Remember that episode of Seinfeld where Elaine confronts her doctor about her medical chart that labels her as “difficult?”
In the opening of The Package episode that aired Oct. 17, 1996, Elaine sneaks a peek at her chart when left alone with it. When the doctor enters, she confronts him about the description of her demeanor. When the doctor promises to erase it, turning to the page and rubbing it with the end of his pencil, Elaine isn’t satisfied. “But it was in pen,” she says. “You fake erased.”
Well, if Dennis Giokas, the CIO of startup MedChart gets his way, then Elaine and patients like her will never have to beg their doctors to view or update their health records again. They’ll just be able to do it themselves through an online system.
After 14 years as the chief technology officer at Canada Health Infoway, the crown corporation that has been working on the implementation of Electronic Health Records with the provinces, Giokas is looking to tackle the problem from a different angle MedChart seeks to put the power of the medical chart back in the hands of the patient. Canada’s health laws already make clear that
the individual owns their data and can request it from their healthcare providers at any point, but in practice that is rarely done. MedChart seeks to simplify the process. Individuals sign up and give MedChart permission to collect their information on their behalf, and MedChart pulls together the data from multiple healthcare providers into a centralized online portal that patients can visit and manage as they see fit.
But the consumer-driven approach is just one aspect to MedChart’s business. After working with MedChart founder and CEO James Bateman in his role as volunteer adviser at MaRS Discovery District, Giokas convinced him the real opportunity was in providing solutions for healthcare providers.
“I kept saying ‘James, how are you going to compete with free?’ Because many of the provinces were standing these up as part of their consumer health agendas,” he says. “Physician offices and hospitals were putting in patient portals and those where being offered for free to their clients.”
So MedChart, a business founded in 2015, pivoted to a business-to-business model where MedChart would serve consumers on behalf of healthcare providers. Giokas joined to help in that mission thanks in part to a MaRS Embedded Executive Funding program. MedChart has also received support from York Region-based business incubator VentureLab. Individuals can still use MedChart to compile their health records on their behalf, but now the business model is to serve as an outsourcer of managing those health records for other businesses that touch health data.
“We’re taking a pain point away from their core competency, where it’s delivering insurance or being a legal firm,” Giokas says. “We make it easier for them to deal with all the payment processing and we make it easier for the holder of the health records to release them.”
Healthcare’s data broker
The bigger promise of MedChart is to reduce the costs of administering healthcare right across the board. By digitizing the entire chain of health records exchange, there’s a few corners it can cut. For example, with authorization forms receiving electronic signatures, there’s no need to print records, fax them, or mail them. Efficiencies are just the start, with a centralized portal of health data being a prime resource for researchers looking to slice different demographics, there could be new business ventures realized soon enough. All the while, the consumer is in control of their personal information.
“The health information custodian is no longer the holder of the record, the consumer is,” Giokas says. “They can authorize that data to use at any organization or with any individual that they are inclined to share with.”
Before Giokas and MedChart can realize that analytical utopia, its undertaking a big job in wrangling all the data. Medical records are stored in a variety of formats, depending on the organization using them. Often enough MedChart is getting a PDF rendering of a piece of paper. Just having an electronic version of paper isn’t fantastic, so MedChart uses machine learning to extract the relevant information from it. The flat document is transformed into data fields that can be requested by other service providers.
“For example, one of the things an insurance company wants to know when evaluating your risk is what impairments you might have, what chronic disease you might have,” Giokas says.
Another way MedChart is collecting data is by integrating with hospital’s electronic records systems. By building APIs into the vendors of these EMR systems, MedChart will put itself in the middle to allow for communication between the systems and enable connection to other third-party systems. MedChart’s machine learning algorithms play a role here too, reading the data that may be stored in different contexts and uniting it in a way that any system could understand.
Giokas is using his experience working with the government sector as well, with MedChart becoming one of the first private partners to work with Ontario’s Spark program, an initiative of the Ontario Ministry of Health and Long-Term Services and eHealth Ontario, with partners MaRS and the University Health Network in Toronto. Giokas describes it as a sort of concierge service that the government has created to allow for the exchange of health information while keeping privacy intact. This will help MedChart connect with health information at the provincial level, including for information on drug prescriptions, diagnostic images, and immunizations.
Elaine would be satisfied.