The drchrono Django Healthcare Hackathon – Learning Django 101

The drchrono hacker team

healthcare hackers.

If you haven’t done so yet, please take the “drchrono hacker challenge” before moving forward. If you have already taken the challenge then read on. We are hiring for a number of roles, you can find a list of career descriptions here.

The Hacker Challenge

We have a lot of talented hackers take the “drchrono hacker challenge” in many different languages, there are a lot of programming languages. You can take the challenge in any language. We love all languages and each have their benefits, but we give preferential treatment to the languages most relevant to working at drchrono.

Our preferential languages to use in the challenge are: Objective-C, Python, Javascript, Erlang. Also if you know Swift, let us know, the challenge doesn’t support Swift, but just mention to us that you have used Swift.

Other languages frequently used for webdev are also impressive to use to use for the challenge: Ruby, Clojure, Go, Perl (to some degree), C/C++ (to some degree).

We don’t use these in drchrono, but will be impressed if you test well using them: Rust, OCaml, Haskell, Lisp, Lua, Racket, F#, D, Scala, PHP.

The languages least relevant to drchrono are: C#, VB.NET, Java.

Our reasoning: The healthcare hackathons consists of mainly JavaScript and/or Django-Python. So our preference is you take the drchrono hacker challenge in something related to what you will be doing here. You can give the challenge a try in the language you know best, then take the challenge again in Python, that will impress us. We are ok with you learning and taking our challenge a few times if needed.

We’re looking for well-rounded iOS developers, ideally with experience in all layers of the stack.

If you really want to impress us, take our “Hard Hacker Challenge“.

The Cram Period

Once we call you in for a healthcare hackathon, you will have a chance to learn as much Django as possible before coming in to impress us with your skills. (We also do iOS — Objective C and Swift Hackathons for people who are looking to join the iOS team)

Django is a web development framework built on Python, to be a successful Django developer you have to know the in’s and out’s of Python.  It is possible to learn both the language and framework together, but it’s much easier to pick up Python first, and then learn Django by following their build-an-app tutorial.  A good Django dev is a good Python dev, but a good Python dev is not inherently a good Django dev. ~Nick S. from the engineering team

drchrono hacker team at work

engineering team at the chronoplex.

For those of you who don’t know Django we recommend taking as much time as possible before coming in to learn as much Django as you can. I can’t stress enough that knowing Django will make it a successful hackathon for you.

django: built by perfectionists with deadlines

I would recommend learning Django ~ 4-6 hours a week to really get a handle on it. Our stipulation is that when you come you are ready to hack away on our stack.

Here are a couple of good resources to get you started, we use the lastest version of Django and Python (2.x):

Free Resources

Great Learning & Courses

Focus on making a small apps instead of just reading docs, show us what you built when you meet us in person!

Optional: Impress us by learning the drchrono Application Programming Interface API also if you have time, it isn’t required but it would be great to see what you think about it and what you can do with it. Work on one of these projects and show it off to us when you are at the chronoplex. Doing one of these projects is a great way to learn Django, learn about healthcare, leverage an API and will for sure impress us during your code review the last day of your healthcare hackathon … more about the hackathon below. Learn a bit about RESTfuls API with this tool.

The Healthcare Hackathon

The drchrono hackathon is 3 days, so you have only so much time here in the chronoplex to do something impressive.

definition: hack·a·thon
An event, typically lasting several days, in which people
meet to engage in collaborative computer programming.

Generally the 1st day is getting acclimated, meeting the team, getting use to the Mac, the development environment, and the software we load onto it for you. Not to mention learning a bit about Mountain View. We are a startup and there are about ~35 people on the team, say hi to people as they walk by! Let people know who you are, what you are working on. Talking to people will give you fun insight into our culture, team and some fun conversation.

It is ok to bring your own laptop to the hackathon, it is also ok to use Google, StackOverFlow and the like for the hackathon. Of course you will have the Internet as well while you are here.

who you will be meeting :)

who you will be meeting.

If you want to have an extra day to explore, just let us know and we will add an additional date to your hotel room, on drchrono’s dime. You can look around and be a tourist for a day.  Apple is about 30 minutes away, Y Combinator is about 15 minutes away and Google is next door to the chronoplex. San Francisco is just a CalTrain ride away. Just let Barbara our office manager know before you come out so we can book the extra day for you!

