When I took over Pacific Heights Plastic Surgery last year, one of my goals was not only to deliver great results and care, but also to acknowledge the technological advancements that could make communicating with patients easier, enhance the care I provide, and simplify processes for my nurses.
I knew I couldn’t have — and didn’t need — the same system I had used earlier in my career. I had previously served as a surgeon at an excellent tertiary-care hospital in Louisiana, where we used a commercial EMR built for huge organizations and hospitals, which allowed me to access all pertinent patient information — as long as I was on the private, firewalled network. This meant I couldn’t easily access data outside my office, and I couldn’t easily share anything externally. The EMR wasn’t really built for a plastic surgery practice, and at tens of thousands of dollars a year, the cost of such a secure server wasn’t practical for my young private practice.
I have long been curious about how medicine can better take advantage of “the cloud.” Every day, my staff and I are handling sensitive patient records. With cloud services like Dropbox, technologically, it now seemed possible to store my patient files, access them from my tablet at home, and share information with my patients or their medical providers. Even though I had used Dropbox personally, it never really occurred to me to use it in my practice. Security was the primary hang-up: I needed to make sure this data wasn’t sitting unprotected in the cloud, not only for the security of our patients, but to comply with HIPAA. My patients’ trust — and my practice’s reputation — depends on it.
Replacing the EMR
But was it possible to make Dropbox HIPPAA compliant? I did a search and discovered Sookasa, a cloud security and encryption company that does, in fact, make Dropbox secure. I realized I could use the two together as a replacement for my EMR. I was able to use a patient-records template that I developed at the Louisiana hospital, which formed the backbone of my practice. The only downside to Sookasa is that it doesn’t currently pair with cloud services other than Dropbox, but it works well with my needs right now.
We were able to get up and running right away — mostly because Dropbox is intuitive to use, and Sookasa is as easy to use as Dropbox, even while it adds this transparent layer of security. I compared that to the process for rolling out the EMR at my prior hospital, which took months for the staff to get fully acquainted. Our nurses use Sookasa to encrypt sensitive files that need to be shared with other doctors. And even if those doctors don’t use Sookasa, they can still view the patient files we’re sharing with them.
A Game Changer
This has been a game-changer for my practice. We don’t have a need for a server or a VPN, and we’ve pretty much gotten rid of the fax machine, which can be unreliable and waste a lot of valuable time. When I need to send a file to another doctor’s office, I’ll simply send them a secure, one-time link to the file via Sookasa, which is a lot easier for everyone involved. Besides, it never ceases to surprise me that faxes are still considered compliant: I can’t shake the picture of a document feeder full of sensitive data sitting there overnight, ripe for someone to steal — even the cleaning crew!
Sookasa has also helped save me time in incremental ways. For surgical patients, I obtain certain preoperative labs and to maintain my office’s accredited operating room, I also have to document that I looked at the labs. The old-school way required me to initial documents whenever a hospital would fax them over. Now, once they’re uploaded to Sookasa, I simply open them up and take a look, and a full audit history registers the time and date — just like it does for all files that are viewed by our office staff. Admittedly, this will be new to the accreditation committee when I show them this new HIPAA-certified solution, but they’ll have to come to terms with the 21st century.
Convenience for Care
It’s also been critical for responding to patient needs efficiently and compassionately. There are many times when I’ll get a call in the wee hours of the morning from a patient who’s concerned about a slight fever, or I want to reference pre-op photos for someone on the weekend ahead of an upcoming procedure, or I need to call in a prescription for a patient. It’s essential that I am able to quickly and accurately reference the specifics of a patient’s medical history. For that, I access the secure Sookasa app on my phone routinely. It allows me to provide real continuity in my patient care.
The bottom line? Sookasa brings HIPAA-compliant security to the cloud in a financially feasible way. As a solo/small group practice, I didn’t want to purchase an expensive EMR — and now I don’t have to.
Disclosure: Dr. Kaplan reports no relevant financial interests.
Jonathan Kaplan, M.D., is a board certified plastic surgeon in practice at Pacific Heights Plastic Surgery in San Francisco.