Giffen Solutions, Created by Fed-Up Doc, Connects MDs and Patients

Michael Nusbaum rarely thought twice about giving his personal cell phone number to patients after he operated on them. Nusbaum is a bariatric surgeon at New Jersey’s Morristown Medical Center, and he wanted patients to be able to reach him easily by phone or text. But then he found out that sending text messages to patients violates federal privacy laws. Whenever patients texted him, “I wouldn’t text them back,” Nusbaum says. “I had to pick up the phone and call them so I wouldn’t violate the law.”

So Nusbaum turned his annoyance into a business plan. He teamed up with his wife, who is a neuroradiologist at New York University, and founded Giffen Solutions in 2010 with the intent to create a secure smartphone app that doctors could use to talk to patients without violating privacy regulations. Giffen beta tested the product, called MedXCom, with a couple hundred doctors for a year before making it available to the broader medical community on April 12, Nusbaum says. More than 35,000 doctors and patients are now using it, according to the company. And Giffen, which raised $1 million in angel funding, expects to secure an additional $5 million financing round this month, Nusbaum says.

Nusbaum designed MedXCom to replace the after-hours answering services that doctors typically use. “There are huge barriers that exist in the communication between the doctor and the patient,” Nusbaum says. For example, he says, when a patient has an emergency and calls her doctor’s answering service after the office closes, the doctor may not have access to her medical records when he calls her back. And if he needs to order a prescription for her, he’s unlikely to remember what drugs she’s already taking.

If a doctor is subscribed to MedXCom, after-hours calls get forwarded to his cell phone instead of an answering service. “Before I speak to you, it will push your entire health profile to my cell phone,” Nusbaum says. “I can see everything—what surgeries you’ve had, what allergies you have, the medications you’re on. I have all that information even before I take the call.” If the doctor wants to order a prescription, he can do so right through the app.

Nusbaum had more than just his experience as a doctor to call upon when he created MedXCom. In 1998, he founded Hamilton Scientific and created one of the first electronic medical records (EMRs). He sold the company to MeridianEMR, which built it into a leading product for urologists before selling it to HealthTronics in 2011.

Since then, competition in the EMR field has intensified, thanks largely to the federal government’s new “meaningful use” legislation, which offers financial incentives to doctors who embrace technology for record-keeping. Dozens of companies have popped up to offer different flavors of EMRs, including New York companies Hello Health and Medivo, both of which have raised venture capital recently.

When Nusbaum started looking for a new challenge in IT, he decided he wanted to take the EMR to the next level. “What I realized is that electronic records are a problem—they’re static,” he says. “You go to your primary-care doctor and they’ve got a chart on you. You go to someone else, they’ve got a chart on you. None of those electronic records communicate with each other.”

Bariatric surgeon Michael Nusbaum created the MedXCom app for doctors

MedXCom is designed to work with any EMR. When patients agree to use the product with their doctors, their EMRs are automatically migrated into the app. Patients can then add information to the app, and they can scan and upload paper records from their visits to other doctors. They can also sign up to get reminders of routine checkups for themselves or their kids by phone or text, and they can use the app to schedule appointments.

Nusbaum says the feedback from patients was so positive he decided to create a version of the app that anybody could use, regardless of whether or not their doctor signs up for MedXCom. That product, called MedXVault, will be released by the end of this month, Nusbaum says.

Giffen charges physicians an average of $49 a month to use the telecommunications features of MedXCom—far less than the $250 or so they would pay per month for an answering service with a live operator, Nusbaum says. Doctors who opt out of the telecom services can still use the EMR features at no charge, and everything is free for patients, he says.

Nusbaum says he believes physicians will be motivated to ditch their answering services and use MedXCom instead. In addition to forwarding patient calls, the app can record those calls, archive them, and transcribe them. Nusbaum believes the recording capability is essential—not only to provide physicians with a complete record of phone conversations to stay organized, but also to help protect them in the event of a lawsuit. “If you call your credit card company, they record the conversation,” he says. “But speak to your doctor about healthcare and we’re not recording that. It doesn’t make any sense.” Patients are informed that they’re being recorded on MedXCom, he says.

Giffen employs a staff of 10 full-time people, including one who’s solely responsible for making sure the apps comply with federal patient-privacy laws, Nusbaum says. Giffen has developed MedXCom and MedXVault for the iPhone and is currently beta testing Android versions.

Besides raising a second round of financing, Nusbaum says he is looking to recruit a new executive team. “This was designed by doctors for doctors and patients, but we’ve grown to the point where we need to have professional management,” he says.

As for the rapid proliferation of competitors in the EMR space, Nusbaum remains confident he can keep his company ahead of the curve. “The future is really in integrating those EMRs and getting all that data together,” he says. “We believe we’re going to be the company that does that.”

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