YourDoctorsAdvice.org uses call recording to help with health care compliance

YourDoctorsAdvice helps patients follow medical advice by turning ordinary cell phones into call recording devices

Decades of debate over how to fix the health care system have convinced nearly everyone that there are no simple solutions.

But Fred Trotter, an open source hacktivist, refused to give up on his belief that the right bits of code could change the world. The original author of FreeB, the world’s first GPL medical billing engine, Trotter had just finished writing a book about health care information technology, when he got the idea for a simple hack that could theoretically save millions of lives.

“One of the biggest problems in health care is that patients do not do what their doctors tell them to do,” Trotter says. The clinical term for this problem is compliance. But often that’s just a fancy way of saying that patients are forgetful.

Trotter’s idea: turn a regular cellphone into a call recording device. He built a app called YourDoctorsAdvice, now live in public beta, that lets people record their doctor’s instructions during their visits and then replay the instructions at home. The HIPPA-compliant app, which is powered by Twilio and protected by secure encryption, makes it easy for patients to share the recorded medical advice with a family member, friend or even another medical provider.

The app is specifically designed to span the digital divide. “Internet access is not consistent among the very poor, but cell phone penetration is more than 90 percent by some estimates,” Trotter says. “Often the very poorest in our society are the sickest, and Twilio helps us build a tool they can use and afford.”

YourDoctor’sAdvice costs $19.99 a year for up to six phones. Trotter is also releasing the code as an open source project, so that hospitals, physician groups, and other medical providers can offer the service to their patients and customize it to their needs.

Trotter sees a future in which all personal health record systems add “audio recording” to their services, improving health all over the world. “This app is going to change health care,” he promises.

  • Ssmithson

    How is this HIPAA compliant?  Twilio doesn’t sign the required HIPAA Business Associate Agreement, and the recordings are stored on their servers.

    • We take privacy and security seriously at Twilio, though the HIPAA compliance will be based on the company building the product. HIPAA compliant apps can, and have been built on Twilio, but using Twilio in and of itself cannot guarantee HIPAA compliance.

      • Derek

        I would respectfully disagree that you can build HIPAA complaints apps on Twilio. Twilio stores data permanently (like SMS) on their servers. Since this is not temporary, this suggests that Twilio MAINTAINS ePHI. Which would mean they are not exempted from needing a BAA. If Twilio refuses to sign BAAs (which seems to be the case), it does not seem possible that they could be used to achieve full HIPAA compliance.

        It seems that with a few small steps, Twilio could fall under the CONDUIT exception (like the USPS). Allowing us to delete data from our accounts or auto-deleting data after a temporary period would go along way to helping us.

  • Ssmithson

    How is this HIPAA compliant?  Twilio doesn’t sign the required HIPAA Business Associate Agreement, and the recordings are stored on their servers.

    • We take privacy and security seriously at Twilio, though the HIPAA compliance will be based on the company building the product. HIPAA compliant apps can, and have been built on Twilio, but using Twilio in and of itself cannot guarantee HIPAA compliance.