By: Laura Hale Brockway, ELS
Texas Medical Liability Trust Communications and Advertising Department
A family physician is covering her practice’s urgent care clinic. Her first patient is a 45-year-old woman whose chief complaint is difficulty urinating. The patient is found to have a high fever, rapid heartbeat, and an elevated white blood cell count. The patient explains that she underwent a urological procedure 3 days ago, but woke this morning and could not urinate.
The family physician asks the patient for details about the surgery and asks for the name of the urologist. The patient — who has been taking hydrocodone for pain — cannot recall the name of her urologist. The family physician has her nurse access a local medical directory to find the name of the patient’s urologist. After several phone calls and two hours spent in the office waiting, the patient is sent to the emergency department to see the urologist on call.
Scenarios like this occur in physician practices every day. Communication between physicians can be inefficient and patient care can be delayed, resulting in frustration for everyone.
These frustrations, however, may be short-lived. Two Austin physicians have created a tool to help solve these communication delay: DocbookMD.
“We wanted to change the way physicians communicate. We wanted to make it easier, more efficient, and more secure,” says orthopedic surgeon and DocbookMD cofounder Tim Gueramy, MD. “We created a program that will allow physicians to talk to one another with new technology.” Dr. Gueramy created DocbookMD with his wife, family physician Tracey Haas.
DocbookMD is a physicians-only iPhone, iPad, and Android app that allows physicians to:
- send HIPAA-compliant text messages and photos;
- assign an urgency setting to outgoing text messages;
- search a local pharmacy directory; and
- search a local county medical society directory (including email addresses and photos).
“DocbookMD allows you to look up another doctor at the point of care. You can then either call the physician or send a text message with room numbers, medical record numbers, even pictures of wounds and x-rays. And all of this is sent securely and in a way that meets HIPAA requirements,” says Dr. Gueramy.
The DocbookMD app is now available in the following county medical societies in Texas: Travis, Dallas, Bexar, Tarrant, Lubbock, Nueces, Denton, Bell, and Collin-Fannin. More county medical societies are joining weekly on a statewide and national basis. TMLT’s sponsorship of DocbookMD in Texas makes it possible for physicians in these counties to use the app at no charge. Only physicians who are members of the Texas Medical Association and these county medical societies can access DocbookMD.
How it works
On-Demand messaging and multi-media collaboration
DocbookMD allows physicians to send patient information securely via text messages to other physicians. Message content can include patient information, such as diagnosis, test results, or medical history. Physicians can also add a high-resolution image of an EKG, an x-ray, lab report, or anything that can be photographed with an iPhone to the message.
Messages can then be sent using the app’s messaging priority system. Physicians can assign each message a 5-minute, 15-minute, or normal response time. “If the recipient does not answer the message within 5 minutes or if the message does not get to the doctor, you will then get a message back stating that it did not make it,” says Dr. Gueramy. “You can see and hear that the message you receive is different from any other text.”
Messages sent and received are all available in the app’s messaging center for quick reference. DocbookMD currently stores messages for one year, but will soon begin storing messages for three years to meet HIT legislation compliance requirements.
All messages sent using DocbookMD meet HIPAA’s requirements for encryption and the security of protected health information. This is accomplished through technology that keeps everything encrypted on the iPhone and the DocbookMD server. Messages are not downloaded to the phone, but are viewed from the phone. Additionally, DocbookMD is a closed network and only physicians have access to the app. Physicians are also required to sign a HIPAA agreement before using DocbookMD.
As physicians begin using DocbookMD, they should be aware that any evaluations, diagnoses, treatments, prescriptions, consultations, or referrals made as a result of using the app should be separately documented in the patient’s medical record. Separate documentation will ensure compliance with the TMB’s Medical Record Rule 165.1.
Using the DocbookMD directory, physicians can look up other physicians in their county by first or last name or by specialty. Physicians can then contact other physicians by messaging, office phone, cell phone, or email. The pharmacy directory allows physicians to search for a local pharmacy alphabetically or find a pharmacy by zip code. Users can also create a “favorites” list of physicians or pharmacies that they contact most frequently.
How it helps
By allowing physicians to exchange information through texting, DocbookMD prevents delays at the point of care. Austin ophthalmologist Ted Shepler, MD recently used DocbookMD to help a patient who needed her prescription urgently. The patient had no idea which pharmacy had her prescription on file. “Thanks to Docbook MD, I was able to find the pharmacy quickly for the patient,” says Dr. Shepler.
DocbookMD can also enhance patient care by facilitating more efficient communication. Austin anesthesiologist and DocbookMD partner Aaron Ali, MD, once used the app’s directory to find a patient’s nephrologist to discuss the patient’s pre-operative lab values. The surgery was rescheduled when it was confirmed that the patient was in acute renal failure. “The fact that I could get a hold of that physician or his office that quickly and accurately was awesome,” says Dr. Ali. “It helped out and I know 100 percent that it helped that patient that day.”
How to access
TMLT is the exclusive sponsor of DocbookMD in Texas. Physicians in participating counties can use the app for free (normally a $50 annual subscription cost). TMLT believes DocbookMD can enhance communication and help physicians practice safe medicine.
TMLT Vice Chairman Stuart McDonald, MD, uses DocbookMD daily. He is “particularly excited about the ability to contact physicians through a secure network to request consults or provide follow-up information. This saves a significant amount of time that would previously be spent on hold or waiting for a return call,” Dr. McDonald says. “The ability to know whether or not my message has been read in a timely manner helps prevent delays in patient care.”
For Dr. Ali, DocbookMD has changed the way he communicates. “We have to be able to communicate with physicians, we have to be able to find them timely and in an efficient manner,” he says. “With DocbookMD, it takes seconds to find someone and seconds to call.”
To register or for more information on DocbookMD, please visit www.docbookmd.com. Texas physicians who would like to use DocbookMD, but live in counties that do not participate, are urged to contact DocbookMD by email at firstname.lastname@example.org.
The information and opinions in this article should not be used or referred to as primary legal sources nor construed as establishing medical standards of care for the purposes of litigation, including expert testimony. The standard of care is dependent upon the particular facts and circumstances of each individual case and no generalization can be made that would apply to all cases. The information presented should be used as a resource, selected and adapted with the advice of your attorney. It is distributed with the understanding that neither Texas Medical Liability Trust nor Texas Medical Insurance Company is engaged in rendering legal services. © Copyright 2011 TMLT.