Two Texas physicians resource underserved communities and help improve doctors’ quality of life

Texas Medical Association, August 6, 2012

When Tracey Haas met her husband, orthopedic surgeon Tim Gueramy 11 years ago, she was an intern assigned to the orthopedic clinic where Tim was a fellow. Although she wanted to pursue broad rural training and practice international medicine, she fell in love with the ultra subspecialist. We met that morning, had our first date that night, and have been together ever since, says Tracey.

Practicing medicine at opposite ends of the spectrum has had its challenges, including Tim’s constant on-call schedule and the 160-mile round-trip drive Tracey endured commuting to her rural practice in Gonzales, Texas, for almost two years when the couple first moved to Austin, but Tim and Tracey have found a way to meld their specialties and work side by side. They both share a passion for caring for the poor and underserved, equipping under-resourced physicians, and strengthening the medical community worldwide. As such, their work has taken them around the globe and into the world of medical apps and health IT.

Improving physicians’s quality of life.

Because of the nature of Tim’s work, the couple has always driven in two cars whenever they go out. After an anniversary dinner interruption that ended up being a non-emergency, the couple began dreaming up an app that would allow Tim to see an x-ray on his phone. Within a year and a half, they had developed DocbookMD.

A secure, multimedia-enabled mobile communication platform with HIPAA-compliant, on-demand messaging, DocbookMD allows physicians to send and receive images and access physician, pharmacy, and hospital directories. Available for iPhone, iPad, iPod touch, and Android phones, DocbookMD eliminates the need for unnecessary and often costly hospital or lab visits when an image of an x-ray or wound would work just as well.

Expectations for the app have wildly exceeded what Tim and Tracey ever imagined. As of July 13, 2012, DocbookMD is supporting more than 9,000 physicians and more than 200 medical societies in 27 states.

We initially envisioned local physicians on the app, says Tim, whose extensive technology background has played an integral role in getting DocbookMD off the ground. To have such a wide impact answering a common problem for a lot of physicians across the country just blows us away.

Getting its start in Texas, DocbookMD partnered with 25 individual counties before the Texas Medical Association (TMA) got involved. Now the company has moved to a state model where state medical societies provide the physician data and medical liability companies provide the funding. In return, DocbookMD provides the free HIPAA-compliant messaging service and directory access for physicians. In Texas, for example, the Texas Medical Liability Trust (TMLT) underwrites the app for all TMA-member physicians.

They see it as a risk mitigator, says Tracey, as well as an opportunity to reach doctors in a different way. With the ability to see an x-ray on a smartphone and consult virtually in a HIPAA-compliant way, Tim and Tracey were able to start going out in one car. Being called away for non-emergencies doesn’t happen anymore. Using the app, they agree, has resulted in a drastic improvement in their quality of life. But what means even more to them is how the app has improved patient care.

Following an international calling

Improving patient care is nothing new to Tim and Tracey. As volunteer medical director of a local non-profit, The Miracle Foundation, Tracey has traveled several times to India, helping to develop medical standards for orphanages in that country. In addition, she and Tim helped to organize 33 back-to-back one-week volunteer medical trips after the earthquake hit Haiti in January 2010. With a background in global public health and a diploma of tropical medicine, Tracey continued her involvement in Haiti for another eight months and continued to help bolster physician training and community health projects.

It’s important for us to leave something sustainable behind, notes Tim. I don’t think we do net good when we just go in, do our thing, and get out. Since many of their trips involve a level of risk, Tracey emphasizes that they never leave the country without medical evacuation insurance. We’re well vaccinated and well insured, she says. It’s worth the money.

Most recently, the couple was in Libya to help with medical needs after the country’s revolution. Although the disaster was man-made, they saw many of the same diseases and catastrophes they had witnessed in Haiti, pulling in both of their areas of expertise. For Tim, there were many limb amputations and fixations as well as the opportunity to provide hands-on training in the operating room for Libyan physicians.

For the first time, Tim was also able to test the DocbookMD app outside of the United States. On some of the more difficult trauma cases in Libya, Tim took x-rays and pictures, messaged trauma experts in Austin with the images, and received a response on treatment recommendations in minutes. The experience of using DocbookMD overseas expanded the couple’s view of what their app could become, as well as suggested other ways to strengthen and support the greater community of medical professionals.

The future of virtual physician communities

In addition to working with many non-profit organizations, Tim and Tracey have met numerous physicians interested in volunteering. The couple’s current dream is to find a way to connect these two groups.

The doctors both recently took a sabbatical from their practices to focus on getting the word out about DocbookMD and to work on their newest technology endeavor, the DocbookShare network, an app that will help match volunteer physicians with opportunities to serve and, possibly, pull in funding sources. Stepping away from their traditional roles, steady jobs, and regular pay is not something Tim and Tracey take lightly. After training for so long, Tracey admits they get a lot of funny eyebrows, but they are sacrificing security to do something they feel strongly about.

With the medical societies, and TMA in particular, we believe we’re strengthening the community of medicine, says Tracey. We haven’t found anyone else who’s trying to build this community. That’s what we’re really all about.