Troy Bannister is the CEO and co-founder of Particle Health. Troy has 15 years of healthcare experience as an EMT, researcher and investor.
getty
When I started Particle Health four-plus years ago, the picture I had in my head was simple: I wanted to download an app and easily pull all of my medical records into it. Thinking about all the things developers could build on top of our medical records ushers a sense of mega potential in an industry that is unnecessarily burning cash and time everywhere we look. It happened in finance when Plaid enabled apps like Venmo, Mint and Robinhood—so why don’t we make it happen in healthcare?
But still, years later, we continue to wait. I attend weekly calls with policymakers, stakeholders and other entrepreneurs talking around the problem we so desperately need to solve, and I wonder, "How is it that we can entangle quantum particles or connect ultra-high-speed internet through hundreds of satellites orbiting our planet, but we still must use the fax machine to get our medical records?”
There is a big moment coming, however—perhaps the last of a series of moments that have yet to be properly leveraged. But still, for the optimistic, it's a moment of potential change.
The government has made it clear: U.S. citizens should have the right to access their own medical records via technically feasible ways. The rule that was set into law years ago is called “Anti-Information Blocking,” and like it sounds, its name is pointed and direct to its nature: to eliminate the blocking of access to people's own medical information (check out HealthIT.gov for more information on this important rule).
But we live in a capitalist world, and by the virtue of how it all works, even healthcare is unprotected from self-servitude. Healthcare data is valuable to those that capture it and sharing it would drastically dilute, if not extinguish, the value. Plus, it would open up risk to those that house the data. What if I discovered there was malpractice evident within my own medical records?
In the same way, Apple’s App Store shaves off 30% from every purchase or subscription, those monolith quasi-monopolies in healthcare follow the same adage of self-prioritization and profit-seeking behavior. And why shouldn’t they? This is the way it works in the U.S.—that is, unless the government steps in.
Now, the Anti-Information Blocking Rule is shaking things up a bit. It’s given rise to avenues of access never seen before. Today, a provider can use an API to search for their patient’s records across the U.S. using just their name, birth date, address and phone number with a 90% success rate. This means the historical hoarders of data are now willing to share it with other providers at risk of moral bankruptcy, but now also at risk of being fined in line with these new rules—and the adoption is past critical mass.
But what if we took the same patients and let them request their own records through the API? The only difference is that there is no doctor asking for the records in-between. Well, I’m sorry to tell you this, but those that hoard the data will not share your medical records with you today. They just flat-out refuse. We’ve tried it, and we’ve seen time and time again—no records found (even if we know they’re there).
So when is this big moment? October 2022 is kind of the last opportunity to make the Anti-Information Blocking Rule actually open up access for you and me. It’s the date when we expect real fines to be administered. So far, no real fines have been issued against violators, and honestly, I don’t know where they’d even start. I don’t know a single hospital, practice or clinic adhering to the rule today. How do we feel, as a country, about a system of government that creates rules, laws and policies but allows entire industries to ignore them completely—either directly through abstinence or indirectly through lobbied, hyper-specific loopholes? It just takes one big, expensive legal shove to loophole out of a profit-wounding compliance problem.
I don’t know about you, but I’m holding my breath. If the ONC, OIG, OCR choose to fight for your right to access your own medical records, we will likely see a renaissance of innovation blossom as we saw in Fintech several years ago. If they don’t, well, maybe it’s time to invest in Xerox.
For those hoping to take steps on this problem today, if you are having trouble getting access to your medical records, it's important to submit a complaint to the ONC here. It's easy, and it's the best way to show the government the problem at hand.
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