Doxy.me

So today we’re chatting about Doxy.me and how it’s used at your company. Before we jump into that, could you give a brief overview of the company and your role there?

We’re a totally virtual mental health provider that focuses on helping Medicaid beneficiaries. We have around 125 providers on board who are all employees, and they cover therapy and medication management. Our team consists of different types of therapists as well as nurse practitioners and MD providers. As for me, I have a dual role in product leadership and technology leadership. This means I’m responsible for defining our roadmap for the technology we use, setting priorities, defining the necessary technology requirements, and then collaborating with our technology team to determine what we should build in-house, purchase, or partner with external vendors.

What drove your need for a product like Doxy.me?

Since we’re a fully virtual mental health provider, having a reliable telehealth platform is crucial for us. Building one from scratch just doesn’t make sense. We used to use VisuWell by Hatch, but they decided to leave the telehealth market, so we had to search for a new solution. We initially tried out a third party Salesforce App, but it didn’t perform well during our therapy and medication management sessions. Our providers had a hard time completing sessions with it. That’s when we started looking for a new telehealth platform, and that’s how we found Doxy.me.

What were the requirements you were looking for when you were evaluating Doxy.me?

So one of our requirements was that the platform offered a free trial. We wanted to pilot it. Doxy.me did, which was great. We were able to get 10 providers on board quickly. Another requirement was a waiting room feature, which would be useful in the future for things like overbooking or if a provider was running late. We also needed an easy way to integrate the telehealth session link into our patient management system, which is Salesforce. Doxy.me enabled us to send links to patients easily. As for EMR integration, we currently use Athenahealth, so we needed to know if it was compatible. Doxy.me is able to launch our EMR integration if we include the patient ID in the link.

From an administrative perspective, we were looking for single sign-on and auto provisioning. This is important to us because we’re growing rapidly and manual user provisioning would be time consuming. And that was available through Doxy.me. We also wanted to export data to our enterprise data warehouse through Fivetran, but we’re still discussing this with Doxy.me. They’re transitioning from serving individual providers to enterprise clients, so we’re talking about it. They also use Snowflake, so a Snowflake-to-Snowflake connection should be feasible.

Another concern was AI note preparation. Doxy.me is exploring a partnership with Nabla, which caught our interest. We’re not currently using these services, but medical documentation is onerous, so it’ll be on our roadmap soon. We also considered translation services and how they were priced. Most platforms charge per minute for translation services.

We also looked at the number of patients that can be included for group therapy appointments. Some platforms allow 11 users, some don’t support groups at all, while others allow up to 50 or even 99 users like Google Meet. Additionally, we considered the platform’s core technology to ensure reliable uptime. There were a few less important factors as well. Payment collection came up in many demos, although it wasn’t crucial for us. However, Doxy.me does offer manual payment collection, which might be interesting for some customers. We also explored Mend, which had an interesting no-show rate ROI guarantee. They claimed their telehealth platform was so good that it would give you a return on investment in terms of reducing your no-show rate. Ultimately, we went with Doxy.me, but we noted Mend for future reference in our comparison table.

What were some of the other vendors you were evaluating?

We were originally using VisuWell. We tried to launch a third party Salesforce App, which didn’t meet our needs. We currently have Salesforce for our patient management system, and they offer a telehealth solution powered by Amazon Chime. Building and testing it within our Salesforce environment was quite challenging. If I had more resources on my Salesforce admin site, it might have been easier, but even setting up a demo required a lot of administrative work. We briefly considered Athena’s telehealth product, but it didn’t leave a strong impression. NextGen was also a potential option, but they only sell their telehealth offering as part of a larger package. We made some progress with Mend, but their free pilot was essentially a different product called Mend Free, and integrating it would have required extra effort.

As a backup, we always have Google Meet, but it doesn’t scale well because it requires many API calls to integrate link generation with our scheduler. We briefly looked into Zoom, but they weren’t very responsive during the sales process, and Doxy.me managed to move faster, so Zoom missed out. I also had a demo with ezAccess by MOT, but their salesperson didn’t understand our needs and gave a generic demo that didn’t resonate with us. It could be a good product, but the salesperson’s approach didn’t get them very far.

