader. How do you do that? How do you— How do you translate? How do you distill the medical technology for, for the consumer?

Yeah. You know, Joe, that's a great question. Again, we actually have 6 issued patents on our technology and our platform. Um, I will give you an example that, uh, I utilize, uh, often, and that is when I demonstrate how the technology can bring in electronic medical records, One of the test patients that we pull medical records in from, it's either Medicare or the VA, I'm trying to remember which one, has a diagnosis of a malignant neoplasm of the right main bronchus. And that is how the record comes in right now. If you say that to your average layperson, they're going to go out there and do about, you know, 6, 10 different Google searches trying to understand exactly what that means. When we pull that in for the patient, we tell them that's the diagnosis, but we immediately explain to them what that means and give it to them in layman's terms. That diagnosis is lung cancer. And if the patient understands very cleanly, very plainly at the beginning that this diagnosis is lung cancer, and then what type of lung cancer that is and what that means to their health, they're in a better position to move forward with asking the right questions, to get the best treatment, to share with their loved ones what their diagnosis is. But if you give it to them in such clinical terms that they're confused about what it is, overwhelmed by what it means, not quite understanding if they're searching the right things, it makes it very difficult. We should be very transparent when it comes to healthcare.. And I think that's one of the keys to getting better outcomes for people.

Yeah.

Okay.

I can see the advantage of that. So a lot of the medical diagnoses can be very difficult to understand, or as you say, compound conditions. So are there other phrases and other—

Oh yeah.

Treatments, not just diagnoses, other terms that are translated?

Well, yeah, that's a, that's a really good point, Joe. The other thing that happens often, and I'm sure, again, your audience has to have experienced this. What would happen for myself in the caregiver's shoes for my mom is, you know, by the time she passed away, unfortunately, she was on about 12 to 15 medications a day. It was very hard to remember what each medication was for exactly. She's getting multiple prescriptions from multiple doctors for multiple things. And oftentimes we would end up where we had to take her in. And honestly, at that point in time, we were going around with two handwritten pages. You know, here is the name of the medication. Here is the milligrams. Here's the dosage of the frequency. And we would walk into the doctor because, you know what's crazy? They would pull up whatever they had from their access to her medical records, and it was never complete. Or sometimes, occasionally, especially towards the end of her life, she would end up in the hospital for, you know, any, any type of, uh, even a cold could go to pneumonia so quickly. We would get— she would end up in the hospital, and they would look at her records. And again, the other problem is it would pull up such a voluminous amount that it would look like she was on 200 meds because every, every medicine that she'd ever been on there. And they're like, they would look at it and the attending physician would almost invariably go, okay, wait, what is she taking now? Because it looks like she's on 100 things. I know she's not on 100 things. What is she on? And again, as the caregiver, as the loved one in the room, you pull out the list and you go, this is what she's taking now. And if you think about how difficult that is, you know, maybe for some of our seniors, they know what pills they're supposed to take, but in a moment where they may end up in an emergency room or an urgent care situation, the ability to truly remember what you're taking, what the dosage is, all of that, it's a difficult challenge. So the ability to demystify that process and not just give one snapshot picture, what, is in that EMR system, which often, you know, leads to complications. But literally, here is my full picture, here is what all my medical records say about me, synthesized and summarized. Um, that's going to lead to a better outcome for that patient.

Well, that makes me wonder, are there occasions when you spot, um, like unfavorable drug-to-drug interactions that nobody else has spotted? Do you ever come across that where you've got different providers? I don't mean to put you on the spot, but seems like you could be the first one to see that where—

You know, Joe, that's a great question. And the short answer to it is we do have something in the works that helps the patient identify drugs that may be problematic that they're taking.

Sure.

You know, but we have not rolled that out. I think what we have, and even at that point, what we would do is please talk to your physician about it. Make sure that, you know, that this is correct and this is the dosage, much like a pharmacist would do. The only problem, and again, from experience, you get to that point, my mother would oftentimes have to get drugs filled at multiple different pharmacies.

Yeah, yeah, yeah. Different pharmacies.

And then at that point, it's very hard for the pharmacist to know that you happen to be taking a few other drugs. You're just filling them at a different location. I mean, in a different pharmacy altogether. They don't see those drugs then. And yes, you can lead— it can lead to an adverse reaction. And I certainly did have that experience with my mother a couple of times. So it's a great question, Joe. I'm sure other people have experienced that before.

