Coordination of patient care is a complex process that requires the collaboration of a diverse team as well as management of critical, often disparate, tasks. Managing these processes puts clinicians and their teams under a lot of stress, often leading to feelings of fatigue and burnout. Designed to assist with the administrative burden of patient care and practice management, Dock Health is a secure collaboration and task management platform. Dock Health was the result of a collaboration between Michael Docktor, MD, a pediatric gastroenterologist and clinical director of innovation at Boston Children’s Hospital (BCH), and Keather Roemhildt, a veteran user experience (UX) designer now at Twitter. Ahmed Morsy, Editor-in-Chief of IEEE Pulse, spoke with Michael Docktor (above) about the potential this platform has to assist with patient management tasks and ease the stress of clinician and administrative burnout.
IEEE Pulse: What was the motivation for developing Dock Health?
Michael Docktor: We had been working for months to identify the ways that elegant design and UX could ease the challenges of patient care and address the growing epidemic of burnout in healthcare. At the same time, my wife and I were using a consumer To-Do app to manage foodshopping lists when that “aha moment” hit. We realized if you boiled down many of the issues of clinician burnout, it was about tasks—literally dozens of “to-dos” for patients that stack up, get forgotten, missed, and lead to unreliable patient care and provider stress and anxiety. Our goal was to take the best of consumer tools like Wunderlist, Slack, Jira, and other popular collaboration platforms and bring these into healthcare while honoring the importance of security, HIPAA, and patient context.
IEEE Pulse: How did you first test your idea?
MD: We had the great fortune of having an existing consumer application in Wunderlist where we could test the concept of collaborative task management without having to build anything from scratch, a veritable minimum viable product (MVP) without a dollar spent. Colleagues agreed to trial a shared task list without using patient identifiers to see if it was easier than the typical communication channels of healthcare such as email, pagers, and electronic medical record (EMR) inboxes. In a matter of months, we collectively checked hundreds of boxes, were working better together, and were noticeably more efficient and less stressed about “dropping a ball.” It seemed we were onto something. Using my experience in clinical informatics and healthcare innovation along with Roemhildt’s skills as a seasoned UX designer in the consumer technology space, we then set out to build a similar concept for patient care and healthcare teams.
IEEE Pulse: What went into building the initial application?
MD: We had the opportunity to apply to the Innovation and Digital Health Accelerator (IDHA) at BCH and in 2016 were awarded a grant to build our vision. Together with the IDHA team, we designed and developed the Dock Health platform. Working with an excellent development partner (HT Developers) to build out the native iOS app, the IDHA team helped to bring the version one mobile and web product to market. The engineering effort, led by Nitin Gujral and the IDHA team, used their experience in enterprise software development and HIPAA compliance to build the entire platform from scratch.
IEEE Pulse: How was the application received by the clinical community?
MD: As director of clinical mobile solutions at BCH, I have led numerous projects to pilot and implement mobile applications from secure messaging platforms like TigerConnect to the Cerner mobile EMR suite of applications and Nuance’s Dragon Medical One product. I’m aware of the challenges of adoption in a busy academic medical center and have written on the hurdles and opportunities of mobile applications in this environment. Despite the challenges, Dock Health has successfully piloted in a variety of departments throughout the hospital.
Interestingly, our greatest early success has been outside of our comfort zone of a large academic medical center. The CEO of a large psychiatric practice had stumbled upon a blog post on Dock Health while we were in beta testing, looking for a HIPAA compliant collaboration platform. Dock Health quickly automated and integrated with a number of their workflows and brought their practice the collaboration and security they needed. After a 6-week pilot program, the practice signed on as our first paying customer. Dock Health has benefited from these initial pilot sites, and learned from the use cases and the invaluable feedback and feature requests we’ve received from early users. More importantly perhaps, the early success of Dock Health in healthcare practices outside of large academic medical centers has significantly shaped plans for our initial areas of focus at this early stage on the road to market.
IEEE Pulse: Is the app designed for iOS only?
MD: Our mobile offering is a native iOS app built for the iPhone and available on the App Store. However, we also offer a responsive website that provides a rich experience for users who may prefer working at their desktop, laptop, tablet, or Android phone (below). We wanted to build the best possible experience for clinicians who were likely going to be carrying around an iPhone and take advantage of some of the key features like push notifications. At BCH, the iPhone is dominant among clinicians at over 90% usage, similar to percentages in the market among physicians.
IEEE Pulse: How would you describe your successes to date?
MD: We are still at an early stage but are thrilled to have had a number of early successes including the accelerator grant that allowed us to build the initial platform. In addition, we received a grant to test Dock as a care integration tool for our burgeoning accountable care organization, and have a number of successful pilots at BCH, and several external paying customers. In 2019, we look forward to spreading our wings and flying out of the nest, with plans to implement in dozens of practices across the United States, building our team and raising capital to make it all happen faster and at scale.
IEEE Pulse: What is your future vision for Dock Health?
MD: We’ve shown that reducing burnout among healthcare providers and their teams is possible with tools like Dock Health that reduce the cognitive burden and anxiety associated with the work necessary for quality patient care. We feel that there is much to be learned from the UXs of many consumer productivity and collaboration tools that are sadly missing in healthcare. In the near term, we look forward to making it easier for users to do this as simply as possible and help them get started with their teams even faster.
Dock Health aims to be the collaboration and task management engine of healthcare. While we’re working tirelessly on our stand-alone platform, we also look forward to helping other clinical apps leverage the power of secure task management and collaboration through the Dock Health API. We are working on a number of partner integrations from EMRs to productivity and communication tool channel partnerships in 2019 and beyond.
IEEE Pulse: What kind of advice would you give to clinicians who have similar ideas and want to bring their products to the market?
MD: We are incredibly fortunate to have the resources of Boston Children’s Hospital and the talent and expertise of the team at the IDHA. This has afforded our team the opportunity to build a company from a true clinical and administrative painpoint. We are proud to have developed together a mature software solution while benefiting from the expertise of engineers knowledgeable in building HIPAA compliant solutions and providing a fertile testbed for user feedback. Despite this, however, before we started building any product we surveyed dozens of prospective users and leveraged an existing product already in the market to test our hypotheses. Our advice would be that in order to solve a real clinical problem, validate that it is a problem for others and not just in your narrow scope of X, Y, or Z field of medicine by asking all stakeholders, not just physicians. Test your hypotheses quickly and cheaply with an MVP, and find great partners to help build your solution with expertise in healthcare and a safe place to test and iterate on your product.
IEEE Pulse: Given the opportunity, is there anything you would do differently?
MD: We spent several months at the outset of our work together trying to address some of the huge problems inherent in a lack of design and UX in healthcare software. Ultimately, we continued to narrow our scope to the core of many of these challenges and we continually arrived at there being a lack of secure collaboration tools, particularly to help teams manage the administrative burdens of healthcare. This was a process and a journey, all of which was incredibly informative. There isn’t much that we would change if we could do it all over; things happen for a reason and we have learned so much throughout this experience. We’re looking forward to the future and seeing how we can help bring beautifully designed tools to healthcare that help clinicians and administrators alike reduce stress and enjoy their jobs a little more while generating more highly reliable care for patients.