How Praxis Works

The Concept Processor

Praxis EMR is based on a simple premise: Medicine is an art.

This means that no two doctors practice medicine the same way: every physician brings a unique and personal touch to the way a patient is treated.

However, all practitioners do have one very important thing in common: a doctor, no matter what specialty of medicine, sees certain cases more often than others.

If one were to plot a distribution frequency of case types versus case presentations, one would see the familiar bell-shaped curve emerge.

How Praxis EMR Works

The principle of medicine as art coupled with the bell-shaped curve observation forms the underpinnings of the Concept Processor, a neural network engine at the heart of Praxis EMR that learns directly from its user.

When one begins to document an encounter with Praxis, three possibilities exist:

1. The present case is identical to one charted before.

Medical schools teach us that no two cases are identical. But, in the reality of daily practice, one often writes or dictates exactly the same litany many times over. This occurs because the mind uses a set of words to express similar medical concepts, and a physician uses the same methods to handle similar situations.

When identical text is found, the case is finished. Praxis generates the note instantly, complete with instructions to patient and staff, prescriptions, admitting orders, procedure reports, letters to referring providers, office or school excuses, and even an optimal coded superbill. The doctor is seeing the next patient!

2. The present case is similar but not identical to one charted before.

In these instances, Praxis presents the text of the closest case. From there, it is just a matter of editing the note to meet current conditions. Even more importantly, the changes made are instantly remembered, so that the next time an encounter falls between two similar cases, editing time is reduced to half, then to a quarter, then to an eighth of what it was before. The more one charts with Praxis, the faster it gets.

Praxis Electronic Medical Records (EMR) - The Praxis Concept Processor Solution Praxis Electronic Medical Records (EMR) - The Praxis Concept Processor Solution Praxis Electronic Medical Records (EMR) - The Praxis Concept Processor Solution

The more you use Praxis, the less editing is needed and charting becomes faster and easier. Before you know it, you are charting at the speed of your mind!

3. The present case is unlike anything ever charted before.

Up to this point, one might think that Praxis simply copies the entire text from a past patient note and presents it during the actual encounter. In fact, what the Concept Processor actually does is quite different. It encapsulates words, phrases, and even entire paragraphs for a particular user into concepts that may then be reused with other patients.

Rare cases are simply new combinations of not-so-rare elements that are present in Praxis from use in other cases. The Concept Processor identifies linkages and relationships among these concepts from previous use, and because each concept has its own independent bell-shaped curve, it is able to bring the right one together with others with speed and precision whenever needed - even when charting a case that is very different from anything seen. For example, the fever instructions for a case of the common cold may be used for a case of Mediterranean Hemorrhagic Fever with few if any changes. At most, minor editing is all that is needed.

Additionally, the Concept Processor takes into account that the same physician does not describe or treat a diagnosis in a single way. In fact, one may handle the same diagnosis in many ways, depending on both medical and non-medical factors (such as the patient's insurance policy, ability to pay, social situation, and many other factors determined by the practitioner's own personal style). However, there is always a method to the provider's madness. If a different patient were to present with the same clinical and non-clinical conditions, that same practitioner would handle that new case in the same way. The Concept Processor, then, captures the doctor's personal approach for handling a case in a certain way and then instantly links all the other charting elements accordingly.

Our clients inform us that it is fascinating to watch their own words coming back to them at the speed of their minds. Many clients report that for the first time in their professional careers they begin to understand how they actually think through each medical case. Most Praxis clients describe a Eureka moment when first using the software; from that point forward, the use of Praxis becomes very intuitive and intellectually satisfying. The physician handles all the creative aspects of a medical case. All the mundane details, all the minutiae, are left to Praxis. This becomes a perfect marriage that turns a most boring task - charting - into a powerful medical tool that helps the doctor practice better medicine.

The Learning Curve

Please see the new Knowledge Exchanger to dramatically speed up your learning process:

The greatest surprise to most of our clients is the speed at which a Concept Processor becomes useful. To understand why, you must first appreciate how we learn to express ourselves.

