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How I Unintentionally Put Myself in The Obamacare Nightmare Period

Healthcare Horror Stories are a weekly post of horrible healthcare experiences. They are posted anonymously. Submit your story; if you’re selected, you get a free Prime t-shirt. The best comment gets the same prize!

Open enrollment ended. I was laid off after open enrollment ended. I did not submit my forms for triggering events within the 60 day period. And now I am not allowed to apply for conventional health insurance anywhere in the 48 states, unless I get a new job that provides it.

So I’m stuck with short-term insurance options that’ll only cover emergencies.

Fortunately I’m “healthy” so really it’s not an issue for me, but really the only way out is to get a job that provides coverage which I’m not ready yet to do. I’m contracting with a company that I potentially want to get hired with, but it won’t be for a while. According to an insurance broker I spoke with, Obamacare provides open enrollment during that period only. And for some reason companies cannot or won’t offer their insurance outside of these periods.

So even if I get short-term insurance, I will still be slapped the Obamacare tax penalty because it’s not considered full coverage under the law.

I was naive to think I could get a new job within the period. I should’ve signed up right away after I got laid off. Now I’m faxing stupid pieces of paper, where the turnaround time is always a week and if something is wrong, it takes another week for them to tell me.

It’s hilarious. It’s like SHUT UP AND TAKE MY MONEY, but they won’t!!

Wish me luck.

Note from the Prime Team: today’s author is from California. If you are a healthcare professional and have any actionable advice for them, please comment below or email tyler@useprime.com and he’ll relay.

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Introducing the Patient Portal Finder

We’re not launching Prime itself to the world just yet (soon!) but we are releasing something else today: the Patient Portal Finder.

It’s become clear to us in our concierge support of thousands of beta users that although a lot of people know where they get care, they don’t know where to view their medical information online. They want to, but not every provider makes it easy.

We’ve learned enough that today we’re taking what we learned and making it available publicly to everyone, for free, in one easy-to-use tool. This is the same technology we use to power Prime itself.

What does the Patient Portal Finder include? A few things:

A list of all the thousands of providers—clinics & hospitals—Prime supports (most of the U.S.)

Links to patient portals for each provider

Full instructions for how to sign up, and access, your health information for each provider

Try it out! Find your doctor’s patient portal and view your results, medications, and doctor’s notes.

There is also a fourth optional step to sync your information to Prime, but that is not required. The point of this tool is to allow anyone, Prime user or not, to be able to easily view their medical information online. We’re making this information available free to everyone because we believe there are many—too many—people who need this information but can’t otherwise easily find it.

One more thing. We’ve also open sourced the full list of providers and their metadata for developers. As we add support for more providers, we will add them to the repo. As we learn more about providers, we will add more fields to each provider. We hope you’ll fork and do something amazing!

This has been a labor of love for us. We’re only able to do this because we’ve steadily increased the amount of care providers we support for over a year now as we race toward launching. From supporting a handful of providers in our pre-alpha days to thousands today, the Patient Portal Finder was not an overnight project. We hope it makes your life even just a little bit easier.

Get early access to Prime! Sign up for your invite

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Student: ‘If My Doctor Had Just Read The Report More Closely…’

Healthcare Horror Stories are a weekly post of horrible healthcare experiences. They are posted anonymously. Submit your story; if you’re selected, you get a free Prime t-shirt. The best comment gets the same prize!

In college I went in for severe abdominal pain. After sitting for hours in the emergency room, in pain, with a rude doctor, he ordered a urine & blood test. Came back and told me I was pregnant & they needed to do an internal ultrasound to make sure it wasn’t an ectopic pregnancy (trust me-this is a bit invasive for a 20 year old that isn’t expecting something like this). Didn’t see anything saying it was likely too early, and told me to go to Student Health Services the next day to check my HCG levels.

I did that and the bloodwork came back and the doctor looks at me after reading the original emergency room report saying, “You aren’t pregnant and never were.” The ER doctor had looked at the qualitative test result (which said positive), but immediately next to it was the quantitative result which was very clearly negative (0.00).

If he had just read the report a bit more closely, it would’ve saved me from being scared, hiding telling my parents about the visit (I was still on their insurance), and getting excited then disappoint with my boyfriend.

photo credit: Waiting Room Chairs Dying Plant Door (license)

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Prime Is Launching Soon—Get Early Access

Over the past year since starting the Prime beta, we've worked with thousands of beta users, added support for thousands of clinics and hospitals, released hundreds of updates to improve Prime, and helped make caring for countless people all over the U.S. an easy, enjoyable process.

We've also learned a lot. We've learned there are so many people, with so many stories, so many of whom benefit from having their family members + health data in one place. It's time to formally wrap up the Prime beta.

So, good news everyone! Soon we will be officially launching Prime.

What does this mean?

