Wed · Aug 10

PatientBank is Creating a Unified Medical Record System

PatientBank gathers medical records on behalf of individuals and businesses. Rather than faxing in documents or visiting the hospital to make an information request, PatientBank lets you request your files online and receive it in about ten days, which is three times faster than the average request.

Since October 2015, PatientBank has collected more than 10,000 medical records from over 2,300 hospitals. We sat down with co-founder Paul Fletcher-Hill to discuss how PatientBank is changing the healthcare industry.

What YC Likes About PatientBank:

"Software that gives patients more control and transparency around their care is truly useful. This is one key piece of how software will inevitably make our healthcare systems better."
-Dalton Caldwell, Partner at Y Combinator

How did you start working on this idea?

Two years ago a couple friends and I wanted to build an app that used our own medical records. We assumed it’d be easy to access our data but quickly realized that was not the case. To get our records we had to mail in formal requests to all the hospitals we’d ever been to, and we ended up with piles of paper to sort through. We decided there had to be a better way, and that was when we started building PatientBank.

Since we graduated from Yale, the first hospital we talked to was the Yale-New Haven Health System. Through them, we realized that obtaining medical records is a common problem not just for individuals but also hospitals, researchers, and private practices.

Why did you start with hospitals?

Hospitals have intake departments where workers welcome new patients and obtain medical records. Each department has a piece of paper with all the local hospitals’ fax numbers scribbled on it. The intake coordinators have to look their number up and then mail, fax, or call in to make those requests. It’s a very manual process.

What we’ve done with PatientBank is streamline and standardize that process. Now, hospitals just log onto our web portal and enter the doctor’s information and what type of medical document they’re looking for. PatientBank generates all the necessary forms and submits them automatically. By law, every doctor’s office has to respond to these requests but how they handle them differs greatly.

The great thing is that at this point, we’ve requested medical records from nearly half the hospitals in the United States, so we have an understanding of how each of them works. It was a struggle at first, but once a hospital receives twenty requests from us, they start to adapt their processes.

Do hospitals charge for these medical records?

That’s a big point of contention. In the U.S., there’s a push to give patients access to their medical records and right now hospitals are given 30 days to respond to requests. However, they often take more than 30 days and are allowed to charge a reasonable cost-based fee. It’s pretty ambiguous, so you have hospitals that don’t charge at all while others charge hundreds of dollars. We charge a flat fee per medical record.

Why can’t you just do a check up with a new doctor and fill out the forms again?

Obtaining medical records is often not for primary care. It’s usually for specialty visits or insurance purposes. When you see a specialist, they need to see your medical history to understand previous diagnoses and medications. Even if you were to fill out a form, doctors don’t entirely trust it because patients often forget what kinds of medication or tests they’ve taken. So doctors just ask that you bring your medical records to avoid all this.

That makes sense. How does requesting your medical records through PatientBank work?

You create an account and enter the information of the person you want to request medical records for. That could be either yourself or a family member. After that, you add all the healthcare facilities you’ve been to -- hospitals, primary care doctors, and testing facilities where you’ve had tests done. From there, you sign a digital authorization form and you’re all done.

On our end, we send a request to each of the facilities on your behalf. Usually this is done through fax. And yes, we had to buy a fax machine for this. (laughter)

The facility then faxes us the records or they can submit it through our online portal. If they send it to us through fax or mail, we digitize the documents so it’s accessible in PatientBank and can be shared with your family or next doctor. We have a database of contacts for more than 2.5 million offices throughout the U.S. so if we can’t find your doctor in our database, I’d be surprised.

You’re dealing with a lot of personal information. How do you keep all this secure?

We use another YC company called Aptible. They’re experts in securing protected health information, and we follow best practices to make sure our servers are safe. We hired a group of hackers to see if they could break in when we first started working with the Yale-New Haven Health System. They spent a few days trying to break in and ended up writing a report raving about how secure we were.

With so many hospitals, you must have a lot of data. Do you do anything with it?

We’ve worked with more than 2,300 hospitals to date. For each medical request, we track every status change. That means we know the average wait time, what format the record is in, whether or not they charge, and how often they reject medical requests. Using all this, we create a business score that ranks all the hospitals on how efficient they are with medical record requests.

It brings transparency to this really obscure process. Now, users have an idea of how long they’ll have to wait before they get their medical records. Over time we want to work with the government to help hospitals improve because this dataset is totally new. For instance, we’ve shared our score dataset with an organization called GetMyHealthData so they can help hospitals improve their processes.

Why has no one built this yet?

There's been a lot of good software built to store and manage medical records. But the process of accessing medical records has not changed. It seems like a small piece of a very large problem, but millions of requests for information occur every week—almost all over fax or in the mail. At PatientBank we're starting with a simple tool to streamline this process and growing from there.

So, you want to unify all the medical records for each individual?

Exactly. Right now you, as a patient, have as many medical records as you do doctors—and they're all in different formats and with different content. We've seen medical records with the wrong birthday even! What we want to do is consolidate all those different medical records into a single, shareable, up-to-date medical record for each person.

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