Parsli’s Tripple Aim (And why it’s so hard)

Parsli Health seeks to enable individuals to truly own their health journey by empowering them with three things:

• Ownership of their health records

• Transparency of insurance coverage and costs

• Predictive tools to help a patient understand where their health journey is taking them

These three areas are particularly challenging for the following reasons:

Ownership of your health records:

It can be difficult to know where all of your health records are because your medical information is often scattered across multiple healthcare providers and systems. You may have received treatment from different doctors or hospitals over time, and each of these providers may keep their own separate medical records.

In addition, different healthcare providers may use different electronic health record (EHR) systems that may not (almost certainly not) be able to communicate with each other, making it difficult to aggregate all of your medical information in one place. Even within the same healthcare system, there may be multiple EHR systems used by different departments or clinics.

Wait, there’s more - healthcare providers are required to maintain strict privacy and security standards to protect your personal health information, and as a result, they may not be able to share your medical records with you or other providers without proper authorization or documentation. This can be a very frustrating experience.

HIPAA regulations, do provide you with the right to access and obtain a copy of your own medical records from your healthcare providers, but this often comes in two forms: paper (awkward) or digital data access via an API (also awkward unless you love APIs).

Transparency of insurance coverage and drug/procedure costs:

I’ll have another post on this topic later, but in summary: price transparency makes the complexity of health records seem like nice book on a comfy couch. Just a few of the challenges facing parsli as we work toward transparency:

• Complexity: Healthcare prices are often complex and opaque due to negotiated rates with payers, service location and more

• Lack of incentives: Many providers and insurers have little incentive to disclose their prices or compete on price or quality, as the current system rewards volume and complexity rather than value and efficiency

• Legal and regulatory barriers: Some providers and insurers may face legal or regulatory barriers to disclosing their prices, such as antitrust laws, privacy laws, or contractual obligations with third-party payers

• Information asymmetry: Patients often lack the knowledge, skills, or tools to navigate the healthcare system and compare prices or quality effectively

• Resistance to change: Healthcare is a complex and highly regulated industry that involves many stakeholders with diverse interests and perspectives.

Predictive tools to help a patient understand where their health journey is taking them

• Data quality and availability: Healthcare data is often incomplete, inconsistent, and scattered across different systems, making it difficult for AI algorithms to learn and make accurate predictions.

• Complexity of healthcare domain: Healthcare involves complex processes and interactions between multiple factors, including biological, environmental, and social factors.

• Need for explainability: In healthcare, it is important to understand how AI algorithms arrive at their predictions or recommendations. This is particularly important for clinical decision-making, where lives are at stake.

• Regulatory and ethical considerations: Healthcare is a highly regulated industry, and any AI-based solutions must comply with regulatory standards and ethical considerations.

If you’ve made it through all of that, you can see that Parsli’s triple aim seem more like a triple moonshot. And perhaps they are. But we know that these things are worth pursuing, because we all have people who have suffered through the challenges highlighted above (or suffered them ourselves).

The taller the mountain, the better the view.