While the Oxford English Dictionary defines more than 400,000 words, most of us use less than 1500 of them. Yet no two of us use the same set of words! Over time, each of us develops our own set of words that we rely upon for generating our unique discourse.

A similar process occurs at the level of phrases, sentences and text fragments. Our mind seems to store a set of comfortable strings of text that we instantly access subconsciously with extraordinary speed when needed.

With the Concept Processor, these naturally occurring principles are simply transferred to the computer. For example, if you commonly describe a normal abdominal exam as follows: "Abdomen soft, non-tender, liver/spleen not enlarged, bowel sounds normoactive, no masses palpable," then you need not re-enter this text ever again! It is ready to be accessed instantly in the future. The same is true for medications, instructions to patients, laboratory orders, and so on.

And, the bell-shaped curve effect guarantees that this learning is geometrical, growing faster and faster the more you use Praxis. Within a few hours of practice, Praxis is ready to be useful in your clinic.

To learn the program, you will be linked via the Internet to a trained Medical Transcriptionist and Praxis expert. Your trainer's task is two-fold: to teach you how to use Praxis, and to "prime the pump" by having you dictate hypothetical cases, starting from the most common in your practice. What you will quickly find is that with each new "sample" case entered, Praxis increasingly assists with the right text ready at hand. Each case is therefore entered faster and easier until Praxis is ready for use in your real world practice.

Praxis Electronic Medical Records (EMR) - The Praxis Concept Processor Solution

Once in the clinic, the physician starts by entering the simplest cases, then the more complicated ones, and finally the rest. The process is that simple.

Praxis Electronic Medical Records (EMR) - The Learning Curve

Time that the average case takes to enter versus number of cases entered. Obviously, the learning process gets faster and faster as more cases are seen.

But even when the charting speed reaches its plateau, the quality of charting will continue to improve indefinitely. You will always be building on your own past documentation to make the next case that much better.

Praxis Electronic Medical Records (EMR) - The Learning Curve

Average speed of cases that may be charted per hour


Introduction: Dr. Bob Comeau on Praxis EMR

"Your mind does not think in a template system. Before templates, before words, your mind has a concept. This concept is related to the diagnosis and then expressed in words. The heart of Praxis is a Concept Processor that links your mind to Praxis. Physicians are not all trained the same way; therefore, they have different concepts of the same diagnosis. In Praxis, this concept continues to evolve as medicine changes."

Dr. Robert Comeau OB / GYN - Praxis EMR user since 2001

Listen to Dr. Comeau discuss his experience with Praxis during a public webinar announcing the release of Praxis EMR v5.

Far More than Charting:

The Concept Processor saves the average physician 2.5 hours of charting each day.
However, Concept Processing is far more than just charting. It handles every aspect of your practice faster and better.

With Praxis EMR, you:

Praxis EMR

Reduce errors and stress

Filter incoming data noise (information overload), reducing errors and stress (Read more)

Make your practice more effective

Create your own Practice Guidelines, making your practice vastly more effective (Read more)

Run and manage your own powerful queries

Run and manage your own powerful queries with the only prospective query engine in medicine (Read more)

Still using Templates?  Switch to Praxis EMR and start saving 2-3 hours a day.

Specialty Case Studies

Otolaryngology Case Study Otolaryngology

Better Medicine

"Praxis means better care for the patients, in a cost- and time- efficient manner; it means better medicine for everyone, patient and doctor alike."

Internal Medicine Case Study Internal Medicine


"Praxis actually learns how you practice medicine, based on how you chart. That's what makes it different."

OB-GYN Case Study OB-GYN

Higher Reimbursement

"Praxis paid for itself in less than a year, and has now paid for itself over and over again!.... It makes my patient visits faster and helps reduce my liability."

Gastroenterology Case Study Gastroenterology

Incredibly flexible

"With Praxis, I even have the freedom to create my own report model for Gastroenterology, using my own words, how I think, and how I practice medicine."