You’ve raised $81 million in investments and your physician membership now exceeds that of the AMA. What’s next? If you’re Doximity it’s time to dream big. This physician social networking powerhouse is setting its sights on real-time care coordination and health interoperability. EPM’s Nicholas Genes, MD, PhD caught up with fellow emergency physician Alex Blau, Doximity’s Medical Director and VP, to learn about Doximity’s value for EPs as well as their challenges and next steps.
EPM: Doximity seems to have reached a new plane since the last time we reviewed it in EPM. Has there been a tipping point that you can look back at?
ALEX BLAU: Doximity has had a fantastic year of growth. We surpassed the AMA’s membership in January and now have 40 percent of US doctors on the platform. There wasn’t a tipping point, per se, just a steady wave of doctors signing up. It’s really the scale of how doctors are using the Doximity tools that is exciting to us.
EPM: What are the unique challenges of developing a physician professional network? We know from our IT work that doctors can be a uniquely skeptical bunch when it comes to new technology. Do you have any specific stories of bumps in the road?
BLAU: I think doctors tend to be skeptical about new technology because the technology we’ve so often been forced to deal with is crappy. Think hospital computers running Netscape Navigator and EMRs designed with billing departments—not physicians—in mind. But when given access to technology that works, that is intuitive, they are quick to take advantage. For example, over 90% of physicians own an iPhone or iPad.
One of our biggest challenges has been building a platform that is backwards compatible with healthcare’s largely antiquated communications technology. While Doximity’s vision is a fully wireless, digitally-connected healthcare workforce, we’ve had to build our online fax service to be a stepping stone along the way. Any physician in the U.S. can sign up and claim a free, dedicated fax number that they can use to send and receive faxes anywhere in the country. It’s a first step towards untethering ourselves as a system from the landlocked technology of yesteryear.
EPM: Doximity bills itself as a master rolodex for medicine. I can see why a new primary care doc in town may want this, but why should emergency physicians join the Doximity network and build up connections?
BLAU: The average Doximity user has 53 connections to other doctors. Emergency physician members use Doximity to find and communicate with outside providers when missing elements of a patient’s history may be critical to immediate management. They use our HIPAA-secure messaging to send bedside photos or study results to consultants or to follow up on the outcomes of their admits. They use our medical news reader to identify and connect with new academic collaborators. And there are those who simply use Doximity as a way to reconnect with former colleagues and old classmates.
EPM: As hospitals throughout the US are being rapidly consolidated into a smaller number of health care systems, contacts and referrals will be more and more made within individual hospital systems. For example, North Carolina is almost there- 5 health care systems total for the entire state, using internal referral systems. How will Doximity’s plans add value to that type of organizational referral system? Do you think this type of consolidation will make it more, or less important for something like Doximity?
BLAU: There’s no question the healthcare landscape is being reshaped by rapid consolidation. That said, competition among a smaller number of systems is no guarantee of health interoperability. Even the “gold standard” EHR systems have major challenges sending records between institutions. Already these institutions are devoting increased attention and resources to competing for lucrative referrals and preventing “leakage” of patients to outside providers. But as long as patients continue to change doctors and receive medical care at multiple institutions, there will be a need for we physicians to coordinate care across systems and above the fragmented EHR level.
EPM: What do I need to know about HIPAA security with messaging apps like Doximity? If I share patient info with a colleague and either of us loses our phone, could I get in trouble? Can messages on Doximity be subpoenaed?
BLAU: As an increasingly mobile workforce, physicians are more and more reliant on mobile devices as part of their clinical workflow. Using a dedicated platform, like Doximity, for mobile communication of protected health information (PHI) is a far safer strategy than relying on traditional email or text messaging, which are not built with HIPAA security requirements in mind. In addition to password protection, Doximity uses unique authentication for every installed app, so the user’s password is not stored on the device and users can remotely wipe the contents of their Doximity app if their device is lost or stolen. And, unlike email or texting, Doximity does not store or cache sensitive information on the device. Of course, it is advisable for all healthcare providers to enable the operating-system-level password protection on their devices in addition to application specific precautions.
Regarding the vulnerability of messages in a court proceeding, while I am not an attorney, my understanding is that pretty much anything is discoverable in a legal review if a judge decides to issue a subpoena: patient charts, your home computer, your text messages, etc. That said, we’ve had no reports of Doximity messages being requested in a legal proceeding.
EPM: What is the vision for Doximity as it grows? You’ve branched into CME, job listings. What’s next – credentialing? Where do you see physician social networks in 5 years? 10 years?
BLAU: Today, we’re able to provide significant career and workflow tools to doctors at scale—CME-certified news, targeted job alerts, schedule management software, a growing discussion community around new literature and more. What becomes possible when we reach 80% of doctors, however, has the potential to fundamentally improve the way physicians work and collaborate. We want to bring healthcare professionals together on a single platform; to provide the backbone for simple, mobile, real-time care coordination that ignores institutional boundaries; to help achieve our nation’s emerging vision of true health interoperability. And many of our best ideas and features are born from our physician community. Emergency Medicine physicians have the best perspective of any provider in the system—so don’t be strangers and please help us find and build new ways to improve everyone’s workflow.