Medgadget: What is a "medical domain"?
Scott: To discuss .md or the “medical domain” it is useful to first establish a common vernacular. In the Domain Name System (DNS) hierarchy of the internet there are Top Level Domains and subdomains, a subdomain is logically a domain that is part of a larger domain. For example, "medgadget.com" is a subdomain of the .com top-level domain (TLD). Examples of top level domains (TLD’s) are .com, .org or .gov. These were the original efforts to create some “vertical segments” for the internet. .com was intended for commercial entities, .org for nonprofits and .gov for agencies of the Government.

Max.md is the name of our company as well as our website, and we have created a TLD for Healthcare with the .md TLD. New TLD's like .md or .travel, .jobs or .tv are all evolving on the web and for good reason .com is a very crowded domain in terms of sheer numbers. There are around 70 million subdomains in the .com TLD and the total number of domains in all TLD’s is just over 150 million domains. This is relevant when you consider that an advanced vocabulary for an adult is around 6000 words. This is particularly noticeable when you attempt to register a .com domain name to establish your online identity.

Medgadget: So you're confident that this "internet" thing is going to catch on?
Scott: It is estimated that 25% of all internet searches are healthcare related. And it is pretty common to bump into some questionable or even objectionable content when researching on the internet. We felt that creating a healthcare “vertical” would serve the needs of both consumers and healthcare organizations well.

Recently the National Research Corporation completed a survey of 200,000 households for its Healthcare Market Guide. The report covered the top 200 MSA (Metropolitan Statistical Areas) in the U.S. The findings of which were recently highlighted in a Ihealthbeat article. From that article we know that consumer’ top online health activities primarily involve both researching and locating services online. They are researching Prescriptions (38% of people) Treatment Options (37%) Medical Procedures (37%) and Disease/Wellness information (31%). After that they are mostly using online sources for locating Directions to a facility or hospital and attempting to locate Doctors by searching through online directories.

.md Because Medicine is your Domain captures the essence of our strategy, efforts and our message. In .md MaxMD is addressing some unique considerations and obstacles that have kept healthcare organizations from capturing the efficiencies and cost saving that other organizations and businesses have long enjoyed through use of the internet.

Most importantly given our unique infrastructure; namely our secure communications platform (patent pending) and focus, we feel that some proposed solutions being offered today in .com are considerably more expensive than they need to be. .md is simply a better mousetrap than the portal structure approach that is characteristic of many .com solutions that is currently accepted by many as the best or sole option.

Medgadget: Have you done any pre-market research to support the need for a "medical domain"?
Scott: Yes, Market Research has been conducted at various points in our 4 years of operating history on several topics by several different organizations such as, Goodmind, Manhattan Research, DigoBrands and Veritas. The research uniformly indicated strong interest in the domain from healthcare organizations and personnel as well as consumers. This was a driving reason for our continuing efforts to invest in the value proposition of a .md domain name registration. DiGoBrands assembled a statistically relevant number of consumers and established that 60% of those tested could not distinguish a real Doctors website from a fraudulent Doctor’s website.

We continue to add value for users by adding .mdEmail®, .mdSecureIM™, Free Domain name forwarding the .md Webcard Plus and more. The fact is we grow our domain virally and through partnerships with organizations such as the Southern Medical Association (SMA), AnswersMediaInc, Verisign and DraftFCB Healthcare. Just recently we established a relationship with DistributeIT an Australian Technology company that requested reseller status after some of their 1500 healthcare clients requested access to .md products. We have reseller arrangements with almost 30 organizations around the world.

Medgadget: To further enable consumers to identify legitimate sites, you've instituted a "physician versification badge." Can you tell us more about that?
Scott: We developed the Verified Physicians Badge and our secure Communications platform (Patent Pending) as a result of market research and customer feedback. The .md Verified Physicians Badge (VPB) is an interactive badge that improves the SEO score of the website it is displayed on. Most importantly the VPB informs consumers that the physician associated with the website is a real Doctor and is licensed to prescribe. Our primary goal in developing the .md VPB was to address the fact that there are very low barriers to fraud on the internet. We wanted to develop a mark that would assure consumers that those that displayed the VPB were in fact Physicians in good standing and not someone that was able to put up a website.

