Bringing Healthcare Out of the Box!

Some of the most interesting ideas come from listening to your customers. In Healthcare, some of the high impact problems are identified after long and insightful discussions with various stakeholders. The sheer vastness of operational expertise required to understand the innards of every health system is a challenge in itself, and I’ve learnt that the best way to identify problems worth solving is to speak to someone as close to the ground as possible.

I’m writing this post as a series of interesting ideas that have come up from these discussions – and how some of them have ended up becoming impactful solutions for Healthcare.

A few months ago, I was speaking to someone very deeply involved with patient care at a large health system. One of the things we talked about, is how painful it is for patients to send their prior records when they are seeing a provider for the first time. In today’s world, they sometimes put all their paper records and electronic data (in CDs and USB Drives) into a cardboard box and send it over to the hospital before their referral. The box (something that would have looked better with a Pizza in it) is usually sent using snail mail – and we all know how outdated that sounds.

In most hospitals and physician practices, over 15 % of their monthly patients are people they’ve never seen before. When the patient requests for a referral to a specialist, their prior medical records are extremely important to decide their further course of treatment – and getting them together is a time-consuming and extremely tedious exercise.

Every specialty requires specific information to be uploaded, and most of them use paper forms that need to be downloaded, printed and filled out.

An idea was born out of a simple question – why use snail mail when we can pretty much transmit anything digitally in today’s world? Why waste paper, fuel and other valuable resources using cardboard boxes when you can upload data with any Internet connected device today? Why were people still doing this? Why was this so common?

I realized that one of the biggest challenges was the complexity of uploading patient data – especially when it came to medical images. Existing solutions (though few in number and not actively used) required installing plugins and some technical know-how that added to the complexity.

The solution that we came up was extremely simple and (we believe) elegant. Why not allow the patients to open a web-link (either sent through a secure email or available publicly on a website) to upload all this information? Why not have a simple web-form and browser-based HTML5 uploader that doesn’t require a technology guru to use?

We decided to build this flow as an example on what can be done on our Minerva platform. We used our existing APIs to make something so simple, it seems crazy that we didn’t think of it before. And we called it Forward.

The workflow allowed the clinicians or administrators to create forms for each of their specialties, giving them the flexibility to use free-text, multiple-choice and tabular inputs to construct their own custom forms. It was important to make it so simple that it took only a few minutes to build a new one.

Now the patients could select the specialty from their patient portal or the health system’s website, fill up the form online and then upload their records instantly. Again, killing the complexity of this process was the key. The uploader was HTML5-based, required no plugins and could identify medical images or normal PDF documents without any manual intervention. It even allowed the patients to click a picture of their documents if they were using their smartphone to fill up the form.

The uploaded data was then available to the hospital’s team using a simple inbox interface, where they could review the information, update statuses and even send notifications back to the patient.

Now you have the patient’s proverbial pizza box available electronically on-line, how do you get this back to your EMR? What happens when the patient is called in for the consultation – can this all flow into his/her new record?

One of the biggest breakthroughs for us while building Minerva was that we created a clinical data repository that stores Clinical data as native FHIR objects. Minerva exposes FHIR RESTful APIs and other Healthcare standard based interfaces to share this data with other clinical systems. We don’t transform data to comply with healthcare standards. We store them in a way that complies with the standard – a very subtle yet powerful difference in approach.

The same application can be used for doctors to have patients pre-fill data before the first visits, radiology exams and other procedures. No more wait times to get patient data. Save time and money – and make it easier for patients to access healthcare services.

If you’d like to know more about Minerva and Forward, please feel free to reach out to me at

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