Doximity: A Mobile Facebook for Doctors, but With Real Privacy Protections

6/21/11Follow @wroush

LinkedIn founder and CEO Reid Hoffman likes to say that in the world of social media, Facebook is the backyard barbeque, MySpace is the dark nightclub, and LinkedIn is the office. To continue the metaphor, Twitter is the corner soapbox—and Doximity, a new social networking tool for physicians, wants to be the hospital.

Or so says Jeff Tangney, founder and CEO of the San Mateo, CA-based startup, which raised $10.8 million in Series A funding this spring from Emergence Capital Partners and Interwest Partners. Tangney was the longtime president and chief operating officer at Epocrates (NASDAQ: EPOC), the provider of mobile drug reference tools that raised $86 million in a February IPO. And Doximity is what Epocrates probably would have been if smartphones had existed in 1999, when Tangney started the company: a combination medical directory, list maker, and secure messaging tool that runs on any iPhone or Android phone. He says the service is designed to help overcome the information barriers that currently make it difficult for doctors in different practices or hospitals to communicate about patient care.

“The goal we were trying to solve for doctors with Epocrates was the problem with medication errors,” Tangney told me recently. “No one can keep in their head all 3,000 drugs and how they interact with each other. ‘My peripheral brain’ was how one doc described it. In leaving Epocrates after being there for 10 years and getting the itch to do something entrepreneurial again, my physician friends and I saw that there is this next big problem in healthcare that can be solved by these super-connected devices like the iPhone, and that is the communication problem.”

Jeff Tangney

The average primary care physician in the United States refers patients to 250 different specialists at 117 different practices and hospitals in a given year, according to Tangney. “Keeping in touch with all those specialists is very difficult,” he says. “I would argue that you need a LinkedIn-style directory and a way that you can securely send e-mail to other doctors. Unfortunately, many of the electronic medical record systems out there are very siloed.” To get his son’s medical records from Stanford Hospital to the Palo Alto Medical Foundation less than a mile away, for example, the documents had to be printed out and faxed, even though both organizations use the same electronic health record system, Tangney says. “So I don’t think you can rely on the corporate level to make this work.”

On the up side, nearly 80 percent of U.S. physicians own a smartphone, according to Manhattan Research (and 30 percent already have an iPad). That gives them a platform for bypassing the existing IT infrastructure in their practices or hospitals and communicating with one another directly. All they need is messaging software that complies with the federal health privacy guidelines known as HIPAA—which Doximity does, according to Tangney.

Here’s a video overview of Doximity from Tangney; story continues after video.

Since introducing the iPhone version of the service in December, Doximity has already signed up 17,000 physicians. “I believe that a megatrend we’re seeing in other parts of the enterprise software landscape—end users increasingly making their own choices about the technology that will help them do their jobs better—will come to healthcare,” says Kevin Spain, a general partner at Emergence Capital Partners. “Doximity is riding this trend by bringing easy-to-use collaboration tools to physicians.”

At its core, Doximity has just five elements:

• Personal profiles, customizable so that doctors can add areas of expertise, publications, and the like.

• A directory of all U.S. physicians, searchable according to their locations, their specialties, the medical schools they attended, and the languages they speak.

• A directory of pharmacies, hospitals, labs, and other medical facilities.

• A private phone list for quick access to local colleagues.

• “DocText,” a HIPAA-compliant mobile messaging system that allows doctors to exchange encrypted text messages and photos and get confirmation that individual messages were received.

The first four features are “a little more lightweight” and basically function as a physicians’ equivalent of Facebook or LinkedIn, Tangney says. Generally, doctors can’t use the real Facebook or the real LinkedIn because they’re not HIPAA-compliant—and the population of physicians isn’t large enough to make it worth either company’s time to develop compliant versions.

But DocText is more unusual. “It’s like any other group messaging tool, but the key thing is that it’s encrypted end to end,” says Tangney. “Say I’m a gastroenterologist and I do a dozen biopsies a day. One is cancerous. Legally I need to tell the patient’s other doctors right away, but we don’t give doctors many tools to communicate, since it’s illegal to send regular e-mail. They can send a fax, but that doesn’t have confirmation receipt. What we do is send a push notification via phone or the Web. It will pop up, you enter your pin code, and you go straight to the message and it’s counted as viewed, and a time-stamped confirm-receipt message gets pushed back. It’s like FedEx—you have to sign for it and let the other person know you got it.”

The whole thing is free for doctors. The revenue plan, says Tangney, is to charge recruiters for job listings delivered via the app, offer sponsored access to online courses for continuing medical education credit, and possibly sell a premium version of the service to hospitals. Down the road, Doximity could also offer market research services with its users as survey respondents.

So far, the 18-employee company has been signing up new users purely through word of mouth. With 17,000 members, it’s already reaching about 3 percent of the U.S. physician population. Tangney thinks penetration could eventually increase to 50 percent—roughly the level Epocrates has reached after 12 years in business.

After leaving Epocrates in early 2010, Tangney joined Interwest Partners as an entrepreneur-in-residence, and he says it didn’t take him long to settle on the idea for a LinkedIn- or Facebook-like site for doctors, with the built-in privacy protections that would make it safe to use for communication about patients. “Almost from week one I felt like this was such a glaring need that it was where I devoted almost all of my focus,” he says. “Clearly, we are benefiting from some of the ground that’s already been plowed by the consumer Internet, and applying it to a relatively small market. Let’s face it, LinkedIn and Facebook are not that interested in doctors, since there are only half-million of them. But it’s a market I love. And we’ve built up a big market in a fairly short time because, frankly, we’re not reinventing the wheel.”

With an experienced mobile healthcare entrepreneur like Tangney at the helm, says Emergence Capital’s Spain, Doximity “has the opportunity to build the de facto collaboration network for physicians.” It’s a market Doximity could have to itself—unless the company running the Internet’s backyard barbeque suddenly decides it also wants to be the hospital.

Wade Roush is a contributing editor at Xconomy. Follow @wroush

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