The VPB can be displayed on any website but it is only available to those that have a .md domain name registered with us. This means that if you have an existing website in .com or .org for example, your VPB can be displayed on that website and we will forward your .md domain name to that website for no extra cost. This will improve your ability to be found. We did this so .md would not present an either or choice and it is addresses early web adopters in a favorable way.

Medgadget: Why is it important for a physician to have a personalized medical website?
Scott: First off let me state that we believe a Doctor is a brand. Doctors work for years to establish a skill and reputation for excellence through school, continuing education and practice. Think about how someone finds a doctor. It is generally a referral from a trusted source and it is almost assuredly by name. Even though a Doctor might not think in those terms if you consider the facts people generally come to realize that is the case. We think it is important that physicians have some web presence simply because it the medium of choice by consumers and virtually every survey of consumers reflect their desire to locate and communicate with physicians online. That is not to say that a physician needs to spend a lot of money on an elaborate website. Most physicians can meet the desires of their patients with a simple web presence. We can establish an online identity for a physician for a fraction of the cost of a yellow page advertisement with greater functionality and the odds are it will be seen more readily as the internet becomes more ensconced in the minds of consumers.

When a physician purchases a .md domain name, he creates the foundation of his virtual practice and establishes an online presence that is his professional address on the web. He also gains access to a secure communication platform as part of the value proposition. With each domain name each registrant receives a free .mdEmail® account in addition to other tools and every time the phsysician sends an email they are reinforcing themselves as a brand.

Today it is not uncommon to see Doctors using email accounts that are not secure. It is not uncommon to see their email address as a series of numbers and letters at AOL, hotmail or yahoo.com. Current estimates are that about 20% -30% of Doctors are emailing with Patients yet only about 7% are doing so securely.

When Dr. Osler sends an email from William@Osler.MD we think it is unlikely his email will be deleted with out being read, or mistaken as spam, his URL will serve as a permanent and portable web address that will not be out grown for the duration of his career. If physicians uses .mdEmail® products they will be in compliance with HIPAA and they can effectively speed up the administration of care today.

Medgadget: You used the phrase "virtual practice," how does that apply to the average medical professional?
Scott: Businesses away from healthcare in general operate both a physical as well as virtual presence. We refer to a website as a virtual presence. It is an online location where patients/consumers who are strapped for time can visit to secure services and/or communicate. It is a fact of life that consumers take advantage of everyday. An online presence or virtual practice can be a more efficient use of time for consumers and office staff. Generally it improves service and is a market differentiator in very competitive environments.

The 2007 survey of over 200,000 households by the National Research Corporation like many reports of this kind contained powerful demographic data to underline what patients would like to see from their physician. We have talked with quite a few physicians in our short history. Some Doctors tell us that they do not need more patients or offer other objections to put off creating a virtual office/website or online presence. Our position is that healthcare is a service and patients are looking for some very simple conveniences. We see elements of disintermediation by Doctors/practices either intentionally or not; there are younger more tech savvy Doctors that will provide these services largely because these patient requests are not difficult to meet. Those that do so will win patients away from those that take a hard line or practice disintermediation. It is a market after all and good customer or patient service is as important as a good bedside manner.

Medgadget: Max.MD's recently partnered with AnswersTV.com, how does this benefit the average physician?
Scott: By combining MaxMD’s secure communication platform and AnswersTV Health best in class, original content and 1080 High Definition programming capability we will deliver to Physicians and practices an ability to communicate securely anywhere over the web and an unparalleled Disease State specific programming that will be accessible by patients when they visit their Doctors website. The key components of the joint offering will include a .md domain name, serving both as the web address/or front door of a physicians virtual practice and the basis of the Physicians secure .mdEmail® account, secure Webmail client and .mdSecureIM™ and most importantly a simple website that contains AnswersTV Health 1080 HD Video Player and library of original High Definition programming hosted by Jane Hanson, the Emmy Award winning Journalist.

This collaboration is designed to put in the hands of Physicians and Practices the fundamental capabilities to harness the power of the Internet to both to speed up and augment the administration of care.

AnswersTV Health original program known as the Answered Patient is designed to cover the continuum of care, be a trusted source, improve compliance and enhance the patient/ physician relationship.

