A View Into The Quiet Health Tech Revolution

The challenges of mending a broken system

Jessica Mendoza

Published in

The Startup

6 min readMar 22, 2018

An optimistic discovery

Last fall I had this idea to create a company to digitize health records. The company would add all patient health records into one place, an app, and the patient would have access to their entire health history when they needed it. The idea came about after I lost a piece of paper containing all of the vaccinations I had ever taken since I was born.

At that moment, it felt that leaving a paper trail of medical information without any digital copies was an outdated, sloppy and foolish system.

I shared my idea with a couple of friends, and the one who knew the most about the healthcare industry said that it was impossible to create such thing, that the bureaucracy and the highly regulated environment around the U.S. healthcare system would allow me to have a solution in ten years.

Nonetheless, I was curious, so knowing almost nothing about the health industry, I searched for aggregated health record companies and didn’t get any good results. So, I went to the drawing board and drew up this:

After some time I abandoned the idea, I was discouraged and had a couple other projects and ideas occupying my time. Of course, once I abandoned it, it appeared in a Slack channel I was browsing, I found OneRecord.

OneRecord is a company that allows you to see your health records all in one place. They have been established in New York City for a couple of years and are working with New York State to standardize health record data.

I was jumping with excitement when I found them. I was happy to know that people are working on solving this challenge and are much educated about the issues that in the health industry.

I met with the founders of OneRecord the day after Apple announced they had plans to bring patient records in their Health app. These two women were not concerned, they understood the ins and outs of our broken healthcare system.

A broken industry

Even knowing the core basics of our health system made me realize that patients and their data are part of a system that, ironically, needs better care.

“Binders on a shelf.” by Samuel Zeller on Unsplash

Paper trails of your information

When you go to a hospital or see a physician, there are two things that usually happen.

Either you are asked to enter your personal information on an iPad or computer. This happens in new or modernized medical facilities.

Or, more likely, the office assistant hands you a clipboard that contains 5–10 pages to fill out with your personal information, insurance details, circling areas of concern, previous medical illnesses, and medical family history.

If you have a chronic illness or are simply looking for a second opinion, you will have to go through the same process at the new location.

One of the founders of OneRecord knows this story all too well. When she was in college, Morgan Knochel, found herself sick and no doctor could identify a cause. She took it upon herself to collect the paper trail of information: medical tests, results, prescriptions, and other medical information about her medical profile. She added everything into binders and showed it to each doctor she visited until one doctor was able to connect the dots and discovered she had a rare genetic illness.

Logins and portals

When it is time to review your results, generally there is an option to log in to an online portal. Some medical facilities have one, some insurance companies have another, and sometimes it’s combined. Portals are a market of their own.

Patient portal providers are platform companies for hospital and insurance networks, and their service is to make it easy for healthcare professionals to store and find your electronic medical record. It makes business sense, except that they fail to recognize that patients may have more than one doctor at other medical facilities and have medical history recorded with them too.

In order for patients to keep track on their medical record they need to remember multiple login and passwords and access different systems.

A mess of data

One of the most significant challenges that companies in health tech face is how they can interact with existing health records.

There are a couple of areas where your data can get messy.

First, the patient portals holding your electronic medical records do not have a system to standardize data fields and responses. That means that if you or the person inputting your records misspelled your name or vaccination, it is harder to aggregate your data and validate its accuracy. Data scientists now have to think creatively to ensure that the correct information is being pulled into one electronic health record.
Second, there may be multiple people with very similar names and health characteristics. OneRecord found a case of a family that had named all of their sons with the same name and they were all in close age range. Given that they are related they also have higher chances to have similar health records. It all amounts to the list of challenges for data scientists to pull clean and accurate data from similar records.
But, there is a silver lining, health information exchanges are using FHIR (pronounced “fire”). It stands for Fast Healthcare Interoperability Resources, which is a resource to standardize health data for programming use and electronic health record use and facilitates sharing medical information securely between hospitals and clinics. This sets a structure to follow for data gathering, which is a good principle to maintain for data going forward. But there still needs to be a reconciliation process for historical records with unorganized structures.

Self-identification issues

While FHIR sets the standard for electronic health records, there isn’t yet a standard to allow you to self-identify your records and keep your health privacy secure.

Each tech company entering the health market has a different method of authorization and self-identification for one’s records.

A fragmented future

Tech giants including Apple, Microsoft and Alphabet, Google’s parent company, are vying to obtain a larger slice of American health care spending, which amounts to more than $3 trillion annually.

While Apple’s approach is to partner with hospitals to gather health record data, OneRecord’s focus starts with state government health data. Their users don’t need an iPhone or an Android to get access to their records. The information is accessed via their web portal, making it easy for everyone, including low-income families, to gain access to their health information.

Other companies are shifting their focus to benefit the people who are closer to them, their employees. Amazon, Berkshire Hathaway, and JP Morgan Chase are also developing a new venture to provide affordable healthcare to their employees.

It is clear that small companies and large companies are slicing the pie as much as they can to define their market share. They are planting the seeds for their future market in healthcare, aiming to bring benefits to different segments of the U.S. population who are already feeling the aches of a broken system.

The road ahead

There is a quiet health tech revolution happening in the U.S. Slowly tech companies are investing time, money and resources in the healthcare industry.

Companies like OneRecord are no longer alone in their fight to provide ownership of records to the patient.

Davids and Goliaths are appearing and looking to conquer their space before anyone else does.

For us, it is a matter of time to get full access to our health records and reap the benefits from health tech innovations.

For them, a challenging journey awaits and more than meets the eye will need to be handled with care.

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