The “chronoplex” address –

328 Gibraltar Dr, Sunnyvale, CA, 94089

 

For a successful hackathon, we give you an idea, a code base to work, and you start hacking from there on the idea. Use your imagination and our suggestions to implement the idea. In order to do this, you’ll definitely have to know how to do a little frontend + backend work, which typically involves coding in:

  • HTML + JavaScript + CSS
  • jQuery (Angular.JS is awesome but not essential)
  • Python + Django
  • Git + Bash (awesome if you know it but not essential)
  • Objective-C and Swift ( not related to this hackathon )

The Code Review

At the end of the hackathon on the last day before you leave, we will do a code review to see how well you did on the task at hand, code quality and functionality. We review code to see how well you think on your feet, hacking away, and to see if the actual “thing” you built works and how much progress you made. We want to see what you’re thinking was, the issues you ran into and why you did what you did.

Also during the code review the team would love to see other projects you have worked on if you have them. We love looking at side projects, past work at other companies and any side apps. This helps us see how you program, tackle problems and see what you’re interested in.

The code review generally takes an hour.

The healthcare hackathon is the main determinant if we hire, the code and if we are a good culture fit.

A real email from a hackathon candidate after a code review.

drchrono-thank-you-email

Some more insight from another hackathon candidate and why it is worth doing.

Our Culture

We see every developer we hire as artists, generally, the developers work when they are most productive, though being at the chronoplex is critical, we are a startup, we all need fast feedback loops and communication, as the platform is created, this applies across all teams from sales to customer success.

We try to minimize the meetings also to two per week with the developer team so you can focus on what is most important, building the platform.

We need a few good superhero's.

Getting Hired

If the engineering team loves your code, we hit it off and you feel like drchrono is your future home … we will make you an offer fast within a matter of days. We are looking for the right people over just hiring anyone and seeing you in action hacking away and meeting in person speaks volumes on both sides.

After the healthcare hackathon, generally the decision is made in about 10 days if not before then, at this point we will give you an update on everything and if all goes well, we will make an offer!

~ Life is short, build stuff that matters.

Note: Thanks to the drchrono engineering team for reading drafts of this.

Daniel Kivatinos Article by Daniel Kivatinos, COO and cofounder, drchrono
Daniel drives direction, brand vision, and business strategy for drchrono. Daniel’s focus has been in the technology space since 2001, as a software engineer and entrepreneur. Daniel holds an M.S. in Computer Science and a B.S. in Computer Science & Psychology from Stony Brook University.

 

Mobile Healthcare Trends

Mobile Healthcare TrendsConsumer Accountable Care – Today’s mobile devices allow consumers to become more accountable for their care. As high deductible healthcare plans become more popular, consumers are empowered now more than ever with access to reviews of physicians and can also track comparison of prices for healthcare procedures. Education about how to manage their own health is now easier, so patients are savvier and more informed with access to more apps and websites.

Here are a few examples of some popular tools and apps that consumers are using to be more responsible and own their health:

Less is Now More – As physicians get paid less, physicians are finding tools to do more with less. For example, with just an iPad a physician can run its practice, accessing and managing patient data. According to a recent article in The USA Today, as the demand for healthcare goes up and as a shortage of 45,000 primary care physicians is predicted by 2020, more non-physicians are doing some of the work, such as nurse practitioners, pharmacists and physician assistants. Quality metrics software pushed through EHRs can also simplify digital health and assist with reimbursements, as well as quality and efficiency standards.

There is so much data coming at physicians on paper, they generally skim a medical record, sometimes missing key information. Organizing all of the data in a digital format flagging the most critical, relevant data pertaining to a patient is a key time saver. The reality of the situation is that with paper medical records this workflow isn’t possible.

Better Connections – As healthcare companies collaborate more, healthcare connections via Application Programming Interfaces (APIs) will allow more diversification from where the data is coming from, with more healthcare moving to the cloud. We will see new trends and insights from this combination of data that were not possible before. For example, epidemics, pandemics, genetics, drug and health trends can be tracked and reviewed in real time.

Older non-cloud based architectures shield data into silos and over the next several years we will see less and less non-cloud based infrastructures. One of the primary ways medical data is still being moved today is via the fax machine, which is archaic and hard to manage. Smartphones and tablets like the iPad and iPhone are becoming more powerful as a business tool, with more health apps managed from devices in the medical facilities. We predict more and more patients will track their personal health data through smartphones over the next year.