The AnswersTV original content is all evidence based, fully vetted, double sourced and has gone before a medical review board. This video on demand capability is a perfect fit for patients and Doctors a like.

The episode structure of AnswersTV health consists of an Overview of Diagnosis and Treatment, and addresses questions like; what are the symptoms? How is it treated; i.e. diet, medication, and compliance. It also contains personal stories and information for better health.

Your Doctor is your most trusted resource for you and your families’ health. MaxMD/AnswersTV Health is providing the tools to Physician and practices to help them recapture share of mind with their patients. We believe that a Doctor is a brand. We give him the tools that reinforce the Doctor as a brand.

Those tools include a domain name that is distinctive, descriptive and mnemonic, a permanent and portable web address that will sustain throughout his career. A Secure .mdEmail® account that allows him to communicate securely anywhere on the web to speed up the administration of care, a secure networking capability with .mdSecureIM™, and a Secure webmail client that allows users to access Email when away from their desk, and the 1080 HD player and content.

The AnswersTV video player is simple to navigate and allows for on demand viewing. Best of all it will be affordable to even the smallest practices. Unlike any other advertising supported models using Physicians will be reinforcing their own brand or practice and not some third party provider or portal.

It is easy to see that the MaxMD/AnswersTV Health offering is just what the PATIENT ordered!

Medgadget: Why should physicians communicate with secure email, instant messaging?
Scott: That is a great question. Again some background discussion is required. It is not common knowledge that standard Email is not secure. Standard email consists of a header and open text. Standard email is sent over the internet through a series of relays. In fact some free email services even scan emails and recommend advertisements based on the content of those emails. Those advertisements generally show up in the margin of the emails and that is the reason you can get a free email account from these services. It is an advertising supported business model.

In general people simply assume that email is similar to the US Post. With the US Mail you send correspondences in a sealed envelop and assume that it will not be read by anyone other than the addressee. Our laws support this notion of privacy by making it illegal to tamper with mail. Email however is much like sending a post card through the mail. As I mentioned standard email is a header and open text and is sent to its intended recipient through a series of relays and it is legible at anyone of these points. It is for this reason that standard Email does not comply with HIPAA. The HIPAA act requires that providers and “covered” healthcare organizations safe guard PHI (Protected Health Information.) There are both civil and criminal penalties for the failure to safeguard PHI. HHS (Health and Human Services) can impose civil penalties on a covered entity of $100 per instance for failure to comply up to a limit of $25,000. Criminal fines can go up to $50,000 and up to 1 year imprisonment. And fines can go as high as $250,000 and 10 years for the intent to sell transfer or use individually identifiable health information for commercial advantage personal gain or malicious harm. So this is a real issue. The good news is that MaxMD can immunize the average practice for what amounts to pennies per user per day and save even more money for a practice by using the application in other ways like e-prescribing.

When you consider that a .md domain name when combined with our practice package of 10 additional email accounts and our audit package costs a grand total of $330 dollars per year it makes great economic sense to eliminate the risk of fines.

When Physicians or practice managers consider the domain wide networking capability of .mdSecureIM™, and the fact that there are no work flow or retraining issues we think this makes great sense on many levels. Registrants receive a domain name that is permanent and portable, a secure ability to communicate with their insurance company, labs, colleagues or patients for what amounts to pennies a day. We believe this is the most unique and affordable solution one can find in the market today. Those that research other providers of secure email services will find the cost to be 3 to 4 times as expensive before considering everything else provided in the registration bundle. Additionally the .mdSecureIM™ meets the technical requirements for e-prescribing software as established by HHS.

The .md Secure communications Platform (patent pending) is designed to create a national scalable solution for healthcare organizations to take advantage of the internet and speed up the administration of care for Doctors, practices, laboratories, insurance companies and all healthcare related organizations at a fraction of the cost of much more expensive solutions that are currently being shoe horned into the .com structure. Our design is simply a better mousetrap.

