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Toward better transitions of care

September 2014

Published in the September 2014 issue of Today’s Hospitalist

CAN A SMARTPHONE APP REDUCE READMISSIONS, shorten length of stay and improve hospitalist efficiency? Toc4Med, a new app to improve transitions of care, claims that it can do just that.

Bhavik Thakkar, MD, co-founder and CEO of Toc4Med (an acronym for “transitions of care for medicine”), works as a hospitalist and medical director in southern California. According to Dr. Thakkar, Toc4Med helps hospitalists and ED physicians cut through the clutter when handing off patients to outpatient doctors.

Inpatient physicians use the app to deliver information about a discharging patient “what the app refers to as “an incident” “in real time. Doctors record a short audio message detailing items like the patient’s principal problem, hospital course, imaging results and medication list.

Toc4Med alerts outpatient providers via an SMS or e-mail with a link to the recorded incident. The audio file is available immediately, and a transcribed copy follows within an hour for additional review.

To enhance physician compliance, the platform tracks recipient engagement and reminds receiving physicians if incidents remain unread. The goal is to encourage incident viewing within 24 hours. Administrators may get involved for reports that remain unviewed.

To help reduce readmissions, Toc4Med also profiles patients’ risk of bouncing back, flagging each patient with a color-coded indicator to help physicians prioritize their care.

“The app allows primary care doctors and organizations carrying risk to keep a close eye on patients,” says Dr. Thakkar. “It also reduces the risk of readmissions by providing real-time, actionable data.”

Why create another stream of information between inpatient and outpatient providers? Dr. Thakkar says that discharge summaries and electronic notes often miss the mark and lack the human touch of a verbal handoff.

Some hospitals are still waiting for EHRs, he points out, and fax numbers are notoriously out-of-date. Even faxes that get through to doctors’ offices often sit unread, while discharge summaries are full of what Dr. Thakkar calls “data primarily geared toward the billing process and to supporting various diagnoses.” Toc4Med, he says, sends “the nuts and bolts that doctors need to have an impact on transitions of care” while providing a comprehensive care document.

Using the app doesn’t impede hospitalists’ workflow, he adds. “This app expedites the process.” And doctors appreciate the speed of getting messages dictated via a mobile phone and “not being strapped to a computer.” Future offerings will include a billing platform, a patient portal, and picture and video capability.

The company behind the app, HappyDocs LLC, is marketing Toc4Med nationally. More information is online at www.toc4med.com.