Praxis Electronic Medical Record

Praxis Electronic Medical Records (EMR) is an American software company headquartered in Commerce, California. The company develops and distributes electronic health/medical records (EHR/EMR) software in the healthcare industry. ^[1] This software uses artificial intelligence (AI) called concept processing, which learns from its users ^[2][3], who are primarily, physicians in small or medium sized clinics, to facilitate clinical documentation. The software records vocal/typed inputs from physicians and then matches these to the programme concepts, classified in a semantic net. ^[4] The company is privately held.

History

Praxis EMR was founded as Infor-Med Corporation in 1989 by Dr. Richard Low, MD. The company, with headquarters in Commerce, California, was incorporated in 1991.

After graduating from Yale School of Medicine, Low practiced as an Internal Medicine and Emergency Medicine physician. He recognized how important medical charting was due to his clinical experience as a physician and by managing locums services for multiple hospital-based emergency care facilities throughout California. At the time, the clinical charting process was increasingly burdensome and time-consuming, placing added pressure on the physicians resulting in clinical errors in documentation and prescribing.^[5][6][7]

Low realized that digitization would improve medicine and therefore he focused his career on the use of computers in medicine through the application of artificial intelligence (AI).^[8][9]

On April 13, 2020, Praxis EMR achieved Meaningful Use Stage 2 certification by the Drummond Group, an Office of the National Coordinator for Health Information Technology Authorized Certification Body (ONC-ACB).^[10]

Technology

Praxis is built on an AI learning technology called concept processing. It records the physician's input and then classifies it into semantic nodes. These nodes are classified and separated in relation to information previously inputted into the system by the physician. The fundaments of concept processing are Venn diagram and Boolean logic. These allow concept processing to find the closest encounter to the one that is presenting and put that case in front of the physician for fine-tuning. Praxis builds up the clinical knowledge base of every individual user by remembering the user's "case types". A "case type" is a unique way each physician reasons and evaluates patients. The knowledge base is constructed steadily when the physician enters new "case types". The "case types" is sent to a SOAP approach and helps the physician organize the reasons and evaluations through successive pattern recognition mental matches. Hence, when creating the medical chart, if the physician enters the same or similar information as previously recorded, the concept processor automatically remembers and brings forward that information for the doctor to use or edit as deemed appropriate. ^[4][3]

According to The Magic of Praxis - A Primer for Physicians, a self-published E- book written by Steven A. Gold, MD, the Drug Database interface and the Fast Coder interface are built in Praxis, and the intra-office emails of Praxis EMR named "Agents", can be linked to specific patients information, e.g., chart data, and be delivered at different times when in need. ^[11]

Products and software

Praixs EMR's platform is built on technologies including Windows, Linux, MySQL, and utilizes databases including PostgreSQL, Oracle, SQLServer. Praxis is currently migrating its application code from C++ and Visual Basic to C#.

The software follows the three "R"s approach (Reminder, Record and Review), an approach to Clinical Practice Guidelines (CPGs) and Medical Query developed by Clayton Reynolds, MD. The new definition of a CPG given by Reynolds is "any rule that a clinician uses to determine the management of any aspect of a patient's care under any given set of circumstances". The CPG acts as the "Reminder" for healthcare providers about what they need to do for specific patients. The providers carry out the work and write the information in the medical record, which is the "Record". Finally, a "Review" is carried out to assess whether the CPG is followed. Praxis can show the CPGs in full text, in a summary or in a diagnosis-specific presentation based on the needs of providers; it has a dashboard display to inform providers what CPG elements are current for a specific patient at any clinic visit of the patient, and it enables the CPG-related data to be exported for transfer to the third party payor for reimbursement. ^[12]

References

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