Data, Data and More Data – As more data is moved to the cloud, an improvement in decision-making will have to happen. Here are a couple instances where more streamlined data can really make a difference:

  • Clinical trials – Right now, clinical trial researchers are hard pressed to find good qualified candidates, but as more data is available, clinical trial drug companies and patients will be able to connect faster then ever before.
  • Real-time dynamic decision insights – Having massive amounts of data reviewed by super computers to see new insights is a reality and this will help in dynamic medical settings for improved decision-making. One example of this is the IBM Watson super computer, which has an API and is said to be able to diagnose at the level of a second or third year medical student, so that healthcare companies and institutions can leverage the data to get a broader picture of a patient.

Moving to Meaningful Use Stage 2 – The medical community is transitioning to Stage 2 and mobile EHR providers are making sure that their platforms for the iPad, iPhone and cloud are updated and ready to take advantage of the new government standards that go into effect on October 1, 2014. Stage 2 includes advanced clinical processes and interoperability standards allowing for a more consistent flow of data between health plans, patients and providers. Consistent data will allow for a smooth transition of care, more continuous care, less unnecessary repetition for the patients and using technology to remedy issues in our healthcare industry. It’s important for the medical community to work with a trusted EHR provider that will offer a seamless transition to the next phase.

Meaningful use Stage 2 is all about doctors and patients being able to communicate better, this is something that is much needed to streamline process and improve inefficiencies in the medical industry.

Genomics – This is a promising new field of digital health technology and many new apps are being developed to cover this area. Genomics offers better preventative tests to predict and personalize a person’s healthcare. For example:

  • Personalized medicine – As we begin to understand more about genomics of each individual person, medicine can become more personalized based on that one person. This also includes learning about new cybernetics, such as regenerative medicine for artificial organs.
  • Predictive diagnostics – Genomics will allow us to be more aware of things we are more susceptible too and how to create preventative care plans.

This was a post I wrote on Electronic Health Reporter.

Q & A: Careers at a digital healthcare company

start-your-career-drchrono

If you are looking for an amazing place to work, drchrono might just be for you.

How did we find and hire our first few employees?
Our very first hires were people we found who were looking for jobs in the recession back in 2009 when we started drchrono. When times are bad, hiring tends to be amazing as talented people are looking for jobs.

Getting out there is key, talking, getting booths and socializing at conferences we met some of our best employees early on as well. Don’t underestimate where you can find good people who believe in an idea, talent is everywhere, you just need to keep your eyes open and get out there.

A key for our company early on was and still is having an inspirational mission. What is our mission? We are trying to make the world a better place by fixing healthcare. Healthcare in the US is broken, very broken, it is hard for doctors to get paid for work, it is hard for patients to see what they are paying, and the healthcare industry today is mainly driven by paper and fax machines. In todays day and age this just shouldn’t be, healthcare can be better. Our goal is to fix what is wrong with healthcare by using disruptive tech, and thinking in innovative ways. Our mission naturally attracts people who are trying to make a difference. People motivated by a mission.

Which positions are the hardest to fill and why?
Generally brilliant software developers are the hardest people to find and positions to fill, we are picky and only want amazing talent at drchrono so it makes it even harder. My cofounder Michael and I are software developers, so we keep the bar high and only look for these best people we can find in Silcon Valley.

Silicon Valley has a shortage of amazing engineers due to all of the startups that are flocking here, starting here and raising capital in the Valley.

We don’t look at an engineers degree, but past projects to tell us what they are made of and can do. It isn’t the developers school but a persons past projects and software built and speed of development that gets them hired.

What are the qualities of an ideal startup employee?
We look for people who want to change the world, not just get a paycheck. We look for people who have done amazing work, they think like a startup of one, building or doing something that makes them standout from the crowd. We want people who are go getters who get things done.

A fun “whois” hack

If there is that one customer you need to talk with, that one investor you need to email, that one partner you want to connect with, there is a way to get their contact info in a fun way.

The secret way to get directly to them is to simply go onto the companies domain (granted this sometimes works, sometimes doesn’t), do a whois lookup and wala, you have a direct email address and direct phone number, there is a fun hack for you!

