adunsulag
In your FHIR implementation, what version of USCDI do you support? I'm assuming you're following US Core profile's with your implementation guides? Have you implemented US Core STU 6.1.0? I know I'd be interested in using your converter and your exchange product if it could help facilitate what's required for ONC certification in 2026. I didn't see listed anywhere your capability statement URL that would give insight into what your doing.

I congratulate you on your launch and I'm interested in your converter. I'm surprised you didn't mention the TEFCA effort and wondering if you're planning on becoming your own QHIN (Qualified Health Information Network) or if you just plan on interfacing with all of the major QHIN's?

How are you handling interstate data exchange privacy requirements. Some states have restrictions on what data can be shared across state (thinking about this in terms of things like PDMP queries). I'm also wondering how you are handling the patient data access audit trail as well as information blocking filtering requirements. Perusing your documentation, it looks like you pass along the AuditEvent, does your system create additional audit trails for those who access the patient data? Or is that all being handled upstream w/ your QHINs?

dariosalvi78
Thank you for this, so much needed. I hope that you are going to come to Europe soon.

Honest question, how was your experience with getting funding on an open source product within healthcare? My experience so far is that the field is, as you put it, 30 years back, also in terms of business models.

pelagicAustral
Congrats on the launch, the site it's quite nice and informative...

"Access comprehensive EHR data for your patients in seconds, with FHIR R4...", I got Vietnam flashbacks from building an app to interface with the NHS Covid Vax certificate, that was my first encounter with FHIR... And honestly, all I wanted by the end of the day was to set myself on FHIR! Such a complex abstraction. Anyway, Godspeed!

gip
Congrats on the launch. I work in healthtech and I'm always shocked by how fragmented and siloed the technology is in my industry. Both at the application level (EHR) and data level, leading to general inefficiency, high costs and innovation that do not always benefit the patients.

Glad Metriport is addressing this! I hope you will drive a new level of standardization on an open and modern data exchange protocol.

One question: at the product level, would it make sense to go one step further and bet on the future being the cloud - and start supporting existing cloud solution like Google Healthcare (FHIR) API (and others) as storage layers?

superchris
This sounds like a really excellent product, and I really love the description in this post of how you got there. Not working on anything just this minute that needs it, but I will definitely keep an eye out for opportunities.
lazyasciiart
If I understood correctly: it sounds like HIEs were supposed to solve this problem but just duplicated it, so you’re hoping to actually solve it this time?
nradov
Best of luck to Metriport. I've worked for years in the healthcare interoperability space and there are still a huge number of unsolved problems impacting cost and patient care.

There actually is a standard for converting C-CDA records to FHIR. It isn't 100% complete but serves as a useful starting point. If you find problems with it you can feed those back into the standards process.

http://hl7.org/fhir/us/ccda/

Microsoft has an open source library which works pretty well and I think implements at least part of that standard, although I haven't used it lately.

https://github.com/microsoft/FHIR-Converter

FHIR also includes unstructured narrative text so it isn't necessarily better than C-CDA in that regard. You'll find that data quality problems come down more to provider systems configuration and charting policies rather than data formats.

robertlagrant
Well done with the launch. This is a tricky space, but if successful you will be very successful.

A health platform I helped build was open sourced[0] (the apps built on it are closed source and deployed in NHS trusts). Feel free to dig around for any inspiration :-)

[0] https://github.com/polaris-foundation

erkok
I commend you trying to tackle such a challenging domain, something that feels should be handled on state level.

As a citizen of Estonia, we pretty much have any government service available over the web, and yes, we also get to enjoy state provided health care, which makes things simpler when it comes to having a single unified system for all health care workers, which we have, have had for quite a while, probably for a decade or more. And it works, including patients who can also log into the system to check any data that is collected on their behalf.

checkoutmygenes
Nice work on the pivot + launch, team! You mention that IAS "may open up in the future." Does that mean I am not currently allowed to request my own record from an HIE?
Teleoflexuous
Is there/do you plan on creating in foreseeable future post mortem of the tracking app beyond the note on your reddit?
hakanderyal
Where I live we have a centralized system run by government that all healthcare providers are required to integrate with. You can access & manage all your data & healthcare history from a single location, for free.

I know this wouldn't fly in the US, but it is a very convenient system for people.

nmitchko
How does this compare to ehealthexchange or other qhins that have many years of experience and charge lower costs?
adamstecklov
When you say that you can use the HIE's to contribute new data to the providers in the network, is that data actually going into the EHR's as if it was a record added in the EHR directly? If not, where are these contributed documents being stored?
justanotheratom
Can I make an App that can show a person their own medical data? i.e, user-provisioned access.
popupeyecare
Congratulations!

I’m a huge fan of Metriport, Dima, and the whole team! I’m constantly impressed by the strides you are making in addressing this significant problem. I often brainstorm company ideas just to have the opportunity to use Metriport.

- Amit

zaking17
Congrats Dima & Colin! We’ve been greatly impressed with Metriport. If there was ever a place that needs tons of well-designed & open-source software, it’s medical records.
pk-r
Apart from your new product, the old metriport app I found very intresting. If you ever considered to make it opensourced, I would be glad to contribute.
chrisfrantz
Congrats Dima and team, it's been cool watching you build this over the last couple of years.
awendland
What percentage, or how many millions, of patients are accessible on the network today?
Joel_Mckay
While any XSLT/XML based interface can act as middle-ware for such a messy ecosystem. There are several problems with touching medical data:

1. Some governments require ISO certifications for security

2. Some standards bodies require commercial accountability (FDA), data site redundancy, and company inspection by a standards body.

3. The ecosystem for the insurance documentation is never open source. It is not only prohibitively expensive, but comes with legal strings in the EULA.

Good luck, but please read the slicer.org story before committing too much time to the project. =)

Logingarrett
Gods work!
moneywoes
why not integrate with the EHR vs the HIEs
moneywoes
how do you make money?