Yeah, that would be a real powerful advantage to this system because you got multiple pharmacies, you might have multiple prescribers and one prescriber may not know what the other one is prescribing. So yeah, I can see there's a lot of risk there, as we all know. Yeah. So, you know, I always feel that it's important that patients, that we all take responsibility for our own health and well-being. And like I mentioned earlier, you're helping people make more informed decisions, you know, and making, like I said, just taking responsibility. And when they see what's going on and How does Dr. Al— how do you, how do you think Dr. Al addresses this? How do you think it raises the awareness for your, your clients about taking responsibility for their own healthcare?

I think that the feedback that we've most often gotten with respect to it, Joe, is that people feel empowered where before they often felt helpless without a full understanding of what was going on with regard to their overall health. The fact that they now understand what those diagnoses mean, what the medications are for, what treatment options are available to them, allows them to ask their doctors and their various providers the right questions to, you know, make the best choices for themselves. It certainly empowers the caregivers to fully understand what's going on. I'll just stay with the personal example with mom and dad, so that you can help them make the best decisions for them. And I think that's really the key. When we're just guessing, we're going, okay, I'm going to do this because the doctor told me. I tell you, you get a lot more buy-in if you actually understand why the doctor's telling you that.

Sure.

You know, and I think that's the, that's the big—

Yeah, that's a great answer. That's a, that's a great answer. Thanks for that. That's, that's really so important. So, um, does Dr. Al allow for more than one person to be on the same account? Different caregivers, maybe different adult children to be on mom's account?

So yes, the app allows you to switch between users. So you can have multiple users in the same app, you know. So maybe if, like in the case of my mother again, she was comfortable using her phone and she could text and all. She was not comfortable with apps. In that particular case, we certainly would have helped her, you know, in that regard. So yeah, we probably would have had, you know, one app that was shared between, you know, the family members to make sure that everybody was comfortable.

Sure.

So that is possible. Again, the power is in the hands of the patient. They can share it or not share it with their loved ones as they choose. And, you know, I think you asked a question about medications earlier, and I meant to add to that. I think one of the things that often you see when you actually get to look at your medical records is occasionally, especially as the records get bigger and bigger, uh, as we've seen more doctors the longer we've lived, um, you'll occasionally find errors in those medical records. There was a study, I'm sure you're aware, from Johns Hopkins and another one from Harvard that pointed out that up to 70% of medical records out there on people contain some form of an error. And I tell you what, the ability, uh, to spot that error, best person to do that is the patient or their loved one, you know, but in order for them to spot it, they have to have access to it. They have to see what the medical records are saying. So I think that's yet another reason. And I don't mean just Dr. Rao. I mean, in general why, uh, this legislation was passed. I think, you know, they really want transparency of healthcare information. And I think another reason why I say within 5 years everybody is going to have a copy of their medical records right there on their phone with them, because they're going to want this information. Joe, think about it. Isn't it interesting that nowadays pretty much everybody out there can tell you what their credit score is They can bank online. They can do all that from their phone. And isn't our health and our quality of living even more important than being able to log into our bank or know our credit score? Not that those aren't important. They absolutely are. But without a quality of life in your health, those things matter a lot less.

Yeah, yeah, I agree. I agree. And certainly have some understanding and looking at progress. And, you know, if we're taking some steps to improve our lifestyle, the more informed we are about any progress, that's really critical. I know when you and I spoke earlier, Evan, I was saying that, you know, I have all my records in the UC system. I'm here in California, and all my records are in one place. So why would I need something like Dr. Au? And you had a perfect response saying that if I should leave the UC system and move to another location, it may be easy, may be difficult to get access. So what you're saying is your records are more or less universal, and anybody can access them from anywhere. They can all transfer, or you can bring in new institutions. So, help—

Absolutely. That's the, That's the beautiful part, right? So you're in the UC system, but if you were, uh, choosing to live maybe half the year on the other coast, uh, or in the Midwest, uh, and you had different providers there, the ability that our technology gives you is to read both sets of records and merge them into one. And that's super powerful, right? And again, it's not limited to just a couple. If you've seen— if you're seeing, as I said, you know, half a dozen different doctors all using different electronic medical record systems, we can read all of them and merge them into one view. And we deduplicate it too. And what I mean by that is, um, if you're seeing multiple doctors and you happen to be a type 2 diabetic Everybody is going to note that you're a type 2 diabetic. You don't need to see it 6 different times. You need to see it once. What the patient really needs to do is understand every one of their diagnoses, all of their medications, be able to look back. So the ability to merge all of these records so it's a clean view, deduplicated, so you don't see 6 different records, type 2 diabetic, type 2 diabetic, type 2 diabetic. And so on. You see it one time. That's clean. That's easy. That's useful.

