Box Expands Healthcare Offerings

9 Mobile EHRs Compete For Doctors' Attention

Box, a cloud storage and information sharing platform used in many different industries, has announced a major expansion of its healthcare focus. Among other things, Box has revealed 10 new partner applications, an investment in iPad-native electronic health record (EHR) vendor Drchrono, its compliance with the latest HIPAA security rules, and a list of some healthcare organizations that are using its services.

Among the latter, the company said in a news release, are Henry Ford Health System, Beaumont Health System, HealthTrust Europe, Johns Hopkins HealthCare Solutions, Wake Forest Baptist Health, San Juan Regional Medical Center and Garden City Hospital. "Hundreds more healthcare customers" use Box "to share, manage and collaborate on content in the cloud," according to the release.

Most of this activity, so far, has been confined to non-clinical functions, although Garden City Hospital, Beaumont Health System and Wake Forest School of Medicine are all using Box to store clinical data as well, said Whitney Bouck, enterprise general manager of Box, in an interview with InformationWeek Healthcare.

Box expects many more healthcare systems will use its service to store and share personal health information (PHI) now that the firm has become fully compliant with the latest HIPAA security rules, which were published in January. Among other things, these rules make healthcare providers responsible for ensuring that their business associates protect PHI and that they have agreements to that effect with those business associates. According to the press release, Box is one of the few cloud providers that have been willing to sign these business associate agreements.

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Unsurprisingly, several of Box's initial partnerships in the healthcare space involve secure messaging services. TigerText offers secure text messaging in hospitals and other clinical settings, helping doctors and nurses communicate with each other about patient care. Medigram, a startup firm, does the same. Both companies will use Box to archive text message attachments such as images, files and notes.

Doximity, which includes a social network and a secure messaging and collaboration service for doctors, will offer Box accounts with 50 GB of free storage to the 150,000 users it says are in its network.

Other Box partners include Umbie Dental Care, a Web-based practice management system for dentists; MedViewer, which allows users to view, communicate and share medical images on iPhones and iPads using a DICOM viewer; MediCopy, which provides release-of-information and document scanning services to hospitals; HealthTap, which offers consumers the ability to get answers to health questions from a network that includes 35,000 physicians, according to the firm; and PaxeraUltima, a PACS viewing application designed for iPads. In addition, Drchrono will store EHR content such as lab reports, videos and images in Box.

Box's ultimate goal "is to be the collaboration and communication layers between a variety of different tools and applications and EHR systems," Bouck said. By doing so, she noted, Box could help providers exchange data with each other and with patients. It would also give them new cloud-based workflow tools that enable them to better coordinate care and fully integrate their mobile devices into that workflow.

Box has hired Missy Krasner, formerly a Google Health executive and an assistant to David Brailer, the first national coordinator of health IT, to lead its healthcare expansion. Asked how Box would integrate with disparate EHRs, Krasner replied that "EHRs are not good workflow management tools, they're recording tools," and that's why so many external applications have been built around them. Much of the mobile communications between different clinicians, she said, would never be included in the EHR but can be efficiently stored and shared in the cloud.

"Box can archive a lot of the messages, including those with attachments such as X-rays or pictures that you're sending to another doctor," she said. "Box can take that material and archive it, and make it totally searchable."

Another major use for Box is to help consumers collect records from multiple providers and store it in a single place, she said. This is difficult now because patients have to log onto separate portals attached to different EHRs, she noted.

Krasner noted that Google Health tried to provide a "very cool looking personal health record" (PHR) that would aggregate these multiple records. The idea was for consumers to import their data from multiple sources and direct it to whomever they wanted. But this "untethered PHR" failed, she said, because it proved to be too difficult to integrate all of the clinical data from different EHRs with Google Health. Many other reasons have also been advanced for the initiative's demise.

Box has a different take on the Google Health idea that it would like to develop. Krasner compared it to what some EHR vendors are doing with the VA-created Blue Button that enables patients to download their electronic records. "Box could be an embedded button on an EHR. So when you're doing that download, it could go directly into a Box account. It could be another doctor's Box account, it could be a shared account, it could be enterprise account, or could be doctor to patient."