Janice Gil knew there was a need for portable, easy-to-manage personal health records, because she’d experienced it firsthand, both as a radiographer and as a caregiver.
At work, she’d see patients who were asked if they were taking a blood thinner and said no even though they were – not warfarin, perhaps, but aspirin or vitamin E.
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And in caring for her elderly parents, she knew the challenges of keeping the family up to date on any new developments, medication changes, etc., especially if she was going on vacation.
She started talking with her sister, Maria Gil, about a solution. It was the late 1990s – when there was no buzz about electronic medical records, as there is now – and while they did find some products and services out there, they weren’t good enough. So they created the ER Card.
It was a fairly low-tech concept: Have patients and/or their families fill out detailed questionnaires about their medical history, drugs and nutritional supplements they took, immunizations, surgeries, test results, allergies, special needs. List their emergency contact information, too, plus their doctors’ names and numbers, and any advance directives.
All this would be typed into a database, printed out into an easy-to-read document, and also made available by phone, on demand, to authorized medical professionals. So if a rescue team picked up an 80-year-old at home at 3 a.m., they could call the ER Card hot line and quickly find out that she had angina, and when her latest EKG was.
They promoted the concept at senior centers and community agencies, with municipalities and EMTs. And gradually, they built up a clientele of more than 3,500 mostly-elderly subscribers, who paid $99 per year per individual, $149 per couple or $199 per family.
It was a solid business, but a modest one – until electronic medical records became a hot topic, and policymakers began highlighting the importance of patient-centered EMRs in particular.
The ER Card is far from the only such product on the market, and it’s pricey, especially if you consider that many are free. But when a group of local angel investors compared it with the offerings of more than 40 other vendors, it stood out for a key reason, said William F. Cesare, a health care industry veteran and serial entrepreneur: It was very high-touch.
“ER Card struck us not because of the technology per se or even the idea of a PHR, but because of the level of concierge services that were wrapped around the delivery,” Cesare said. “It was a PHR with a high level of care management, and that’s unique.”
While most PHRs are do-it-yourself products, ER Card subscribers are contacted at least quarterly to ensure their records are up to date, as well as every time that their record is accessed – say, if a rescue crew pulls it up on the way to the hospital.
The ER Card team also works with clients to ensure they really have accurate records – that they really are taking, say, diazepam (an anxiety drug), not diltiazem (a hypertension drug). And in partnership with the University of Rhode Island’s College of Pharmacy, the company is conducting a study of all members who take 20-plus medications that has already found an average of 3.5 problems per person, said Maria Gil.
In March, Cesare and his partners in Angel Health Strategies LLC, an investment group and consulting firm based in Providence, bought a stake in the business and created a new company with the Gil sisters, ER Card LLC.
Since then, they’ve invested in a major technology upgrade – starting with a move from a server-based system to a Web-based system hosted by PURVIS Systems Inc. Next they’re planning to make the ER Card truly electronic, by making the patient record available on a flash drive the subscriber can carry on a keychain.
And the company is reaching out to new potential clients, offering the ER Card to businesses as a benefits package enhancement. Cesare said universities could also be a good market.
In addition, the company is working with Rhode Island Primary Care Physicians Corp. to link the group’s EpiChart system for doctors’ offices with the ER Card. “The goal is to create the first integrated PHR/EMR system,” said Maria Gil.
Eventually, Cesare said, more sophisticated and comprehensive systems will exist that eclipse the ER Card. But they’re years away, and in the meantime, there’s a fertile market for this company in New England and beyond.
“We think the [ER Card] is going to provide a stepping stone to some of the larger electronic medical record solutions,” he said. •
Company Profile: ER Card LLC
Owners: Maria and Janice Gil, Angel Health Strategies LLC (investor group)
Type of business: Personal electronic health record provider
Location: 1370 Main St., West Warwick
Employees: 8, including Gil sisters
Year established: 1999, reincorporated 2007
Annual revenue: WND
