How Moxe is Responding to the 21st Century Cures Act

In most cases, business owners complain about new government regulations, but sometimes they facilitate business development. Such is the case with new regulations stemming from the 21st Century Cures Act, which have put Madison-based Moxe Health in a more intense phase of helping patients direct how, and with whom, their personal medical data is shared.

Demonstrating real moxie on health data sharing

Dan Wilson, CEO of Moxe Health, a clinical data clearinghouse, acknowledged that players in the health data exchange market are responding to the law’s consumer-centric objective. The law, enacted and signed into law in 2016, puts the patient in the middle of the data-exchange process because subsequent regulatory guidance says that a patient can get access to their information and share it with anyone they choose.

“We’re fans of the final rule of the Cures Act, as it is all about patient empowerment,” Wilson states. “It allows patients to access their health data and share it with whomever they choose. While it creates complexity for health systems and health plans in terms of compliance and security, the goal is very consumer centric. We all make better decisions when we have accurate information at hand.”

Task partner

Moxe’s technology connects directly to all major electronic medical record systems to enable targeted extraction and the sharing of actionable insights from payers to providers at the point of care. The Cures Act and subsequent regulations have elevated the national discussion around data sharing.

To help make the job easier, Moxe Health has partnered with the American Health Information Management Association (AHIMA), whose members are health information management professionals tasked with safeguarding patient medical information. They have developed a database of different digital health applications that patients may use, and they have created a privacy-centric assessment that those applications can complete to demonstrate their commitment to patient privacy and data security. The program is called dHealth and is available to all the health systems and HIM professionals “that are now being tasked to assess where patients are asking to send their information.”

Moxe’s data exchange technology is designed to secure personal medical data. Every health IT vendor has the responsibility of encrypting data and keeping it safe from hackers, but there is the additional consideration of privacy when it comes to who it’s shared with in the health care system. Wilson explains how Moxe’s technology works by citing a concept in health care called minimum necessary exchange. It’s the idea that the amount of personal medical information that is shared should be minimized to only the information required to solve a problem or address a need, and it’s done out of respect for the sensitivity of the information.

Privacy, Wilson adds, is in the eye of the beholder, and what is sensitive or private to one person may be very different than what is private to another person. Even the same piece of information — a lab result, for example — may be viewed as sensitive by one patient, while another is perfectly fine with sharing it.

Moxe Health’s software basically allows a patient to indicate to their health care system what information they are comfortable sharing with an insurance company for different use cases, and its software manages all of that. There is nuance involved, and the software helps health care professionals understand the different scenarios in which patients are, or are not, sharing information. The technology has many privacy and security protocols in place, which are constantly monitored, and Moxe works with providers to ensure that the patient information shared with health plans is the minimum necessary and reflects patient preferences.

“Our software allows providers and health plans to securely share clinical data digitally — in the format and workflow that works best for them — so they can make more informed, timely decisions that lead to better health care outcomes,” Wilson explains. “This saves time, money, and trees — no more paper — which is all administrative waste.”

As Wilson notes, privacy concerns aren’t the company’s only motivation. Moxe focuses on eliminating one of health care’s most costly and unnecessary areas — administrative waste. This waste is estimated to be a $900 billion annual problem, which equates to approximately $2,500 per person in avoidable costs each year. Wilson believes that removing that waste can lower health care costs.

“We founded Moxe because we wanted to make health care more affordable,” he notes. “We all have a story about being blind-sided or worse — bankrupted — by our health care system. Just one diagnosis, one encounter, one accident can be financially crippling. Health care is way too expensive, and it doesn’t have to be.”

3M partnership

Earlier this year, Moxe Health received an additional round of capital from 3M Ventures, the capital arm of the 3M Co., but that might not be the biggest news of the year thus far. 3M must really like this Madison company because 3M Health Information Systems , which is also trying to wring cost out of the system, announced it will offer Moxe’s data platform across its customer base of hospitals, physician groups, and health systems.

3M has a significant health IT business. The fact that they looked at the market and identified Moxe as the best solution for its clients is a vote of confidence. “We’ve been fortunate to work with a lot of innovative health care organizations that are also trying to reduce the cost of health care,” Wilson states. “It will take all of us, and it will be worth it.”

The latest round of funding will enable Moxe to further develop and market its products and, Wilson hopes, tackle additional areas of administrative waste in health care. “We want to grow our network of providers, payers, and partners and expand the potential of timely, accurate clinical data,” he explains. “It’s a big, $900 billion problem, and we’ve only scratched the surface.”

2020 in review

All things considered, the pandemic year of 2020 wasn’t bad for business development, given the launch of Moxe’s release of information (ROI) product and certification from CommonWell Health Alliance, which has a nationwide network, to enable the sharing of clinical data. Mostly, however, it was an opportunity to come to the aid of the stressed health care industry and look inward for improvement.

“The pandemic was hard for everyone,” Wilson notes. “Early on, we just wanted to help our community; we’re in health care after all. We realized that with so much uncertainty, the one thing we could control was our work. So, we focused on enhancing our products and making sure that we were giving our customers the best solutions we possibly could.”

The fact that Moxe’s clinical data exchange products are digital helped customers work remotely and safely. For example, its provider customers didn’t need to be in their offices (often hospitals) while manually processing paperwork, so Moxe helped them continue to run their business remotely.

The pandemic also allowed Moxe to “find ways to help new customers gain value from working with us,” Wilson adds. It was a little easier knowing that the Cures Act implementation would create opportunities, especially as potential customers confronted new rules to prohibit data blocking.

“Interoperability is not new; getting the right data, at the right time, in the right place, in the right format is something organizations have been tackling for decades,” Wilson notes. “However, with the recent regulations, advances in technology, and demand, interoperability has gained significant momentum. The time is now, and we’re excited to be in this space, making data-driven health care happen.”