Founder’s Journey:
In 2006, I moved from being an academic physician in a large health care system out of state to a small group private practice in suburban Southern California. Initially it was a culture shock for me but, I quickly thrived in that environment adjusting well to private practice only with a few exceptions. One of my biggest frustrations in that setting was getting patient information at the point of care in order to make informed decisions about their health. Most providers were using paper charts with dictated and transcribed records. Getting these records meant cumbersome authorizations, faxes back and forth, and inevitable wait. This resulted in delay of care, duplication of tests, inadequate communication between providers, errors, and inevitably poor quality of care. I realized at that time that my parents who were visiting me from overseas had more adequate health data with them than my patients in my practice. I also had the revelation that if the patients had all their own relevant health records with them, they could provide them to the care provider easily at the point of care. That is when I decided to create MyMR (my medical records). My idea was to digitally recreate what my parents had (all their own relevant health records on paper) for my patients and give them a tool to do this seamlessly.
It turns out that I was not alone in this pursuit to improve health data documentation, storage and transfer. In February 2009, the Obama administration signed into law the Health Information Technology for Economic and Clinical Health (HITEC) Act to incentivize implementation of electronic health records (EHR) by clinical providers. It initially provided monetary incentives to implement EHRs and achieve “meaningful use” but also started penalizing providers who did not meet certain meaningful use by 2015. Because of this, there was widespread adoption of EHRs by providers. Most providers chose to use EHRs that helped achieve basic meaningful use certification. Unfortunately, due to lack of universal standards, EHRs developed in separate silos without the ability to communicate with each other. Due to privacy issues, the government had already had passed the Heath Insurance Portability and Accountability Act (HIPAA) in 1996 to protect personal health information. Now HIPAA applied to electronic personal health information (ePHI) used by all covered entities (providers) and business associates (EHRs, billing companies) under the threat of significant penalties. This not only resulted in providers unable to share medical records in a uniform language but also made them reluctant to do so even if they could due to fear of violating HIPAA. The patient was completely left out of this process, except to provide signature consent to create health data.
The government created the Office of the National Coordinator for Health IT (ONC) in 2009 to maintain certain standards, to encourage interoperability, and provide certifications for the EHRs. Since all EHRs are private entities developed in isolated environments and do not talk the same language, nonprofit organizations like the Health Level Seven International (HL7) attempted to created standards to bridge the gap. The latest version is of this effort is the Fast Healthcare Interoperability Resources (FHIR), which is a data format and an Application Programming Interface (API) to exchange EHRs. EHRs now have made ePHI creation, storage, and provider access easy but portability, exchange, and patient access and engagement has been still very problematic. The HHS has mandated a rule that went live in 8/2022 where all providers are required to provide entire ePHI in an electronic format when patient requests it without charge. This has lead to a significant burden to the providers.
Therefore, the solution to this problem is to provide patients their entire health record so that they are the owners, guardians, and collectors of their health data for storage and exchange. In every other industry we make the individual/consumer do this, except for health care. Imagine banks not letting you easily see your money transactions. There is no reason why the patients should not own the data about them. Currently, it is like giving an art reporter the rights to the sculpture which the artist created. The patient therefore should have the right to do as they please with their health data. We should create tools for them to do this seamlessly.
In 2008, I and a few friends registered MyMR and tried to develop a PHR platform using digital storage device that the patient could carry and a software that could upload and download data to realize this vision. We were successful in filing a patent, registering a trademark, domain name, and the PHR platform using phones and laptops. We hit a wall with providers due to lack of interoperability and therefore abandoned the project in 2010.
Because of change in regulations, improvement in interoperability, communication technology, secure electronic storage, and machine learning we believe the time for MyMR has come. MyMR was therefore reconstituted in 2020 in partnership with like-minded physicians, domain experts, and entrepreneurs.