Bringing Clinical Data into Box to Better Coordinate Care

Box launched Box for Industries at the last Boxworks in September of 2014 to accelerate business transformation in key industries such as healthcare and life sciences, legal, media & entertainment, retail and financial services. As part of this effort, Box is working with third-party developers and partners who leverage the Box APIs to deliver tailored industry specific solutions. Today, Box announced a key partnership with a 3rd party developer, Carebox, a cloud-based healthcare company built on top of the Box platform. Here is an excerpt from my interview with Brian Weiss, the founder of Carebox on why he chose the Box platform to build on.

First of all, what does Carebox do?

Carebox is a digital health company that makes it easier for hospitals, pharmaceutical companies and payors to aggregate structured, clinical data from medical records and make them viewable and shareable in Box. The Carebox integration with Box enables Box to interface with electronic health record (EHR) solutions and patient portals for the purpose of collaborating on patient data using government approved industry standards. Carebox supports CDA/CCD storage and viewing as well as Direct messaging and it uses the Box HIPAA compliant platform to safely store clinical data.

What problem are you trying to solve in the healthcare industry?

Carebox is trying to solve for the lack of interoperability and data sharing in healthcare. It focuses on two challenged areas: one is on the patient and the other is on the healthcare enterprise. For patients, Carebox focuses on how to make it easy to collect and organize patient records from disparate sources such as hospitals, physician offices, retail pharmacies, labs, clinics, and insurance companies. For the healthcare enterprise, Carebox helps organizations aggregate data on the patients they treat to help them deliver better services. The Carebox service can be offered to a patient via a sponsoring hospital or pharmaceutical company in an effort to retrieve data on the patient with the patient's consent. The sponsoring healthcare organization wants to help the patient find data that resides outside of their organization - such as additional medical records in doctor offices, genetics test results, user generated data from wearable devices, imaging studies, or lab reports. This will help them deliver more comprehensive and quality care. Carebox finds all this data and securely stores it in one place, in the Box platform. The data can be viewed and shared from within Box as the patient directs. The key value is helping healthcare organizations better coordinate care in an environment where organizations are incentivized to cross-pollinate data due to new models of value-based care, like Accountable Care Organizations (ACOs). Aggregating this type of disparate data also helps with drug development, population health, chronic care management, and clinical trial enrollment and disease registries. By providing a more agile, cost-effective, and patient-mediated way for healthcare organizations to share clinical data across the care continuum, Carebox helps organizations aggregate data for better quality care.

Tell me a little bit how you got started?

I am health IT veteran where I previously developed interoperability solutions for connecting patient data across healthcare organizations. Prior to starting Carebox, I was the EVP of Product at a leading Healthcare Interoperability Exchange (HIE) vendor named dbMotion which was acquired by Allscripts in early 2013. I have also been active in international healthcare standards work at HL7 where I authored a knowledge base on document standards for clinical data known as C-CDA, CDA, and CCD. These are clinical document standards that the U.S. government has mandated that all healthcare organizations (and the software vendors that serve them) use to exchange clinical data. I learned a ton from my time in health information exchange but felt that large HIEs were hard to deploy and complicated because of the governance models required for organizations to agree on how patient data should be exchanged. I felt it was better to focus on a patient-mediated exchange model and to always put the patient at the center of the data transfer, and that is why I started Carebox.

Why did you chose to build on the Box platform?

I was thrilled when I found out that Box was HIPAA compliant and focusing heavily on vertical industries. I did not want to build a sharing model with granular permissioning and other enterprise content management features. I thought that I could leverage some of the cloud-based file sharing solutions that were already in the market. Glen Tullman, former CEO of Allscripts and an investor in Carebox was also a special advisor to Box and was working directly with you, so that helped us get introduced. I was also intrigued, as you had done so much work on medical records and interoperability via your early days on Google Health and with David Brailer at the first Office of the National Coordinator for Health IT under the Bush Administration. So for all of these reasons, I was drawn to Box.

How do you view the Box platform in relation to other platforms you could have built on?

As a platform, Box is much more then a cloud-based file sync and share solution. It offers an enterprise-grade content management system with granular user rights for sharing, audit trails and event reporting. The company signs HIPAA Business Associate Agreements with its customers and partners and recently acquired MedXT to enable the storing and sharing of DICOM images, such as X-rays, MRIs, and CT scans, in Box. It offered the perfect content layer for storing and sharing medical records. I felt I brought specialization to the Box platform in acquiring, previewing and leveraging structured clinical data formats through the Carebox service.

How does Carebox integrate with Box?

Carebox is built on top of Box using the Box Conent APIs, so patient medical records are stored in Box folders. One example of the added value Carebox brings to Box is that we enable the viewing of structured, clinical data, formats that were previously not viewable in Box. Another example is that we enable Box to use a special, industry approved, secure e-mail called Direct Messaging to send medical records from one enterprise system to another. We also provide a consolidated view of healthcare data across multiple documents within a Box folder. So overall, we enable Box to communicate with EHRs, PHRs and HIEs and to also aggregate some of the newer sources of patient data like genetic test results. So in summary, Carebox offers Box a rich collection of tools and capabilities that extend the Box platform to be able interact with clinical structured data formats. This helps Box provide more value to their healthcare customers and allows me to leverage the secure Box content layer for storing and sharing patient records.

What are some examples of Carebox customers or beta testers?

We service hospitals, retail pharmacies, payors, self-insured employers, patient advocacy groups, telehealth companies, and clinical trial recruitment services. We help these organizations securely retrieve, aggregate and share clinical data on patients - all with the patient's consent. We are a B2B company, and not a B2C company. We're not trying to compete with patient portals and personal health records (PHRs) that provide direct-to-consumer access to medical record storage and management. While we do offer some of the same basic benefits, we focus on data aggregation from multiple disparate sources to help healthcare organizations perform deeper population health analytics and to ultimately better coordinate care.

For more questions on Carebox, email For questions about the the Box APIs, check out our Developer site. Come visit us at the HIMSS trade show in Chicago April 13- 15th at booth #8714, North Building, Hall B where we will be demoing the Carebox technology.