Bodies Don’t Equal Success in a Startup

people

Take a look at the number of employees Kozmo.com and govWorks.com had. Take a look at the funding that Pets.com had, all failures.

It isn’t the amount of people you have in a startup company that makes it successful. It also isn’t the nice office space or the amount of funding you have, it is more than just that. Overhead can create massive problems if you grow without the right plan, the right culture, the right vision, the right team.

The problem with true hyper-growth… It’s the problem like baking a cake in three minutes. You’re in the kitchen and you have sugar, flour, egg on the ceiling. What the hell are you doing?

Marc Andreessen at a Y Combinator talk, spoke about how startups are like baking a cake, you have to put the ingredients in at the right time and timing has to be just right, if any of it is mixed up then the cake will not come out right. Andreessen said at his early days at Netscape days they were hiring around 100 people per week.

It isn’t all the glitz, press and funding that creates success. What makes a company successful? Passion, a great dedicated team, execution, timing, bad or lack of competition, good idea. It is critical to have growth. That growth can be exponential user growth or sales. When the right company with all of these elements gets funding sometimes magic happens, it is hard work but the company grows like crazy.

Look at Apple, it had exponential sales in the early days, a lot of sales. Look at Instagram, it was exponential user growth, a lot of users. Or even CraigsList, they are a very small team, but everyone has heard of them. Growth is what creates a healthy company. If a company is to survive it needs growth.

When your first starting out you might hire a few people but keep making sales and users happy. Sales, support and growth are essential.

The right people in your company are what make it successful, people are everything, but counting the number of bodies in a startup doesn’t mean the company is successful, it is the quality and passion of the people who are there working day in and day out on the company that make a great company.

There’s nothing wrong with staying small. You can do big things with a small team.
~Jason Fried, 37signals founder

How to Start A Tech Company in Healthcare

The best person to start a company with is someone you have known for years. Someone who has a talent, drive and who you have seen work intensely work. Through the course of our life, there are a handful of people in your mind you think you could start a company with. I have only a few people in my mind and picked one when I started the company drchrono.

Michael was my college roommate. He had a talent for understanding complex software and could hack out just about any idea. He was doing a dual major in computer engineering and science major, and it was a breeze for him. I was a psychology and computer science major, and understood people. We took a bunch of classes together and worked well as a team, doing scrum like teamwork. As in all of our courses together. I made a mental note, he would be someone who I could work with in the future. After we both graduated Michael went on to work for Bloomberg LP and I went on to work at several startups in NYC. Several years passed when we got together to talk about working on an idea.

I recall sitting down with Michael in 2008, and we spoke about how we wanted to change healthcare over a cup of coffee. We didn’t have a business model, nor medical backgrounds, but we could build software. He was one of those people on my list I would start a company with.

After swapping personal stories about healthcare, we decided to start a company in that market. From seeing family members have a hard time working with the healthcare system we thought we could make a difference. Doctors were doing everything with fax machines, pen and paper. It was clear to us both healthcare was broken.

We really didn’t think too much about our name, jumping in with the name drchrono from day one. We picked that name as it related to time. We wanted to build something that took people and managed health over time, “dr” for doctor and “chrono” for time. There was no hard path for the company, but we had a vision for connecting doctors and patients and tracking health.

Michael quit his job of eight years to start the company with me. This was a commitment check for me to see if he was serious about doing this startup. Michael quitting his job showed to me he was serious, very serious.

We started working out of a small place called the Sunshine Suites, where we rented two desks. It was an on-demand office space with virtual offices in New York City. We then moved into an incubator space were we expanded the team.


he company jumped on an unconventional band wagon of using the cloud back in 2009, most companies were just starting to think about cloud. Most medical records company during 2009 were not using the cloud, part of our vision is to run all medicine in the cloud, the data, scheduling, billing, etc. Other companies were building for the desktop or using Adobe Flex, Flash or .Net, we decided that was the wrong route and it was a mistake. So we built on the same type of infrastructure that Google was using, Python and Linux. It pays off to really look at the tech stack you use, not to jump on a tech fad band wagon, it can hurt you in the long run. There are a number of healthcare companies in the cloud that are using bad tech stacks and they just aren’t able to build fast which hurts them. Using a good technology stack is critical to having an amazing experience for your customer.

