Medical Record Retrieval: Reducing Friction, Improving Outcomes

 

An interview with Shannon West, Datavant’s Chief Product Officer

Datavant recently announced that the Datavant Switchboard includes the ability to support patient-mediated medical record retrieval to power clinical research. We spoke with Chief Product Officer Shannon West about the work that led her to Datavant, and why Datavant is building technology to make record retrieval faster and easier. Shannon came to Datavant with a deep history working at the intersections of government, healthcare, and tech innovation, including roles at IHS, US Digital Service, and CMS. 

Shannon, before coming to Datavant, you spent considerable time in the public sector. How did you end up as Chief Technology Officer at the Centers for Medicare & Medicaid Services (CMS) Innovation Center?

My mom is a physician turned informaticist, so things like immunization forecasting and the power of data to change health outcomes were regular dinner table topics growing up. My first exposure to software development was working at Bungie (the Halo developers) which eventually led me to the Indian Health Service (IHS). IHS is a federal agency responsible for providing care to 2.5 million American Indians and Alaska Natives. I cut my teeth there managing development contracts for IHS’ homegrown EMR (RPMS) while learning how the government works, how it spends money, and how it builds software in the context of health care. 

Because of the procurement work I did inside IHS, I joined the US Digital Service (USDS) focusing on technology procurement. The federal government spends billions of dollars a year outsourcing software development to private contractors under significant regulation that governs procurement. With my background in healthcare via IHS, I gravitated towards our teams at CMS, VA and other HHS agencies, eventually leading the healthcare team at USDS focused on building products at the Center for Medicare and Medicaid and Health and Human Services. 

I spent two years working with an amazing team building products like the Quality Payment Program, Blue Button 2.0, Data and the Point of Care and Medicare Payment System Modernization. After leaving USDS, I moved to the CMS Innovation Center as their first Chief Technology Officer and worked on improving the data and systems we need to support Value Based Care through innovative payment models. 

As Chief Product Officer at Datavant now, you are building technology to tackle the challenge of medical record access. You recently detailed the many steps needed today to access medical records in the blog: Breaking Through Clinical Research Barriers. Why is medical record retrieval so broken, and why is it so hard to fix?

There are many reasons – most of them have been well-intentioned things that have happened over the years that, when combined, didn’t go as anyone might have expected or intended. 

As patients, caregivers, providers and other requesters of records, we expect the experience to be the same across all health systems, clinics, and hospitals, but it’s not. This is because of the different levels of policy that exist at the federal, state, local, and then individual health system level. Different hospitals have different procedures, which might mean a different request form, a different mechanism for how you submit your request, or what specific information they release to you. All of those things add to the friction of record retrieval. 

Another piece comes back to my work at the CMS Innovation Center: incentives. For a really long time there was no incentive to share data. In fact, sharing a medical record might be a bad thing, because it might mean that a patient was going to seek care elsewhere, or that a provider was being audited. 

And last but not least, there is the technology. In 2009, Meaningful Use was mandated into law as part of the The American Recovery and Reinvestment Act. It took us from metal filing cabinets to digital filing cabinets but didn’t connect the filing cabinets across the street from each other. All of this has contributed to the extreme amount of friction in the medical record retrieval process and our perception that the system is broken.

What are you doing at Datavant to help solve this challenge?

First, in a world where you’re trying to change a problem that is really entrenched in a number of different areas, whether that’s policy, process, or technology, you have to have solutions for every entrenched piece. When Datavant combined with Ciox in 2021, it gave us access to a huge breadth of providers that trust us to manage the way their data flows in and out of their health system, their hospitals, or their clinics. That trust is not something given away lightly. Of course, it has to do with compliance, but it’s also about protecting their patients and ensuring that they’re doing right by the people they’re providing care to.

The second part is the technology. Datavant has built a cutting edge, industry-shifting technology with our tokenization and data connectivity platform. Combining that with the footprint that we have across the Ciox provider ecosystem, we can build the best platform and the best products to meet the needs of our customers. 

Third is scale. We are building connections to hundreds of providers in a way that smaller venture-backed start-ups don’t have the opportunity to do. We touch every provider in the country, whether it’s through a digital connection, a phone call, or somebody sitting inside a health system. At the same time that we are building digital connections, we also have a staff of over 5000 health information managers embedded with providers to do the hard work of compliantly managing record access; this hybrid approach of technology and service gives us significant network scale. When I started talking with people at Ciox, we were discussing the impact of working at CMS. It’s really hard to have a big impact in healthcare if you don’t already have a footprint across both providers and payers.

When you combine these pieces with Datavant’s speed and quality of execution, that’s where the magic happens that is super unique to us as a company.

How does this benefit customers and record requesters?

We talked about the complexity of navigating different requirements across different providers. There’s a significant amount of friction that gets removed from the process when Datavant takes on record retrieval. We internalize that friction into our system in order to make sure that our customers are not feeling it. 

Because we have connections to 100% of providers, we are the best at getting access to medical records. We’ve spent a lot of energy and dollars investing in our ability to get the most number of medical records from the most number of providers, which is something that takes a lot of experience and time, and quite frankly, dollars to do. Companies don’t have to stand up their own teams to make 100 phone calls a day to get access to medical records. 

By the end of 2023 with the introduction of more digital connectivity for record retrieval, we anticipate the timeframe for record retrieval dropping from weeks to hours for a large portion of the records that we retrieve today.

What excites you most about this undertaking?

I’m most excited about the long-term impact for patients in the healthcare system overall. I genuinely believe that more data connectivity will enable more people to get the right treatment at the right time. It will ensure that more people have access to the care they need without having to navigate the current complexity of the health system. (Maybe we’ll all make fewer phone calls to our health insurance companies too!) Finally, I think accelerating medical record retrieval can change the game in terms of our ability to identify large-scale health trends with real world data (RWD), which is oftentimes locked in silos. Rapid medical record retrieval would provide the keys to access information quickly, helping healthcare stakeholders make data-informed decisions that ultimately improve patient outcomes.

Learn more by downloading the Datavant Switchboard for Medical Record Retrieval product sheet.