An emerging company has a simple but lofty mission—making patients the custodians of their own medical information, able to share it with any providers on an as-needed basis.
Ciitizen is part of a personal mission of its founder, Anil Sethi, who most recently led the health tech division at Apple. It’s part of a promise that Sethi made to his sister, Tania, who died this past September after a battle with breast cancer.
He and his family were closely involved in supporting her through her care, and he vowed that he would develop technology that would help very sick patients manage their illnesses. As a result, Ciitizen initially plans to focus on providing services for cancer patients.
Sethi made the decision to leave Apple, which is working to integrate healthcare applications into its some of its mobile products. Recently, Ciitizen has been adding key staff to pursue its mission, and this next week will be among hundreds of public and private companies that will be at the annual J.P. Morgan Healthcare Conference in San Francisco, looking for funding to advance its development.
He says Ciitizen has an ambitious plan to develop a technological approach that will be able to pull information from electronic health records and other sources, with a plan of its technology actually being used by patients by the end of 2018.
“By mid-2018, we will have a core of technology ready for deployment and will be interviewing interested health systems and other vendors to participate with us,” he says. “We think by the back end of 2018 that there will be patients using the platform in production.”
Sethi says he can’t yet share specifics of the underlying technology—“this is core intellectual property and quite revolutionary,” he explains. “We leverage mobile technologies for citizens to authorize release of information or direct the transmission of their records to a device or cloud service of their choice.”
It’s similar to the vision that Sethi had for Gliimpse, a startup he founded that was acquired by Apple in early 2016. Gliimpse had a similar mission of providing a personal health record platform for patients, enabling them to collect and share data. Ciitizen intends to go a step further, by using technology to tap into providers’ systems and then share data back, as patients and their families authorize the release.
“Patients will be able to share their health information to be viewable directly in the clinical workflow of an electronic health record,” Sethi says. “This benefits the patient-physician relationship by increasing the quality and discussion time physicians have with patients. There’s no dependency on EHR vendors to facilitate this.”
Sethi believes that healthcare organizations will be interested in using the technology because of its ability to incorporate patients’ individual data.
“Provider organizations benefit by having access to a majority of outpatient data outside the organization,” he adds. “In chronic care, increasingly larger amounts of health information are generated outside the purview of a facility’s EHR. We aim to include patient reported outcomes, genomic and imaging data, along with clinical data, patient-gathered from external EHRs.”
Cancer care makes sense as an initial focus for Ciitizen because patient information is often widely dispersed among a variety of care providers, says Farid Vij, who has an executive role in the company.
“We’re focusing on the cancer space because this is where the problem looms the largest,” Vij says. “Time is of the essence, there are a lot of specialists who need to share information, and all the work comes in understanding the data. Cancer is really a data problem—if I have a complete picture of your data (as a clinician), the likelihood of finding a solution increases exponentially.”
Also joining the company in the last couple months is Deven McGraw, the former deputy director and health information privacy officer at the Office for Civil Rights at the Department of Health and Human Services. McGraw has joined as Ciitizen’s chief regulatory officer, a key position in navigating data sharing arrangements.
“She thought she could do more good being on this side of the industry, helping us make practical and pragmatic the ability to make health data portable,” Sethi says.
Mobile technology will be one piece of the technology puzzle that Ciitizen intends to use, as Sethi believes that both the technology exists to facilitate data sharing, and consumers are now more ready than ever to want to manage and share their data.
“With electronic health record and other data producing vendors, the formularies are localized for their needs, but yet there is a need to be able to take this dissimilar data and make it computable across fragmented data resources,” he says. “We hope to standardize dissimilar data, according to U.S. and international terminologies, which will make the data highly computable by artificial intelligence and apps.”
Sethi’s past experiences with a variety of startups have emphasized the transportability of data. “My interest across all of my previous ventures mostly has been the movement of data out of proprietary systems and exposing them—interoperability or data portability offers benefits both to patients and care-giving teams.”
Data sharing is also key for patients and their families, who often are highly involved in the care of their family members, Sethi says. “When we’re dealing with patients who are the sickest of the sick, the patient isn’t the one managing the portability of their information or the majority of their healthcare. Although we want to put the patient at the center, we need to expand beyond that—they’re often the least capable of handling the data deluge.”
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