Hospitals and clinics still use pagers extensively for doctor-to-doctor communication. In fact, more than 90 percent of hospitals are estimated to use pagers in the United States as of 2013. Pagers are still used because their networks are reliable, they still receive strong signals even in rural locations, and they are inexpensive.
However, pagers can only provide a limited amount of information. They can’t be stored with a patient electronic medical record and there is no way to the track, analyze, or securely archive the messages within pager messages. Physicians could benefit from more modern means of communication.
The application centers messages around individual patients. Seratis was created by Divya Dhar, MBChB MBA MPA (@divyadhar), a physician, along with her team, and is being tested at Penn Medicine and other sites around the country. She has been featured at TEDxAuckland and on TechCrunch, and has done extensive work on social issues. We interviewed her on her experience on going from clinical medicine towards bringing the application to fruition in the digital health industry.
First off, how does Seratis work?
Divya Dhar: The person who is lead physician, like the primary care physician, probably has to [take care of messaging] anyways because their administrator has to send e-mails and refer requests. Why not get their administrator to enter their patient info and invite the other physicians to come and join? We created an architecture [to accommodate this] and everything is done securely. For independent physicians and practitioners, we’re doing limited on-boarding for free. So if anyone gets in touch with us, we’ll let them start immediately.
Whom exactly are you targeting?
Divya Dhar: [We are targeting] two particular [types of physicians]: (1) You’re at the hospital, using inpatient wards. (2) There’s another group of PCP’s and independent specialists, and I’m interested in that community.
What we could do for them is enable them for high-touch patients, like having multiple doctors and nurses because they are chronically unwell. If you’re a primary care physician, [and you’re treating congestive heart failure], you might have [an] outreach nurse, cardiologist, case manager, and yourself. [It would be optimal] to have everyone connected, whether or not everyone is in the same facility. What we do is enable cross-collaboration across different facilities with different EMR’s.
How did you get started with Seratis?
Divya Dhar: I got started because I was a physician myself, and I didn’t know seven out of ten physicians on our [patient care] team, because they were [in] different specialties or had different roles. Despite them being different from me, I still had to coordinate care for them. I found it really difficult to do this.
We build team transparency. Seven out of ten members of the patient’s care team are unknown to each other. [With Seratis] we tell them in real-time who else is looking after the patient, and can securely send them a message. This is about making workflow [more streamlined]. I was wasting one hour a day on communication [otherwise].
But aren’t there other secure messaging apps?
Divya Dhar: We enable team transparency like no other. People talk about care coordination but that could be a nurse ringing people. We actually bring visibility to the entire care team. (As I said, seven out ten members don’t know each other, and we make those seven visible). Secondly, we are also the only company focused on real-time data analytics for population health management. [We] tell you if there is a flu outbreak by text mining for that word. Lot of other companies do secure messaging. We are really pioneering workflow management.
What were your top challenges in making the transition from clinical medicine to digital health?
Divya Dhar: Obviously, as a clinician we’re told to be very confident before making decisions. It’s all about [evidence-based medicine]. But in a start-up, there’s no previous study, no previously charted ground. You’re supposed to create the ground for yourself and make that path. You’re going to be the pioneer, and you’re the one testing different things. You’re still creating evidence-based processes, but through different means. Instead of a randomized-controlled trial, at least on a small scale, you end up doing A/B testing, so you ask different users to use the product in different ways. That was hard to grapple with.
Second, it’s about understanding of technology. My role as a clinician is to look after the patient and understand the art of medicine. The science part doesn’t always include technology. It was pretty hard for us to come to a common understanding of the technology, and how the workflows go. I had an understanding of processes and workflow development. How do you test it? How do you know there are no bugs in there?
What’s in store for you in the future?
Divya Dhar: We hope to get this to transform healthcare communication. That’s the dream. Really finding a world where doctors and nurses are truly connected with each other, so communication is seamless. But on top of that, ideally in a few years’ time, we would include patients in that communication as well. There are lots of doctors wanting to engage with their patients but not knowing how to do so. They would like to have that one primary system doing everything. we’d like to be the hub for that.