You probably saw some of the headlines last week where Box announced that is supporting HIPAA and HITECH compliance, signing Business Associate Agreements, (BAAs) and integrating with several platform app partners such as Doximity, drchrono, TigerText, and Medigram to help seed its new healthcare ecosystem. I also announced that I was formally advising Box on their healthcare strategy.
I was drawn to Box because of all the lessons I learned at Google building a consumer-directed, personal health record (PHR), Google Health. Google Health allowed you to securely store, organize and share all of your medical records online and control where your data went and how it was managed. It was unlike the other PHRs in the industry that were tethered to the provider or payor or part of an Electronic Health Record (EHR) system.
Sound good? Well, it was in theory. The big issue with Google Health was aggregating your data from the disparate sources that stored data on you. We had to create a ton of point-to-point integrations with large health insurance companies, academic medical centers, hospitals, medical practices and retail pharmacy chains. All of these providers and payors were covered entities in the world of HIPAA and were required to verify a patient’s identity before releasing any data to them electronically. It was a very bumpy user experience for even the most super-charged, IT savvy consumer.
When Google Health was discontinued in January of 2012, I started using Box for my family’s medical record aggregation needs. That’s right, the queen of patient portals moved away from PHRs and started using a secure Box folder to organize copies of her family’s medical records. This included: scanned copies of paper files, Evidence of Benefit (EBO) statements, consult notes, and imaging studies (x-rays and MRIs from CDs that were burned for me at my Mom’s doctor’s office). I now give access to my health folder in Box to family members and other care providers as I deem fit. And because Box offers support for HIPAA compliance, I am even inviting office staff at my Mom’s doctors’ offices to access her medical records via Box.
The Future of Medical Record Aggregation in Healthcare
There is a great amount of work going on at the Office of the National Coordinator for Health IT (ONC/HHS) and in the private industry on interoperability, file transport and data exchange. But let’s be honest, we are not fully interoperable as an industry yet. And I can say this given I worked in the inaugural ONC office back in 2005 when it was first set up under Dr. David Brailer and the Bush Administration.
The Direct Project and the Blue Button initiative are very promising and so are HIE profiles, but the bottom line is this – Meaningful Use Stage 2 is coming in early 2014, and most EHR companies are scrambling to meet the new criteria around giving patients access to their medical data. In order to continue to get paid by the government, doctors using EHRs have to prove that 0patients can download, view and transmit their medical data. EHRs also have to demonstrate a low bar for data exchange.
So here is my hope for the future. If most EHRs can currently export a Continuity of Care Document (CCD) via the Clinical Document Architecture (CDA), why couldn’t Box grab that clinical care summary format and stylize it in a way that made sense to other doctors or patients via its documenting previewing technology? This would help the interoperability and file transfer juggernaut get a whole lot easier.
There is still a ton of work that needs to be done in this area, but it’s a good day when I can take my Mom to 3 doctor’s appointments in different community practices and every practice is on an EHR. It’s even more rewarding to see that 2 out of 3 doctor practices have patient portals connected to their EHRs. Now I just need a safe place to keep all of her medical content, as the onus is on me, the consumer, to extract data from each EHR solution and aggregate it into a format that makes sense to my family and my mother’s attending doctors.
And this is exactly why I got excited about the Box vision: to deliver simple, secure content sharing that users and IT love and adopt. Box doesn’t have all the answers yet, but by applying its elegant solution for file sharing and collaboration in the cloud to healthcare, it certainly can solve some of my own healthcare file sharing needs as well as the average patient’s needs.