Health & Spirit

Startup seeks to hold doctors, hospitals accountable on patient record requests

Lori Basheda, Kaiser Health News on

Published in Health & Fitness

When Kelly Shanahan had her OB-GYN practice in South Lake Tahoe, Calif., she was meticulous about providing medical records promptly to all patients who requested them, she said.

But since being diagnosed with metastatic breast cancer in 2013, an event that forced her into retirement, Shanahan has discovered that not all of her doctors are as attentive to such requests.

Getting copies of her records has been, as she puts it, "a colossal pain."

With few exceptions, federal law requires that health care providers make copies of medical records available within 30 days after patients request them and, when possible, in the format they desire. Under California law, providers have 15 days to hand over the records if they are being sent directly to the patient.

But many patients, who may have records scattered across doctors' offices, labs, hospitals and clinics, say responses from health care providers can range from sluggish to churlish. Assembling the records can be onerous.

Earlier this year, Shanahan turned to a Silicon Valley startup called Ciitizen, which requests medical records on behalf of cancer patients and redacts them for clarity and legibility.


Shanahan logged on to the company's website and signed an electronic consent form, handing over to Ciitizen the task of requesting her records from multiple providers. The company emails her when a record is ready for her to view.

Ciitizen does not charge patients for gathering their medical information. Rather, it hopes to make money "in the near future" by taking a transaction fee for "matching third-party researchers with patients who wish to share their records," said Deven McGraw, Ciitizen's chief regulatory officer and former head of health care privacy policy at the U.S. Department of Health and Human Services. She said the company plans to offer its services to people with other serious illnesses in the future.

On Tuesday, Ciitizen, based in Palo Alto, Calif., released an update to a report card it first published in August that uses a five-star system to rate how health care providers comply with federal rules governing record requests. The scorecard, which Ciitizen plans to refresh every few months, can be viewed online at

It shows that of the 210 providers from whom Ciitizen has requested patient records so far -- including hospitals, doctors and specialty clinics nationwide -- 51% have only one or two stars, meaning they were noncompliant or required significant intervention by the company to comply.


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