See the bottom of the post: "We charge per full medical record retrieval for a patient (which we call a query). This starts at $1 per query (with a monthly minimum), and scales down from there based on volume. We only charge for queries that return at least one record (and even if a query returns 1000 documents for a single patient, we still count that as a single query) - no charge is incurred for sharing data back to the networks, or making API calls to generate medical record summaries, for example."
Agent-based healthcare concierge basically (agents constantly trawling literature for ways to optimize your health, doing scheduling/appointments for you, moving data to new doctors when needed, etc.)
Thinking is: this was a massive tar pit in the past, new interop laws and AI tooling makes it possible now.
Health optimization based on literature searches is a fool's errand. A certain niche segment of the "worried well" is constantly reading studies (often of questionable quality) and chasing marginal gains with the latest drugs, supplements, recovery modalities, or whatever. Meanwhile they still have poor sleep hygiene, insufficient exercise, and unresolved emotional problems. Major in the major, minor in the minor.
Those other agent features could be useful, though.
No offense but the whole "biohacking" and "quantified self" community is mostly a clown show. It might be a fun hobby but there's little or no reliable evidence that any of that stuff actually leads to improved outcomes in terms of lifespan or healthspan or performance or whatever. Any business built around that community might get a few early adopters but won't cross the chasm to the mainstream market.
And I write this as someone who has personally wasted money on stuff like genetic tests for athletic performance. Interesting, but not actionable.
For common symptoms, conditions, and medications consumers mostly just rely on WebMD or similar sites.
Thank you - it's a difficult problem for sure, but that makes it all the more fun and rewarding.
> should be handled on state level
Many of the aforementioned HIEs in the US are actually offshoots of state, or federal, government initiatives like TEFCA. We didn't go into details in the post, but the main HIEs are definitely not privately held startups - mostly nonprofit state sponsored organizations.
> we pretty much have any government service available over the web, and yes, we also get to enjoy state provided health care
There are pros/cons of state run centralized government systems for sure - with Metriport as a communication layer, we're hoping to bring providers in the US the best of both worlds for data exchange.
> In the US, this is part of the EHR push, each EHR is supposed to accept any outside application
To be explicit for readers here, outside applications can connect to some EHR systems using SMART on FHIR, but not all (this is what Apple Health supports in their PHR) - and this is separate from HIEs. For reasons OP mentioned, this is impractical for treatment at scale, but is currently the best way to get your health records in your pocket, or to insurance companies, for example.
This is a only part of the equation - for example, one of the biggest networks we connect with is Carequality, and this is more of a framework that's not operated by any vendors. Rather, vendors connect to a shared directory and speak the same language for medical data exchange.
> The evil part of the operation is that now Metriport has proxy access to the data and eventually will get hacked
This just speaks even more volumes to our open source approach - we're not hiding behind obscurity for security.
> and bought by private equity that will sell the data to TransEquirian Insurance Score agencies.
Only if someone wants spend a long time in prison! We can not legally do anything with the data we have proxy access to, except deliver it to the healthcare organizations we work with that are involved with treating the patient - nor would we want to. There are acquisition events with healthcare organizations all the time, and the HIPAA rules protecting the data do not change.
Hopefully you can agree that, especially with us being the only vendor in the space that's open source, there is no evil at play.
>To be explicit for readers here, outside applications can connect to some EHR systems using SMART on FHIR, but not all (this is what Apple Health supports in their PHR) - and this is separate from HIEs. For reasons OP mentioned, this is impractical for treatment at scale, but is currently the best way to get your health records in your pocket, or to insurance companies, for example.
Just a minor detail here. My understanding from my attendance at some of the ONC Information Blocking seminars is that if the EHR is ONC certified, they are required to provide access to a patient using any app of the patient's choice. The rules are very different if its a provider app or an app that can provide access to data for multiple patients. Unfortunately, not all EHRs are certified (looking at you mental/behavioral health sector, and cash-only EHRs).
We continue to struggle with this in our own EMR implementation as app providers constantly complain that provider/system level access to the data requires manual human intervention, which we aren't going to change anytime soon. Things like Unified Data Access Profiles (UDAP) Dynamic Client Registration are looking to mitigate some of these problems.
What I'm intrigued about with Metriport is that app providers could connect directly to them to get the patient data as long as our EMR feeds data into the HIEs they work with.
That's right, we can't even request our own records using Metriport - this currently can only be done for a Treatment purpose of use (and opens up a lot gray area of what that means, as you can imagine).
The promise of TEFCA, and QHINs, is to open up more use cases for data access, like individual access, payment/operations, and etc. We're optimistic that eventually this will become a thing, but there are a lot of politics around this, and full implementation of these use cases has been getting delayed for some time now. It's technically possible today, but responding to requests outside of Treatment is not a MUST, so essentially nobody (namely the big EHRs) will actually respond to IAS requests.
In the meantime though, we're sprinting to hook as many providers up to the networks as possible, which then can share records with their patients.
