DocbookMD Enhances Patient Care  

 Texas Medicine Logo 

Practice Management Feature – November 2012 

 By Crystal Conde 
Associate Editor 

Tex Med. 2012;108(11):53-56.  

The days of emailing or texting a physician colleague and wondering whether the message fell into a technological black hole or reached the intended recipient are in the past for Arti Gupta, MD. The Dallas nephrologist says the hassles of daily practice dropped significantly since she began using DocbookMD, a free Texas Medical Association member benefit, about nine months ago.

"I heard about DocbookMD through a colleague. I tried the app, and before long several of my colleagues at Dallas Nephrology Associates became users. Patient-related messages pop up immediately and securely, and it's easy for me to respond promptly and to provide more efficient patient care," she said.

DocbookMD allows physicians to transmit text messages and images to each other that meet Health Insurance Portability and Accountability Act (HIPAA) encryption and security requirements. It is available for iPhone and Android phones, as well as for iPad and iPod touch.

DocbookMD is available free of charge in Texas only to TMA and county medical society members.

The Texas Medical Liability Trust is a sponsor of DocbookMD.

The Austin husband-and-wife team of Tracey Haas, DO, and Tim Gueramy, MD, developed the app and launched the flagship application in January 2011. Dr. Haas, a family physician, says the app eliminates the need for unnecessary and often costly hospital or lab visits when an image of an x-ray or wound, for example, would suffice. The app allows physicians to: 

  • Prioritize outgoing text messages,
  • Confirm receipt of text messages,
  • Search a local pharmacy and hospital directory for up-to-date contact information, and
  • Search a medical society directory to locate area doctors by name or specialty or by facility or group with which they're affiliated. 

DocbookMD supports up to one phone (iPhone or Android) and one other device (iPad or iPod touch) per user account.

Dr. Gueramy says that the app helps physicians enhance patient care, improve their practice efficiency, gain and give referrals, and avoid mistakes.

"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, and even pictures. And all of this is sent securely and in a way that meets HIPAA requirements," he said.

Anywhere, Anytime 

Drs. Haas and Gueramy set to work creating the app after a "medical emergency" interrupted their first wedding anniversary dinner.

Even though it turned out not to be an emergency, Dr. Gueramy, an orthopedic surgeon, had to go to the hospital, where he remained for hours to help with other cases. The couple developed an app that allowed Dr. Gueramy to see an x-ray on his phone. Determined to ease hassles and improve communication for physicians, they developed DocbookMD within a year-and-a-half of starting the project.

The couple's technological brainchild flourished. DocbookMD currently has more than 10,000 users and is available in 28 states and more than 200 medical societies, including all of the county medical societies in Texas. And in late August, the company released version 4.0 of the app, which the physician creators describe as "faster, more stable, more intuitive, and easier to use." The new version features threaded messaging, message forwarding, and quicker message downloads.

Version 4.0 gives users the option of enhanced notification, which sends physicians an email and a text message if they fail to open a message from DocbookMD within a specified time.

"Our reason for developing DocbookMD was that we wanted to connect physicians. This way, physician users can securely get test results and other information on a patient while they're at dinner, traveling in another country, or watching a baseball game. They can be reached anywhere, anytime," Dr. Haas said.

She and her husband had an opportunity to test the capabilities of DocbookMD while they volunteered their medical expertise in Libya following the country's revolution. Dr. Gueramy performed many amputations, and DocbookMD allowed him to consult with Texas physicians on the more difficult cases he encountered. He sent x-rays and other images to Austin trauma experts, who responded with treatment recommendations within minutes. The experience of using DocbookMD overseas expanded the couple's view of what their app could become and other ways it could strengthen and support the medical professional community.

Austin King, MD, a member of the TMA Board of Trustees and an Abilene otolaryngologist, has used DocbookMD for more than a year. Dr. King is a member of the Taylor-Jones-Haskell-Callahan County Medical Society, which was an early adopter of DocbookMD.

"As a physician working in a semirural area, I really appreciate the app's ability to connect me to other physicians many miles away and to do it in a way that's HIPAA-compliant," he said.

According to Dr. King, about 25 percent of the county medical society's members currently uses the app.

"We're trying to get more of our member physicians to use DocbookMD by promoting it at meetings. We're also thinking about having some technology experts attend a meeting so they can demonstrate how to download the app onto smartphones," Dr. King said.

Secure Communication 

Using DocbookMD, physicians can send text messages instantly while complying with HIPAA.

The DocbookMD website lists four major HIPAA security criteria mobile apps must meet: 

  1. There must be a termination procedure that allows rapid removal of protected health information (PHI) from the device or rapid termination of access to PHI. DocbookMD can remotely shut down access to the app and any data containing PHI when a physician reports the device lost or stolen.
  2. Access to the device containing PHI must be limited. DocbookMD encourages physicians to keep their devices safe and to password protect their phones and tablets.
  3. PHI must be encrypted based on the highest encryption standards available. Secure encryption must be continually tested. The DocbookMD website says DocbookMD uses 256-bit encryption for all PHI on the device, server, and during transmission.
  4. Any device that contains PHI must have a backup and recovery procedure. DocbookMD has data backup procedures and a disaster recovery plan if a device or PHI is lost. Servers also have these systems and emergency recovery procedures.

 All physician users of DocbookMD must sign a HIPAA business agreement, which specifies the company's data protection policy and the responsibilities of all parties to ensure confidentiality of patient information. As HIPAA-covered entities, users of the app must abide by HIPAA and Health Information Technology for Economic and Clinical Health Act rules, including privacy and security rules.

 Physicians, Patients Benefit  

Dr. King has reaped many benefits from using DocbookMD. He says before the app, it took two to three days to transcribe and fax his dictation to another physician. Now he can send it immediately via secure messaging.

And the app helps him deliver more efficient patient care.

"I was at a meeting outside Abilene and received a call from a patient who was having bleeding following a tonsillectomy. Using DocbookMD, I was able to contact the physician covering for me right away, share the patient's medical information, and ensure the patient received urgently needed medical care immediately," Dr. King said.

Cristie Columbus, MD, an infectious disease specialist, says she uses the app for its pharmacy search function and secure messaging with referring and consulting physicians. Dr. Columbus is assistant director of graduate medical education at Baylor University Medical Center.

"At Baylor, we provide our residents Dallas County Medical Society membership, thus giving them access to DocbookMD. I am an advocate for residents' use of the secure messaging function as a means of HIPAA-compliant communication regarding patients," she said.

Dr. King recommends DocbookMD to physicians who haven't yet used the app.

"It's a great way to transmit information immediately in a secure fashion, and I look forward to the development of even more sophisticated applications and features," he said.

Over the next few months, Dr. Gueramy says he and his wife plan to continue to add new features based on user feedback.

"Every addition to the app's functionality is always aimed at helping physicians help their patients and connect with their medical communities," he said.

Dr. Haas encourages TMA members to try DocbookMD. (See "How to Get DocbookMD" below.)

"DocbookMD offers a unique way for physicians to send messages to their consultants and colleagues about the patients they share or may soon share. Because the app is portable and intuitive, it's not intimidating to use, but rather it's like using any other app on a smartphone," she said.

Crystal Conde can be reached by telephone at (800) 880-1300, ext. 1385, or (512) 370-1385; by fax at (512) 370-1629; or by email. 


How to Get DocbookMD 

To get more information about DocbookMD, visit the DocbookMD website. You can download the DocbookMD mobile app on the TMA website.

To obtain the necessary credentialing data to start using DocbookMD, call your county medical society or contact the TMA Knowledge Center at (800) 880-7955 or (512) 370-1550 or by email.  

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