What made you choose Doxy.me?

I think speed. It’s incredibly easy to get it out of the box and start playing with it. The speed and simplicity make it user-friendly for both the product owner and end users. It’s a well-executed product that’s not overengineered. Other platforms required a lot of setup and implementation time, but due to the previous platform launch that didn’t go well, speed and simplicity were the name of the game.

Another feature that my providers loved during the pilot was the waiting room functionality. They could easily see when their next patient was coming and even message the patient if they were running late. Having a single waiting room was a huge benefit for them. Other platforms had separate waiting rooms for each individual session, which was quite clunky.

Additionally, the ability to troubleshoot easily was another factor that impressed my providers and tipped the scales in favor of Doxy.me. They made troubleshooting quite simple. And we have the capability of switching from high definition to standard or low definition if the connection is poor during a conversation. It’s a very intuitive process. Another useful feature is that if a patient doesn’t grant access to their microphone and camera, Doxy.me notifies the provider and provides instructions on how to guide the patient through the process. This ease of use factor is huge, especially when you’re dealing with patients who are new to telehealth and may not be very tech-savvy.

How would you characterize the sales and implementation process?

The only downside we had in the process was that we had a new salesperson on the Doxy.me team who wasn’t fully familiar with the product yet. For instance, the Nabla integration. I never intended to purchase the product solely for the Nabla integration; it was just an added feature. However, it was marketed as already integrated when it was actually still in beta. So, looking back, I wish we had tested the sales rep more thoroughly on their product knowledge and how new they were to the company. It wouldn’t have affected our decision overall, but it was a bit disappointing.

How was the onboarding and setup?

Onboarding and setup were pretty quick. All we had to do was share a Google Sheet containing our user details. They got everyone signed up and invited them to the platform, and we were good to go.

What are the specific use cases you use Doxy.me for?

Currently, we’re using Doxy.me for scheduled telehealth appointments between individual patients and providers. For example, patient John Smith is going to have a session with provider Dr. Doe, and he receives a unique link for Dr. Doe’s waiting room. We use the telehealth functionality for our therapy sessions and medication intake sessions (60 minutes) and medication management sessions (20 or 30 minutes).

Some other features we use include the individual waiting room, patient chat, and screen sharing. Our providers find it helpful to share their screens and show activities or homework to patients. On occasion, patients also share their screens. We were pleasantly surprised by the file sharing feature. One provider shared a unique situation where they needed a patient’s medical record. The patient happened to have a copy of it, which is not always the case. However, with the file upload feature, the patient easily transferred it to the provider’s computer, and it was put right into the medical record. It was great.

What are some of the strengths and weaknesses or areas of potential growth for Doxy.me?

In terms of strengths, I think its simplicity, ease of use, and quick implementation. As far as weaknesses, it lacks integration. But it’s still highly usable due to its simplicity.

When considering what features work well and what could be improved, I find that many of the features work well. However, I do wish for better integration with EMR, such as a button to easily attach files, messages, or call transcripts to patient charts. This level of integration would push Doxy.me to the next level.

Doxy.me is a telehealth platform, and as long as there is a reasonably good internet connection, it performs well. Considering that it is now 2023 and we have gone through the majority of the pandemic, we’ve mastered the tech behind video calls. Doxy.me excels in meeting this core use case, and it does it with simplicity and the ability to modulate connection settings. It is evident that they have a competent team of UX professionals who understand the key aspects of a telehealth product.

How is the stability of the platform?

I would say it is relatively reliable and bug free. There are not a lot of stability issues, and when there is a bad connection, you can switch down to low definition.

Are there any features you’re not using?

I think the only feature that we’re not always using is the group feature, since it only supports up to 11 people. We have some groups with 12-15 members, so that’s another limitation. However, we’ve been using Google Meet to address this situation, so the only thing I need to do for my providers is better integrate the Google Meet link to send out to their patients. But that’s my own roadmap item.

How were the APIs and documentation?

