MTJ: What is the current focus of gMed's business?  

Rubinsztain: Specialty-based EMR solutions for Gastroenterology, Cardiology and Urology groups/practices

MTJ: How has this focus changed in the last 2 years? 

Rubinsztain: Expanded focus from Gastroenterology to include Cardiology and Urology.

MTJ: What are your current initiatives? 

Rubinsztain:
1)  Version 4.0 is a full product re-write to simplify the user's experience, accelerate adoption, decrease maintenance and implementation costs and offer hosted multi-tenant solutions. 
2) Expansion into additional medical specialties and additional procedures in each target specialty. 
3) Balanced scorecard to fine-tune internal management systems.

MTJ: How has your market segment changed over the last year? 

Rubinsztain: Buyers are becoming more sophisticated and demanding integrated systems from a single source.  Increased knowledge has allowed specialty systems to gain more traction, and accelerating the adoption rate.

MTJ: What are the greatest challenges for your customers in adopting and implementing technology for your customers? 

Rubinsztain: The greatest challenge is promoting a shifting culture and creating a conforming team capable of implementing and managing change at the practice. Within this process is managing communications and overcoming end-user resistance.

MTJ: How are you helping your customers address these challenges? 

Rubinsztain: gMed encourages practices to increase the amount of up-front work prior to implementation, in addition to guiding the customer in the creation of an implementation committee with executive support and flattening the learning curve with simpler products. We also promote best-practices such as regular streamlined communications, weekly meetings and learning laboratories. In short, getting closer to the customer, coaching them on best practices and making products that, while highly function, are easy to use.

MTJ: Describe your company's position in the industry with regard to the solutions you deliver. 

Rubinsztain: gMed is the market share leader in integrated Gastroenterology clinical systems and an entrant in Cardiology and Urology.  gMed is the only vendor offering fully integrated solutions to address the complete patient life cycle within the target specialty.  This includes office visits, medical procedures, billing, Internet communications and electronic links with partners, payers and medical devices.

MTJ: What do you believe to be the state of the industry in terms of growth, maturity, and availability of viable products to address the technology needs of the medical community? 

Rubinsztain: The market is at an infancy stage with about 25% adoption.  Technology is somewhat immature due to a lack of standards that are just now slowly emerging (CCHIT, HITSP, etc.).  Most products are still complicated and service intensive and implementation failures are, unfortunately, still commonplace.  The market segment that is most immature is the small practice (1-2 physicians); this segment represents 80% of the physicians and has less than 5% adoption rate.  It is a very challenging segment due to practices' traditional management style and financially judicious.

MTJ: What advice would you offer to organizations attempting to implement any technology projects?

Rubinsztain:
1) Consider EMR as a change agent and take the opportunity to redesign the way you work. 
2) Develop an implementation committee that has executive support and full representation of all disciplines (i.e. MDs, nurses, front-desk, billing, etc.). 
3) Create and track a realistic implementation plan.
4) Meet regularly (daily at the beginning) and streamline internal communications through a designated project manager. 
5) Allow people an opportunity to learn at a slower pace than normal. 
6) Hold follow-up training sessions to promote best-practices.

Joe Rubinsztain, MD, Founder, Chief Executive Officer: Joe is a physician with over 16 years of experience in Electronic Medical Records. He graduated from Universidad Central de Venezuela (Caracas, Venezuela) and served as president of R&R Comed, a pioneer in EMRs from 1990-1995. In 1996, he became Clinical Product Manager in charge of NextGen for Quality Systems Inc. gMed was founded in 1997 to address the needs of medical specialties. Joe has been interested in computer-based technologies since 1981.