Healthcare // Electronic Health Records
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8/15/2013
11:47 AM
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Startup Will Build New York's Ambitious Patient Portal

Mana Health portal will give patients the ability to view records from multiple doctors in one place, a first for statewide health information exchanges.

 7 Portals Powering Patient Engagement
7 Portals Powering Patient Engagement
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A New York City startup firm, Mana Health, has been awarded the contract to build a patient portal for the Statewide Health Information Network of New York (SHIN-NY). This portal, which will make electronic health records available to consumers from all of their participating healthcare providers, will be the first such website to be offered by a statewide HIE when it's rolled out in the first quarter of 2014.

Mana Health, which won the competitive bidding for the contract, also placed first in the Patient Portal for New Yorkers Design Challenge, which was held earlier this year. Mana will work with the New York eHealth Collaborative (NYeC), which operates SHIN-NY for the New York State Health Department, to build the user interface for the portal website and its connection to SHIN-NY.

What made NYeC, the state health department and the RHIOs believe that a tiny startup like Mana could deliver a reliable portal at the scale of New York State? "Their prototype was built against the SHIN-NY sandbox in the design competition," NYeC executive director Dave Whitlinger told InformationWeek Healthcare. "What they'd already done was proof that they could do it."

[ Learn why doctors are dumping their old electronic health record systems for new ones. Read EHR Roulette: Gambling On Medicine's Future. ]

As for why Mana stood out from its competitors, Whitlinger said, "Their design is clean, elegant, straightforward and easy to understand, and easy for multiple demographics to use," such as elderly people who might need different size fonts and mothers who are keeping track of their family's healthcare.

There are some large companies that sell patient portals, but NYeC believed that small Web design firms might be more innovative and give the project more concentrated attention. "We've had a lot of success with small, hungry firms that want to succeed and will do anything to succeed," he said.

Meanwhile, Mana is beefing up its management resources as it enters the world of big-time IT. Following the announcement that it had landed the SHIN-NY contract, Reggie Bradford, a serial entrepreneur who is currently a senior VP at Oracle, joined Mana's board.

SHIN-NY connects regional health information organizations (RHIOs) -- known elsewhere as health information exchanges (HIEs) -- all across New York State. For a physician to participate in the patient portal, his or her EHR must be linked to SHIN-NY, which can be done only through one of the RHIOs. So the physician must belong to a RHIO to allow his or her patients to view or download their records on the SHIN-NY portal.

Currently, Whitlinger said, about 80% of hospitals and their employed physicians have connections to the statewide HIE. The percentage of independent practices hooked into SHIN-NY is much smaller, partly because most of them didn't have EHRs until a year or two ago, he noted. "We're just now getting those folks to connect to the SHIN-NY."

The new patient portal will give hospitals and physicians the ability to meet the patient record sharing requirements of Meaningful Use stage 2, he pointed out. Consequently, it will eliminate the need for providers to buy expensive portal portals for their EHRs. In fact, he said, using SHIN-NY's portal will save them even more money, because the site will do all the maintenance work, such as registering users and setting passwords, that the owner of a consumer portal has to do.

Although the portal will include a Blue Button that enables patients to download their records, Whitlinger said that what SHIN-NY will offer is something fundamentally different than the kind of Blue Button access that EHR-related portals provide. Right now, he observed, patients who see multiple physicians must download their records from the portals of each one to their computer hard drives and figure out how to collate and make sense of the data. The SHIN-NY portal, in contrast, will allow patients to view all of their data from multiple providers in one place, organized into useful categories. And they'll be able to control who sees that data.

In the future, he adds, NYeC hopes to offer consumers additional portals, such as pediatric- or geriatric-centric sites that focus on helping patients manage conditions such as diabetes or heart disease. Having built APIs for developers into the SHIN-NY platform, the organization hopes that more entrepreneurs will create innovative solutions to manage the growing amount of clinical data, he said.

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Charlene Ngamwajasat MD
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Charlene Ngamwajasat MD,
User Rank: Apprentice
10/20/2014 | 5:11:42 PM
Physician Member of the Mana Health Portal Team
Thank you for covering the portal. It's something I'm proud to have contributed to as both a native New Yorker and a physician who has trained, worked and lived in NYC all her life. 

In terms of security, it's part startup responsibility, part state, part whoever plugs into the portal, but my personal opinion is that everyone should treat it like it's 100% their responsibility. As you know health data is incredibly rich and there can be ramifications to data leaks or security hacks. We hear about leaks at least once a week in industry articles as well those from general press. 

I'm glad we were chosen and that the public who voted as well as the NYEC judges liked the design. It was meant to be exactly as was described. Clean, modern, fun, colorful, and yes, address many different demographics. I wanted the tile format because (1) healthcare's move toward cloud and mobile, (2) the ability to customize/re-arrange your screen (just like you can on a Windows desktop or on your phone) (3) it would still be relatively understandable if you spoke a different language or perhaps were not literate. I think a lot of times people build for themselves (20 y.o's building for other 20 y.o.'s) but it was important for me that we build for lots of different kinds of people and meet people where they are, and having worked in hospitals all over the city as well as in community health clinics, I felt that a New York portal should build for the diverse melting pot that is New York and make it as accesable and even fun to use as possible. 

Good point above. If you build it, will they come? I think that engagement has been an issue. First off you need infrastructure (Internet access, owning a computer or a smartphone, being near a local business center/computer lab/library, having Wifi etc). Second you need to know that this is out there, "free to use". Third, the experience of using the tool and liking it and above all gaining value from it has to be there. Traditionally, the design for these things have been like Excel spreadsheets or MS DOS circa 1990 so I'm hoping the re-design will help. It's hard to change people's behavior unless they are committed to changing, but I think that when people make that decision, it's important to have tools out there for them when that decision is made. Mana Health actually started out as a clinical decision support company and aspects of that may be integrated into the patient side. 

I think that healthcare people, digital health enthusiasts, techies, people who are curious, people who are caretakers will initially use the portal. (I really wanted a feature where you could have proxy access to your parents' or childrens' data in a color-coded form so one could be more organized and also not have to open another screen). I agree that I wish more states or locales would try and do what SHIN-NY is doing. We as individuals move around and are portable, it doesn't make sense that in the age of the Internet, that our data can't be portable and move around as well in an organized, one stop shopping, no need to click a billion drop-down lists kind of way. 
David F. Carr
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David F. Carr,
User Rank: Author
8/28/2013 | 1:42:00 PM
re: Startup Will Build New York's Ambitious Patient Portal
Will this small company be responsible for keeping the data secure? Or is it just building the front end interface, with details like security handled by others?
jaysimmons
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jaysimmons,
User Rank: Apprentice
8/19/2013 | 11:01:43 PM
re: Startup Will Build New York's Ambitious Patient Portal
I hope more state wide HIE's take the lead from SHIN-NY and start offering their members more of these resources such as this patient portal being offered. By giving these sorts of incentives to members, they are building up the appeal of their memberships and hopefully can reach more practices. I also really like that the patient portal allows patients to access multiple provider portals from one location instead of having to use multiple locations.

Jay Simmons
Information Week Contributor
ChrisMurphy
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ChrisMurphy,
User Rank: Author
8/15/2013 | 7:52:54 PM
re: Startup Will Build New York's Ambitious Patient Portal
We can provide access, but it's still a challenge to get many patients to look at our data, or to take action based on what we learn. There's a presumption that information will make us healthier. But Modern Healthcare just wrote about a study that shows poor (even dire) lab results didn't spur older adults to change their behavior:
http://www.modernhealthcare.co...
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