One of the things I really like about Doxy.me is its simplicity. It’s so easy to use that you don’t even need an API. Personally, I like the idea that each provider has their own meeting room link, like doxy.me/clinic name/provider name. With this setup, generating a link for an appointment becomes a simple lookup task. All you need to know is the provider’s name and their corresponding link. It eliminates the need for integrating with an API, which is great.

The documentation for Doxy.me is pretty good. They have a support website called support.doxy.me which is very thorough. During the pilot phase, it came in handy for me. Whenever I received questions from pilot users, I could easily answer them and provide a link to the relevant support article for further reading. The support articles are comprehensive and cover topics like auto provisioning, SSO, and EMR integration. Although we’re currently not utilizing these features, it’s reassuring to know that they’re available. And if I want to use EMR integration, all I have to do is take the existing link and add some HTML variable passing by appending something like “?patientID=12345.” Then, the clinician can launch the EMR directly from the Doxy.me window, which is pretty great.

How has the integration process been?

We’ve put the Doxy.me link into Salesforce. In Salesforce, we have a field on the provider record specifically for their Doxy.me link. So whenever I create an appointment with that provider, I simply retrieve the link from that field and add it to the appointment. It’s a very straightforward process. Additionally, I will eventually append that patient ID into that link through a simple concatenation. These integrations didn’t require a big lift. My developer only had to add a couple of lines of code, making it a smooth process. Honestly, even without a developer, I could have accomplished it using low-code/no-code Salesforce administrators.

Are there additional integrations you’re planning on using?

We’re interested in testing the patient ID for launching the EMR from Doxy.me. It’s basically just a simple concatenation on the patient URL. We’re looking at Nabla, which is currently in beta with Doxy.me. I’m trying to get into that beta for the integration. Otherwise, we’ll just use their Chrome extension for now. With the extension, we have to copy and paste the patient ID into the EMR, which is not ideal. It would be great to have an integrated “push to EMR” button in Doxy.me.

A lot of these features are still in development, and I’ll probably have more feedback on them in about six months.

There’s one other thing on their marketplace that I wasn’t impressed by: the Adhere.ly therapy tools. Adhere.ly offers measurement-based care therapy tools. The PHQ-9 is a nine-question depression screener, and GAD-7 is for anxiety. They’re pretty specific to behavioral health. With Adhere.ly, you can assign a questionnaire to a patient and review their results before or during an appointment. I would love it if I could assign these questionnaires to a patient and they could complete them while in the waiting room. But it doesn’t integrate well with Salesforce or Athena, so it’s just an extra thing that confuses patients. It seems like Doxy.me is exploring different options on their marketplace, but many of them are not well-integrated.

If Doxy.me wants their marketplace to be successful, it’s important for them to have integrations available, so that the features from their marketplace partners are actually useful and actionable, instead of creating duplicate work. For example, if I have a patient complete a PHQ-9 with Adhere.ly, I still have to manually input the data into the structured fields in my EMR, which is time-consuming and clunky.

How is the account management and support team?

We’ve established a bi-weekly touch point with them, especially as we get up to speed on launching all the features we want. Overall, they’re pretty good, but it seems like they’re spread a little thin, and their response times can be a bit slow. Currently, we’re mainly focused on technical questions regarding the implementation of launching our Athena charts from Doxy.me, and it seems that they heavily rely on the same technology resources that are stretched thin. Despite this, they are knowledgeable and willing to assist, just a little slow. But that might be because we just move fast.

Do you think you made the right decision moving forward with Doxy.me?

Yes, so far, so good. We made the right decision with the information we had back then. I’m not sure if we would’ve chosen the same thing if we weren’t feeling pressure, but given the situation, it was certainly the right decision.

Is there anything in particular that might cause you to reevaluate vendors in the near future?

If the call quality suddenly deteriorated, it would be a major factor in evaluating our current solution. Additionally, as we look at other EMRs and other vendors, if there are alternative options that integrate well with our tech stack, that could be another reason we potentially look at another product.

What advice do you have for folks who are looking into products like this?

Do the trials. See what you can pilot, and see what you can get your providers to test, because we found that to be really telling. I had providers who were offering me brownies and flowers if we signed a deal with Doxy.me. They loved the pilot so much that they then became my change agents.