Company:
- The startup’s national health information network works to allow seamless data sharing between patients, payers, providers, digital health companies and labs.
- Its platform uses a suite of FHIR-based application program interfaces (APIs) that digital health developers can integrate into their own solutions to aggregate each patient’s entire clinical history in one place.
Problem Space:
- Your doctor might not have access to accurate medical records. For patients to receive the best care possible, all players in the ecosystem need to work together
- The right people having access to the right health data is critical so that the right decisions can be made in a more timely and informed manner. It is rarely the case.
Value generated:
- Secure, compliant, and standardized way to share healthcare data between patients, payers, providers, digital health companies and labs.
- The startup says it prioritizes aspects of data sharing including high security and patient identity matching to simplify the task of extracting a patient’s health information from another clinical records system.
Future Plans:
- The company is also applying to become a qualified health information network, a federal designation introduced this year to mark networks that connect to one another to support national health information exchange.
- The startup said it plans to use the series C funding to continue to build its team and invest in its product development and go-to-market strategie
Who pays?
- payers, providers, digital health companies and labs
- The startup offers a health data API platform that delivers comprehensive data across providers, insurance
- what data - conditions and procedures treated as well as cost and quality metrics.
- Despite significant investments in digital health and focused innovation specific to patient experience, patients struggle with the seemingly basic task of finding an in-network and conveniently located provider or facility that focuses on appropriate care. This confusion is caused by fundamentally flawed and disparate data that have become particularly burdensome as digital health advances.
- Data on medical providers, including information as basic as address and phone number, have been cited as being only 48% accurate. These provider data flaws directly impact patients’ ability to compare procedure prices before seeing a clinician, according to Ribbon Health.
- With 1 in 3 patients skipping care due to cost concerns, there is a critical need for accurate data on providers, specialties and insurance that takes price transparency and quality into account.
- “While consumers can easily find the address for a local restaurant, the same can’t be said for patients who are looking for a phone number to make an appointment for a critical MRI or to confirm they are seeing a clinician who is in-network and of high-quality, so there are no unexpected costs associated with their care visit,” said Nate Maslak, CEO and co-founder at Ribbon Health, in a statement.
- “This doctor data problem harms patients as it often leads to people delaying care, opting out of treatments, or dealing with unnecessary and burdensome financial impact," he said.The technology:
- Customers use Ribbon as the core infrastructure to build healthcare solutions, and Ribbon continues to expand and enhance its data set to support many different use cases across the industry.
- With Ribbon, companies can seamlessly integrate and quickly update provider data directly into their existing workflows, according to the company.
- “Ribbon helps us connect members with high-quality providers and ensure patients are making knowledgeable decisions on their care, leading to improved outcomes, reduced costs and peace of mind,” said Marcia Otto, vice president of product strategy at Health Advocate.
Ribbon Health's data elements
Future Plans:
- Ribbon plans to use the fresh capital to prioritize team expansion
- technology investments to build a best-in-class data platform
- to simplify healthcare decisions across the industry
Short answer is payers, providers, and digital health companies. Ribbon Health has 4 products as of now and each is directed towards a specific B2B need.
- Provider directory; customers include
- Health Insurance Companies
- Third-Party Administrators
- Digital Doctor Finders
- Referral Management; customers include:
- Referral Manager Software
- Clinics and Hospitals
- EHR and EMR Systems
- Care Navigation
- Care Navigators & Advocates
- Doctor Search Platforms
- Health Savings Accounts
- Insurance Enrollment
- Benefits Administrators
- Health Insurance Exchanges
- Enrollment Platforms
Comments:
- It sounds like services like ZocDoc should have built this functionality years ago and could have offered as part of premium subscription. The process of finding a convenient provider is really cool but not expand vertically and ensure other aspects like Ribbon Health?
- The problem space is really hot mess, mostly because it is hard to solve but it also represents a huge opportunity. Although some claims by Ribbon health seem far-fetched around the problem space they might be very true. Yeah, it is that bad.
- To live up to the potential of the opportunity Ribbon need to expand much beyond provider and insurance data. Although it is a great start, real mess most likely happens when we look at the clinical data. For example, in clinical trials standardizing clinical sites data is hard but manageable problem. Standardizing clinical data is another ballgame, much much harder.
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A Qualified HIN (QHIN) is a network of organizations working together to share data. QHINs will connect directly to each other to ensure interoperability between the networks they represent.
The title is part of the Trusted Exchange Framework and Common Agreement (TEFCA), released by the Office of the National Coordinator for Health IT in January 2022, five years after the first draft.
Companies leveraging national data-sharing networks have grown in popularity in recent years among organizations seeking easy access to patient data. Investors are pouring more money into interoperability solutions, too. The global market is expected to grow to $5.8 billion by 2028, more than doubling from $2.8 billion in 2020.
With the release of TEFCA, healthcare entities will soon be able to apply to be qualified health information networks (QHINs). These networks will connect to one another to support health information exchange nationwide.
Goal of TEFCA
- Provide a single 'on-ramp' to nationwide connectivity
- Electronic Health Information securely follows you when and where it is needed
- Support nationwide scalability
Companies leveraging national data-sharing networks have grown in popularity in recent years among organizations seeking easy access to patient data. Investors are pouring more money into interoperability solutions, too. The global market is expected to grow to $5.8 billion by 2028, more than doubling from $2.8 billion in 2020.
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