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I think one of the most interesting pieces of your offering is the ratings system for hospitals. This will surely stir the pot if it hasn't already. Great tool for patients to make informed decisions and pressure their providers to be more open. Are you doing anything to include the digitized records as structured data/go the HIE/FHIR/interop route?
Hi @lukedeannif – thank you for bringing our Hospital Scores (https://www.patientbank.us/stats...) up! It is an important piece of our offering, since we learn a lot as we gather records for more and more patients. These learnings are useful to inform patients' decisions, encourage hospitals to perform and show appreciation to the institutions that are already doing a great job fulfilling medical record requests. In addition to our Hospital Scores, we cover individual hospitals in our blog: https://medium.com/patientbank-blog
For the second part of your comment: We currently have 5-6 ways of gathering records from institutions in the US. In all cases, we ask for structured, digitized information (CCDs etc.) and store structured data in our FHIR database. If the hospital cannot provide digitized records, we use other means (OCR) to start digitizing the records.
Hope this addresses your comments :) And thanks again for your support!
Hey @lukedeannif, glad you like the hospital ratings! Our hope is to push some accountability to the HIM department -- typically it's a bit of an afterthought in the patient experience. As for formatting the data, we accept records in a number of formats (browser-based upload, DIRECT, etc.), and we're looking forward to more widespread adoption of HL7/FHIR standards. Currently, however, most hospitals exclusively release records over fax, which we serve to users as PDFs.
@mert_celebi Awesome. I can see a real opportunity to structure the records after you receive them and increase interoperability and flow of information. Are you all thinking about what you can do with these records other than simply delivering them to patients? I realize that may touch on HIPAA issues, but it could also be a huge value add for patients and the health care delivery system.
@lukedeannif@mert_celebi Yes! Data fragmentation in healthcare causes lots of problems, so giving patients easy access to their own data is just a start. You're right that we have to remain HIPAA-compliant, but eventually we want to empower patients to share their records for research.
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To get the docs securely in your portal, are you using HL7, APIs or some other industry secure standard?
Hi @mrabramowitz – that's a great question. So while the way a user orders medical records on PatientBank is the same across all U.S. hospitals, we have 5-6 different ways hospitals can fulfill those orders – we do whatever it takes to help the hospitals comply. These vary from fax or even snail mail to integrations (i.e. DIRECT to pull CCDs). We actually opened up a lot of our performance data from hospitals here, if you're interested: https://www.patientbank.us/stats...!
Thanks for the question @mrabramowitz! As @mert_celebi mentioned, we offer hospitals a variety of methods for fulfilling PatientBank requests. In most cases, they actually still use fax to send medical records to us—and we're responsible for ingesting and digitizing those documents. We also give every hospital their own credentials to a PatientBank portal they can securely upload files to.
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@pfletcherhill@mert_celebi last question(s): are you working with only hospitals? What about small practices? And are you seeing pushback or reluctance to send docs to a 3rd party? Great app. I'm excited for your success!
@mrabramowitz we appreciate the kind words! And no, we're not limited to hospitals—the process is the same for a large academic hospital as it is for a single physician practice. Some large hospitals have certainly posed more of a problem than others, effectively resorting to data blocking behavior. But the goal of our hospital scores (https://www.patientbank.us/stats...) has been to bring more transparency to who actually is pushing back vs. accepting new ways.
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This has been done by several startups and a good many fail. This is in part due to so many disparate systems and those systems not written to talk to each other. Then we have several hospitals and doctors offices with their own integrated systems that you're going to have to deal with as well.
So my first question is are you adhering to HIPPA regulations for storage of records? You're security is outsourced to another company, where are you documenting what they are doing for PHR protection? You're basically scanning copies of faxes or pages of health records, why not work to actually digitize through OCR and not just serve a pdf. You're more of a digital filing cabinet it seems.
I'm not trying to be rude I've just been in Security and dealing with several in the same space you're in and I'm seeing things that have me concerned.
You're absolutely right, @hgottfried—there have been a number of notable attempts to create patient-centric medical record systems (i.e. Google Health and Microsoft HealthVault). I would add though that what we're doing today is just one small piece of that system. We're starting by just helping people order medical records more easily (online instead of over the phone, over fax, or in-person).
@mert_celebi can give a more in-depth description of our security measures. Though most of it that pertains to HIPAA can be found here: https://www.patientbank.us/legal....
The question about why we don't seem to process the data much when it is returned is a good one! Most of this discussion boils down to prioritization though.
We have implemented a number of systems to extract data from PDFs and normalize data formats. However, the majority of our users aren't asking for us to solve that problem. They're asking for help requesting medical records—often in PDF form, because that's what the doctor, lawyer, or insurance company asked for.
So ultimately, we're very interested in standardizing the medical data itself. But right now we're kept busy just helping people access any data at all!
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Awesome work, team. Quick Question: how does this work with military medical records? I suspect there are a ton of veterans out there who need help hunting down medical records from their time in service.
Keep up the great work! Love the clean UI and easy user experience. I've been waiting for something like this for a while.
Hey @khalil_tawil, I hope all is well! Thanks for note and well wishes.
You can create requests for records from any VA hospital like you would for any other public hospital with PatientBank. Our database includes a list of the VA hospitals. If you are referring to the actual service records it seems like there is different process: https://www.archives.gov/veterans/. Does that answer your question?
This is awesome. The website is informative and well designed. Overall PatientBank is doing what the healthcare industry should have done several years ago.
One question: how does security work? Are my personal medical records stored on your servers somewhere?
@derek_t_lo Thanks Derek! Good question about security. We do store the records on our servers--we use HIPAA-compliant hosting and practices to make sure records aren't accessed when they shouldn't be. We use a great company called Aptible to handle a lot of this—you should check them out too at https://www.aptible.com (cc @fancyremarker@chasballew)!
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Your pricing is pretty reasonable. Do you also charge doctors/health facilities for access?
Are you in contact with the regulatory bodies OCR (for HIPAA), CMS (Medicare & Medicaid), ONC (IT)...AHIMA etc... I wonder what their take will be? @pfletcherhill@ahimaresources
Thanks for the note, @osayilasisi! Whoever is requesting the medical record pays the processing fee. In most circumstances, individuals are requesting their own medical records (or info for a family member). But in some cases, we do have hospitals or other healthcare orgs requesting. The Yale-New Haven Health System is a good example of one of those.
From a regulatory perspective, HIPAA is crucial for us! Without it—and the right it gives patients to access their medical records—we would have a very hard time convincing hospitals to respond to us. We don't work directly with any of the organizations you mentioned, though we've collaborated with GetMyHealthData. Check them out here: https://getmyhealthdata.org.
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Best. Thing. Ever. I had Cushing's Disease. It's difficult to diagnose. My case took almost 10 years, doctors in 4 states, and file boxes full of medical records. Patients with incurable diseases or chronic conditions have even steeper mountains of paperwork to manage. A service like PatientBank will help patients and caregivers spend more time living and less time doctoring. That's high up on our list of dreams.
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