The .md solution is elegant in its simplicity and utility. It works because each .md Registrant receives a .mdEmail®, .mdSecureIM™, and a secure Web mail client in addition to other tools when they purchase the .md domain name. Each .mdEmail® account integrates readily with any existing modern email client and therefore does not require switching. Each account connects to our secure servers located in Dallas Texas via POP, IMAP, or SMTP over SSL. When a user sends an email from their desktop to any other .mdEmail account no further encryption is required to comply with HIPAA because that email is never exposed to the internet. It simply moves from the desktop through a secure pipe (SSL connection) and then into the proper email box. If a user wants to send a secure email anywhere else in the world, they simply type “secure:” into the subject line and this prompts encryption for delivery to a .com, .gov or .edu address. (Any address other than .md)

Many have made the mistake of assuming that some expensive EMR and E-prescribing solutions promise a secure communication capability however that is usually with just those customers of the vendor/provider usually behind the vendors firewall. Our service is intended to address the healthcare market as a whole in a way that is affordable to even the smallest organization and is extendable in all directions. Our solution does not require retraining or purchasing a system that is redundant to existing systems and the buy-in is affordable to all and frees up capital to be deployed in other areas.

Medgadget: HIPPA laws are so complicated that they have done more to prevent, than encourage, online communications. How have you addressed this issue?
Scott: We have addressed communications between Healthcare professionals in a scalable and most importantly an affordable manner that can serves the healthcare industry as well as the Physician in particular. Our technology and approach is revolutionary because of our unique property. It is simple in design. It is not disruptive. It does not require a significant capital commitment. It can allow secure communications for what amounts to pennies per user per day. This simplicity is what allows it to scale well. It is a national solution to communicating in compliance with HIPAA. It is extendable in all directions.

It is not disruptive because it does not require switching vendors or retraining office personnel in a new operating system. It is not an either or choice that makes a new registrant abandon existing systems. Each organization reinforces their own brand and does not subordinate their brand to a third party provider or portal by using the platform. It is not advertising supported and therefore does not make users worry about misleading advertisements affecting their credibility. We believe the design’s simplicity and scalability are compelling arguments that outweigh very expensive solutions that are being shoehorned into the .com TLD. This solution complies with the technical specifications for e-prescribing systems as established by the HHS.

In the .md TLD as in the Healthcare market in general our approach establishes the Physician in the center of the Healthcare universe. Our secure communication platform (Patent Pending) for healthcare is accomplished by providing each .md domain name registrant with a secure .mdEmail® account, with paired .mdSecureIM™ and secure web mail client as part of the registration bundle. Each account connects to our secure Servers located in Dallas Texas via IMAP, POP, or SMTP over SSL. This email account easily integrates with any modern email client like YAHOO, GMAIL, OUTLOOK, Blackberry or Mozilla etc. It can be formatted for hand held devices. No switching is required it just become another email account on your desktop. Because each account connects to our servers via a secure pipe (SSL) emails are not exposed to the internet. There is absolutely no chance to lose control of PHI in these communications. In practice this means that each .md domain holder can communicate with any other .md domain holder anywhere in the world without any further encryption, without worry. To communicate anywhere else in the world like .com, .gov. or .edu all that is required is to type the term “Secure:” into the subject line of the outgoing email. This prompts encryption using our Send Anywhere feature. Users can provision passwords from their own desktop for secure mail recipients and those recipients can respond back to the sender securely as well.

We see the .md domain as a scalable solution to speeding up the administration of care that can be implemented today for pennies per user per day. We recognized that the Physicians office is a remote island in a connected, wired world. Physicians can influence their own electronic fate and the economic reality of their practice by registering a .md domain and asking their routine business partners to do the same.

Medgadget: What is the .mdEmail® SendAnywhere service and why is it important to medical professionals?
Scott: .mdEmail® has a capability that we call Send Anywhere. It describes a method for communicating anywhere over the internet. This means you can send an email to any address in any of the over 250 top level domains that comprise the internet. For example you can send a secure encrypted email to a hospital in New Delhi, India or the hospital or laboratory across town that uses a .com or .org domain name by simply typing the term “secure:” into the subject line of an outgoing email. This prompts encryption of the email and renders it unreadable to only the addressee. The intended recipient can open up the email by entering the password provisioned from a users desktop or they can create their own log in and password by following some simple instructions contained in the secure message received. Once the appropriate password is provided the email can be opened up and read. The recipients can respond back in a secure manner as well.