For the first year, we spoke to doctors, one by one, shadowing and listing to them, asking them what they wanted. We would rapidly iterate over the feedback and repeat. We interviewed and shadowed doctors in hospitals, in large clinics as well as private practice doctors.

Ever entrepreneur should take as much feedback as possible and work on it, but remember filtering is critical. We get feedback from all kinds of doctors and patients; we picked what makes the most sense. Some physicians would give amazing input and others would give unproductive feedback. We still shadow doctors today, and that is how we know what we are doing right and what we are doing wrong. Software is an ever evolving thing that needs care.

After working for over a year, we built out a medical platform that could do medical billing, scheduling and email reminds to patients. In April 2010 the iPad came out, and I pushed us to build an app for it, I believed mobile was the future and it is. Thousands of doctors downloaded the initial release. We were the first medical records app on the iPad. It was an inflection point. It pushed us to build the best mobile EHR in the world. Today we have the highest rated medical records app in the iTunes app store. Our goal is to create the best healthcare experience through technology and we are doing just that.

Doing a startup in healthcare is not an easy thing. I tell entrepreneurs who want to jump into the healthcare space to do a startup be ready to take at least 7+ years of your life to create something meaningful and passion is a must and find people who are as passionate as you to build the company with.

It takes years to build something meaningful in healthcare. drchrono isn’t an overnight success, it was years of hard work. Yes most startups are a long journey, but startups in healthcare are the hardest type of companies to build. Overnight successes just don’t happen in healthcare.

When Michael my cofounder and I started drchrono, no one told us that it would take years to make something meaningful, it is our passion for changing healthcare that pushes us every day. We feel like we have only started.

drchrono now has over 45,000+ thousand physicians signed up and over 2,500,000+ million patients.

Will Open EMR Survive?

When we started drchrono, we contemplated using open source software to build the company.

We thought about running instances of Open EMR for medical practice clients. The idea was great in concept, we would become the “Red Hat” like company to the EMR world. There were and still are other companies doing this and it looked like a viable option at the time.

Showing our first paying users Open EMR to see if it would fit their needs, the physicians looked at the software in a skeptical way saying it was missing critical components.

We reviewed everything Open EMR over and over, it has scheduling and it’s cloud based. Sounds good right? Well there is a lot that is missing. It doesn’t really cut it. To me it almost felt like a valiant effort to a failed operating system Kernel.

I thought about it and asked myself, why isn’t Open EMR up to par with where it should be? The passion wasn’t persistent over time with the people working on it. The love that was needed to build and maintain something of that magnitude wasn’t there, it looks like the developers gave up.
Yes it is there and yes it “works”, but it is more of a starting point. It needed and needs massive amounts of work.

Take a look at how old Open EMR feels –
OpenEMR-Calendar

OpenEMR-Demographics

So we looked for other solutions and there simply wasn’t a good open source EMR with a good vibrant developer and support community around it. We thought about it, we could invest our time submitting updates to Open EMR, that was an option, but we didn’t like the technology and the lack of love that was put into the project. It felt like we would be doing the heavy lifting if we invested into the project.

It was at this point we realized we needed to build our own EHR from scratch, from the ground up, it was a long term endeavor, but we committed to building the best EHR in the world. Year after year, improvement after improvement, we leap leapfrogged anything Open EMR could do. There is still a lot to do. ( I just want to thank the drchrono team for working so hard to get to were we are. )

We are meaningful use stage 1 certified and working on getting meaningful use stage 2 certified. We were voted the best Mobile EHR by Blackbook rankings who surveyed over 16 thousand physicians. We are pushing hard to be the best disruptor in the space.

Open EMR isn’t meaningful use certified, hasn’t won any awards that I have heard of. We made the right move building our own platform.

But now that we have built the best EHR, “the kernel to our operating system”, we are now focusing on having developers join the platform as we just released the drchrono healthcare API. There is so much the developer community can do to help us fix healthcare.

Coming full circle we are now allowing developers to build on the drchrono healthcare API. With 100’s of developers looking to join our vibrant community, we would love to see the open source community build on top of drchrono along with proprietary being developed.

So this is a challenge to every developer out there, build on the “new Open EMR”, our goal at drchrono is to supporting the “Kernel”, with developers building with us.

WILL OPEN EMR DIE?

The answer is no, but will the community of developers who are building the software keep innovating on Open EMR? I would say no.