In Himss 2025 in Las Vegas, B. Well Conneccted Health caught attention to demonstrate the recovery of patients from extreme to extreme patients through the Tefca network, in association with Commonwell Health Alliance. Last week, the founder and executive director of B.Well Kristen Valdes and Paul Wilder, executive director of Commonwell, spoke with Health innovation about the implications that patients can easily access their own longitudinal health data and the next steps they imagine.
In collaboration with Commonwell and Athenahealth, B. Well verified the patient’s identity through Clear. He safely transmitted the verified demography to Commonwell, a qualified health information network (QHIN) under Tefca. Then he recovered the integral locations of the patient data and extracted detailed health information through CCDA. Then B. Well proved to convert complex medical records into accessible and friendly summaries for patients, the company said.
Health innovation: Kristen, could you start talking about some of the implications that patients can access their records so easily through Tefca?
VALDS: I have a child with a rare disease. Not having access to your medical records has really shaped the time for diagnosis and treatment time, and medical errors have almost cost her life throughout our trip. This is not ridiculous of the earth from a technological perspective, but from a patient and caregiver perspective, it is devastating. Especially for those who have to do with many specialists, or who are older, we do not remember the names of all the doctors we have seen. We have not tracked them over time. We do not have a natural library of things that make up our medical care. But at the same time, not having access to our information to give doctors who are treating us or specialists who need to get involved in our attention delays their ability to diagnose and treat.
The greatest friction point for consumers to access their medical records is that we put this concept of a portal that logues in the way of giving people their data. People like my daughter have 26 portals of clinical patients, and there is no interoperability among the portals. I don’t know if there should necessarily be, but consumers should have the right to access their information and share it with whoever they perceive to add value in their care.
HCI: Can you describe a little about what you demonstrated in Himss?
VALDS: Beauty in this is how elegant it is, because consumers should not have to understand all handshakes, complexities and networks behind the scene. But we do believe in progress in privacy by making this safer. The projection of an individual at the TSA level to say that David is the one who says he is behind the device should be able to unlock where his records are, and with his consent, to be able to bring them. That is what I think we are so excited.
We made a video demonstration in hymss of how easy this is with a person we call Kate. Making multifactor authentication takes a minute to configure and verify. We created the account, and we wanted to obtain its medical records, so Kate clicks on ‘Obtain medical records’, and go to the Commonwell Network, and using their demography that we collect, it took about 30 seconds to discover that he had records, and begins to return them to their health summary. Then you can see all your information historically, directly from Athena, by way of Commonwell. Then there are interfaces that B. Well builds so that this information is understandable by consumers.
He took less than a minute and a half for someone to have all his medical history of his primary care provider in Athena, including registration for the IAL2 level identity. This is the frictionless experience that consumers deserve. [IAL stands for Identity Assurance Level. With NIST’s IAL2, evidence supports the real-world existence of the claimed identity and establishes the applicant as the true owner of this identity.]
HCI: So are other EHR developers and health systems?
VALDS: We need more adoption. While Athena has said, yes, you can do all this without logging into a portal with a password for each of its doctors, we have other EHR suppliers that say: ‘OK, we will use the IAL2 to flow, but we still want me to place its login and password of its portal, and there is no good reason for that. So we are working with the industry, and now we have a series of health systems that say they want to participate, and they are raising their hands to say that this is the way we must create access without friction to data for consumers.
HCI: When you recover all this data, how difficult is it for B.Well to turn them into accessible and friendly summaries for patients? Do you sometimes get tons of data about someone, and then it is difficult to do that intelligible for the patient?
VALDS: Yes, it’s really difficult. Fhir APIs through the United States core have traveled a long way to improve that, but many people are still making transactions through older and inherited exchange roads such as CCDA. We have to do semantic interoperability. We have to let go, because we obtain the same information from multiple suppliers and multiple systems. We are gathering data between payer, supplier, pharmacy and laboratory that has historically merged, and was never designed to go well. We have something we call the intelligence layer that we execute in the unprocessed data that enter so that we can normalize it and show it to an individual in a way where you can see if your laboratories are normal or not. All these things are incredibly complicated.
HCI: Is it hope that this will lead to an ecosystem of starting companies that provide individual access services as intermediaries to health systems, with B.Well as an excellent example?
Wilder: I think you will see more innovation with the data, but it is difficult to work with the data. Kristen’s team has done a good job about it, but without publishing the data, why would someone try to imagine how to innovate in that, right? Other people will probably try to continue, because once you have this spike, you can now look at the data, and now we have large language models, and you can see if they can try to solve these things for you, but it will still be more difficult than it seems.
I think B.Well and those who have done this job in recent years have a significant clue to work with a competitive advantage. We appreciate the specific application for the pre-diabetic, for example. I suppose B.Well will add specific things from the states of the disease. Once you put yourself to the unique things, I would expect unique micro-application to appear.
HCI: Is it important that other Qhin besides Commonwell get involved in individual access services?
Wilder: I think many of them do not yet have the incorporation service to have a B. Well Connect. But B.Well has used others over time to try several pieces and input ramps. And for now, we are happy to be your home, and we hope we can maintain that relationship of trust. So I do not think there is enough participation such as the entrance ramps, but I have given up fighting to force them to do so, and instead I love the idea of showing everyone else why this position is wrong and see what happens from there. Let the market influence people’s hearts and minds. It shows that it works. If you can obtain 40% of the moved market, that is enough voice that you cannot listen to it and cannot begin to react to the negative parts that realize that they are creating, either by intention or by accident. We want to educate that it is possible and safe.
HCI: Kristen, anything else you want to say about the next steps? He mentioned working with the other health systems. Does this also imply working with more EHR suppliers?
VALDS: Yes. I think Paul makes the heroic effort to help support and demonstrate to others that this is possible and how they should be doing this from a perspective of the next step, to show what we have just done, but do it at the national level at the scale. We need more adoption from the Tefca network. We need people to join. We also need health systems whose EHR has not configured solutions to accept Iial to work around their EHR and respond, because they have the capacity and technology to do so. They need to respond to a token ial2 because it is the right thing from a consumer perspective.
We need all entities to understand that consumer access is a federal mandate. It is something that is here to stay, and it is something that consumers really need. Therefore, we want more people to adopt, but there must also be the adoption of the token ial2. There are a number of identity suppliers. B. Well, it is only associated with Clear. They have been a phenomenal partner for us. And Iial2 is something that we need that payers and suppliers and laboratories and pharmacies and those interested in health adopt, because it is significantly safer and more private. And ial2 is really an activation factor that we have put in national networks, because we don’t want anyone to arrive and steal demography.
I used to work in the centers for the fraud, waste and abuse of Medicare and Medicaid services as a contractor, and could buy a list of Medicare beneficiaries for less than $ 300 on the street with all your information to identify them. As we advance in this digital era, that detection is really important. We want to make sure that more and more people adopt these additional privacy tools so that we can begin to reduce fraud, waste and abuse in our medical care provision system, but also make people feel safer that they can collect and add their records and that they are safe and used only by them.