Thanks. That's great. That's a great explanation. Um, so, uh, how is this paid for? Who pays for Dr. Al's services?

So it's, it's free for people to use the technology. Um, I think those are the best technologies out there, uh, when you're talking about internet space and apps. So it's free to the patient if they choose to use it. What they will see is it's paid for via ads that are run when, you know, when they're viewing it occasionally, not even that many. We try and keep it very unobtrusive. And the other thing that's very different about our system is we never reveal any personally identifiable information. So the information is kept HIPAA compliant. It's kept encrypted. So the advertisers don't know who they're advertising to. That's never revealed to them. So that's how the app is paid for. So instead of paying us $5, $10 a month or whatever some people might charge for it, we just go, no, it's free to you. You'll see some ads. No different than if you went out there and said, hey, I'm a type 2 diabetic, let me search on Google or WebMD or, you know, any of those other medical sites, and I'm going to get some ads. Same thing.

Sure. So if you have any sponsors or advertisers, they're not targeting a specific group or subgroup of patients. That's, yeah, that's great. That's great.

Well, exactly. They, yeah, they, they, they don't know who they're advertising to.

Yeah. That's great. I love that. I love that. So what's the takeaway for our listeners, Arvind? What would you like our audience to remember from this conversation?

I think the thing that I'd like them to remember, whether they use Dr. Owl or any other platform or just choose to stay with a bunch of different apps to see those medical records, I think what I'd like them to understand is that Taking the time to understand what your medical records say about you could be one of the most powerful things that you do to live a quality life. And making sure that your family members have an understanding of your medical conditions is actually a very empowering thing that'll help you live the best life you can. Um, I don't think any one of us can even do this journey alone. The more you learn about it, you understand that it is important to have access to this information, and it's important to have, you know, an advocate for your healthcare. You know, as long as you can do it for yourself, fantastic. But there should be a loved one or someone you trust who is available if you are unable to, you know, take those decisions or need help in making those decisions in the future.

Wow, great, great information. Valuable service. Thanks. Thanks so much for sharing that with my audience. Arvind, it looks like we're out of time for today, but before we wrap up, I just want to remind my listeners to visit my website, livingto100.club, sign up for our email list, and download a free copy of my 9 tips to make living longer enjoyable. You'll also see an option to contact me with your questions and comments. I welcome your feedback. And finally, thank you again for being a premium club member. Your support helps us keep the program going. I believe that the messages we share each week can lift our spirits, help us to stay engaged, and look forward to getting older no matter what gets in the way. Arben, thanks so much for being a guest on our show.

Thank you.

For those who might want to contact you, How can they do that? And tell us about your website.

Uh, certainly, Joe. Thank you so much for having me on. I truly enjoyed the conversation, uh, today. And I think the best way that anyone interested in learning more about our technology, uh, the app is available both in the Apple, uh, App Store as well as the Google Play Store. And there is a website at dral.com that they can go to and they can reach out to info@drowl.com if they want to email in any further questions. We'd be happy to help them out.

Great. drowl.com. So there's no— Yes.

Yeah, drowl.com. All right.

Well, that's great. Okay.

Thank you, Joe.

You're welcome. You're most welcome, Arvin. I really enjoyed this conversation. Thanks to you and thanks to all of our listeners for tuning in. Hope to see you next time.

It's time to rethink, renew, and reimagine retirement. Hey everybody, Jared Sebaste here, host of Retire Repurposed. Now, this podcast is about the non-financial parts of retirement, which many times can be even more challenging than the financial. We believe retirement is not the end, rather the beginning of what could be the most impactful, purposeful, and fulfilling season of a person's life. So don't retire, become repurposed. To listen now, search Retire Repurposed on your favorite podcast platform, Senior Resource, or Life Audio.