The .mdSecureIM™ will provide them with an unprecedented secure networking capability right off their desktop. No need to login to a portal on the web to speak with a peer or an insurance company or local pharmacy for that matter. Users can see if a normal business partner or peer is at their desk to begin a secure chat.

As an interested observer of the heath care business it appears that things are happening to Doctors that are putting them in a position where they have to constantly react to developments that they are often centrally involved in. Usually at significant cost and no apparent return.

Our Secure Communication platform ( Patent Pending) and the .md top level domain presents an opportunity to Doctors where they can determine their own fate, save significant money, earn more income, improve efficiency, and most importantly speed up the administration of care. They can speed up the resolution of aged receivables from their insurance companies by using a secure email account like claims@JoshuaUmbehr.md . No more phone tag, simply send a secure email to the insurance company with the fact pattern and PHI of the claim. It acts as a time stamp and audit trail. It will be difficult for the Insurance company rep to miss your call, be away from the desk or what ever other reason leads to so many aged insurance company payables that are collecting interest for the Insurance company. The .md can be a solution to HIPAA and E-prescribing without creating another financial burden on practices that already face margin compression; and the technology is familiar and effective.

Medgadget: What are some of the unique ways that medical professionals are using your services?
Scott: There are many interesting services and organizations that have opted to register and build their online identity in .md. Organizations and business models continue to evolve as awareness grows. There are around 20,000 Doctors represented by physician or practice websites. Aside from the value proposition of our secure communication platform and the tools we offer, there is great availability of valuable domain names that are descriptive, distinctive and mnemonic. With around 70 million domain name already registered in .com it is difficult to find a relevant domain name to establish an online identity. Domain names are valuable internet “real estate” that has potential to increase in value. Just recently the domain name fund.com sold for $10 million.

We have partnered with the Southern Medical Association ( SMA ), DraftFCB Healthcare, Answers Media Inc and are expanding our relationship with Verisign to name just a few of the businesses that are working with us.

Medical Societies and specialty groups have also created .md websites and at last count we had 5 Medical Universities using .md domain names as part of their online identity.

Medgadget: What do you tell doctors when they ask about the ROI for your product?
Scott: We tell them that we have priced our services so that the ability to harness the web and improve their practice efficiency is so affordable that an ROI or breakeven is a moot point. Realistically creating a simple website, with a secure communication capability for a practice of 10 people with 4G of Audit storage for full HIPAA compliance for less than a dollar of day or about $330 per year in my opinion does not necessitate a discussion of ROI.

In fact since it is estimated that only about 7% of physicians are actually using a secure email system we would say that the breakeven using the HHS Penalty scale for our offering pays for itself in the first four emails you send!

Medgadget: What future services, partnerships do you plan in the future / would like to see in the future / current .md users are creating?
Scott: We are working with Verisign Inc to possibly bring more sophisticated online security devices and services to our customers. Our plan is to continue to bring together resources that benefit our customer base as a whole. We could be adding more services to our AnswersTV Joint Venture for example. Our goal is to continue to partner with organizations that are recognized as experts in the field if that will help our customers

Medgadget: Where can interested professionals go to learn more about your services?
Scott: People can learn more about .md, MaxMD and our secure communications platform by visiting a few places on the web. First I would suggest that they visit www.max,md . On www.max.md professionals can click on featured sites or testimonials to get an understanding of some of the thousands of organizations that already have established their online identity in the only domain dedicated to healthcare professionals. Additionally we have some excellent tutorials that describe how people can implement and use our services and if they still have difficulty we encourage folks to give us a call. Our technical staff is wonderful with customers. They are intelligent, honest, straight talking people that will walk users through an issue. The .md registration renewal rate of 80% over the past 4 years offers new customers an assurance that we consider customer service a high priority. Professionals can also listen to a <a href="http://www.max.md/products/email.php">ReachMD podcast</a> or read about our secure communications platform on our products page. Alternatively professionals could visit the ReachMD website and listen to any of the 4 shows that cover .md and our efforts to bring the capabilities and utility of the internet to medical professionals and the healthcare market as a whole.

We want to know what the readers think? Is the prospect of fresh domain name real estate plus the secure communications package enough to entice you? Would you change your current website to a .md domain? Do you salivate at the idea of instant message notes from the pharmacy instead of pages and office calls?