Vincent Friedewald, M.D., a veteran of electronic health information innovation, is not concerned with whether his newest brainchild, a comprehensive cardiology clinical decision support platform called CORcare, will integrate with electronic health records.

"We don't pay any attention to electronic medical records anymore," says Friedewald, founder and CEO of Houston-based COR Medical Technologies.

While Friedewald and his colleagues initially considered integration while designing the platform, he observes: "Doctors aren't asking for it. This is totally standalone. And another thing about EHRs is, doctors hate them. I don’t want us to be labeled as something that works along with EHRs. Seriously."

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In an industry climate of great concern about interoperability and "meaningfully" exchanging information, one might be tempted to call Friedewald, who is board-certified in both internal medicine and cardiology, a gadfly. But he is no rookie when it comes to health information technology. In fact, one might say he inherited his interest in information technology in the service of medical care.

His father, also named Vincent Friedewald, M.D., began work in 1948 on a card sorting mechanism in which the medical information contained was organized according to matching symptoms, signs, and other diagnostic information entered into the machine. The idea was granted patent protection in 1953, and the younger Friedewald's technology is a natural inheritor of that idea. He says the ultimate expression of the almost 70-year-old concept has only been possible in the past couple of years.

"The thing that has changed fundamentally in health information technology, at least as far as physicians are concerned, is their use of mobile devices," he says. "My Dad's original invention in 1948 was a massive computer that could only sit in a big hospital. And even when PCs came around, doctors couldn't carry them around. But they do carry their iPhones and iPads."

CORcare is based on the principle that patients don’t present with conditions and diseases – they present with signs and symptoms. CORcare's foundation is a relational database using a keyword lexicon, which allows the clinician user to quickly check likely cardiac-related causes from the most common to the most rare.

The program leads the user through possible complications of a likely condition, as well as optimal treatments based on American College of Cardiology Foundation and American Heart Association guidelines. After the diagnosis and treatment plan are decided upon, information from CORcare can be securely transmitted to the patient and home caregivers in a HIPAA-compliant messaging format to improve adherence to the healthcare plan.

The platform also includes access to data by case number for research registries and advanced studies in medicine, as well as links to a large number of journal articles and patient information sites – "if you printed out COR in Word files it would be several thousand pages long," Friedewald says. "And this is all in a relational database."

"Heart failure is the most complex condition involving human beings," he adds. "Anything you want to know about heart failure you can access in less than 10 seconds with about three touches. Anything you need to know is accessible at the point of care with the patient."

CORcare (COR stands for Clinical Outcomes Resources) is currently in its launch phase. The subscription-based platform costs $249 per year, with a 30 percent discount for those who sign up through May 2015. The company is offering a free chapter on heart failure and cardiomyopathy through the American Journal of Cardiology's Heart Failure Educational Resource Center and, through a partnership with publisher Elsevier, will update and expand the center (Friedewald is an associate editor of the AJC, responsible for the journal's electronic services).

The collaboration provides real-time updates from CORcare on the latest clinical guidelines and new advances in the diagnosis and treatment of heart failure. It also adds multimedia features, and offers healthcare professionals continuing education credit for select content.

"With the CORchapter we have about 500 physicians and nurse practitioners signed up, interestingly enough, in 42 foreign countries as well as the U.S.," says Friedewald. "We are working on agreements with some major organizations to make COR available at discounts to their members and that's the way we're going to launch it. We wanted to make sure it was working well, and it really is."

The company is also actively developing resources pertinent to diabetes, hepatitis C, and hyperthyroidism, according to Friedewald. Ultimately, he believes the COR platform, which will be compatible with both iOS and Android devices, is the answer to his father's vision.

"We are doing now what my dad wanted to do in 1948," he concludes, thanks to the mass uptick in mobile device use by physicians.

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