Prime is coming soon, available to everyone, and with some major updates and new features. We've secretly already been taking everything we learned and working on the new Prime for the past couple weeks. We have some amazing things to share and I can't wait to show them to you soon.

Prime beta will remain available in the meantime. And of course feedback is still welcome! Just because we're launching out of beta doesn't mean we don't still love to hear from you. Help us make Prime better for you.

Follow @use_prime and on Facebook for sneak peaks and extra early access contests.

Follow this blog for more great conversations like our latest Caring Conversations and Healthcare Horror Stories here on our blog. Subscribe in the sidebar →

Get early access! Sign up to get your invitation:

Sign up to get your invitation. Get early access!

And of course much more. But I don't want to give away too much right now.

I want to thank our tens of thousands of beta testers who've provided hundreds of hours of feedback. We never could have imagined such an amazing response. Collecting feedback has been a bit overwhelming at times, not that we're complaining.

Our vision and our hope is to finally bring caring for those close to us into the 21st century. Communicating and coordinating with family and carers is about to get even easier. Stay tuned, and don't forget to sign up for your invitation!

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Meet the Prime Team: Tyler Hayes

Name: Tyler Hayes

Title: Cofounder & CEO

Education & Experience: St. Olaf College ’08 — BA in Psychology/Neuroscience and Asian Studies/Japanese. I started my first company Tyler the Techie “Your Personal IT Guy” in the Minneapolis-St. Paul area when I was a teenager and then sunsetted it at 24 when I sold everything I owned to move to San Francisco. I joined Disqus as a community support representative in 2010 and left as a Product Manager leading publisher, mobile, and international teams.

Tell us about you. I’m a huge nap advocate (major accomplishment: got a nap room put in at Disqus), play beach volleyball as much as humanly possible, and pretty much become an undecipherable mess whenever I see a husky.

What’s something interesting about you? When I moved to San Francisco I ate nothing but pumpkin seeds for a month. I learned a lot about spices that month. I’d saved up a decent nest egg but made a pact with myself that I wouldn’t spend any money I didn’t have to until I had my next career lined up, either landing a job or starting another company. Fortunately I met the Disqus team pretty quickly

What’s the deal with the hair? No comment.

Best health tip? Water. Lots of it.

When I was 11 or 12 I had a hunch that whenever I felt hungry I was actually just thirsty, but because I was so trained to “clear my plate” I always instinctively reached for food when I needed to recharge. So I started drinking water whenever I felt low on energy and confirmed my hypothesis: it got me going again!

Worst guilty pleasure? Swedish Fish. Every road trip, every movie, game over.

Where do you get care? I subscribe to One Medical and fortunately don’t have any chronic conditions so just have a PCP.

What type of insurance do you have? Medi-Cal. Funny story: when Prime went through Techstars I had Blue Shield of California. I also switched most of my banking from Wells Fargo to Simple, and forgot to update my insurance billing. So Blue Shield kept mailing lettrs to our house notifying me they’d cancel if I didn’t pay my monthly bill. Only one problem: Techstars was in Kansas City. So I was gone for 4 months, and came home to find out my insurance was canceled. I had been uninsured for a whole month without knowing. Medi-Cal has saved me in the meantime.

How do you handle your health? I jog 3x/week and do yoga 2x/week, and eat healthy for the most part. No crazy diets, no hardcore rules. I just try to eat lots of veggies and no food after 9 PM because I’ve noticed those help me the most. But I’m not hard on myself when I have candy at a movie or miss a jog; willpower is a finite resource that depletes each day.

What’s the funniest/craziest thing you’ve seen while working at Prime? That time Will printed his face inside a human-head sized jar and put it in the office fridge.

Why are you working at Prime? My dad passed away from lung cancer when I was 24 and I saw first-hand just how messed up the healthcare system is, primarily the huge lack of communication and access to timely information. Everything had to go through the doctor, and there was no easy way to find out what was going on unless I tagged along to every appointment. Felt like it was time for a change!

What do you do at Prime? As a cofounder of a small team we all do a lot of things. Originally I was mostly coding our backend. Think of it like infrastructure—the stuff that’s responsible for syncing your data from your doctors and family messaging. Nowadays I’m mostly focused on growth, which means finding more people who’d love Prime, telling them about it, and making sure the product fits their expectations and desires.

Favorite part about working here? That’s an easy one: helping people live their healthiest life possible. We have a long way to go to fulfill that dream but we’re well on our way.

What don’t you like about working here? Some days it just feels like there’s so much resistance to pushing things forward in healthcare. It’s the beast with a thousand backs. I balance those days with the great ones. Like this one time when a customer started crying, which was concerning, but they explained they were tears of joy. They were unemployed and couldn’t afford to get their health records and evidently no one was responding to their requests—turns out us just even helping them get access to their patient portals was a huge deal.

What profession other than your own would you like to attempt? Space explorer.

What profession would you absolutely not like to participate in? Professional pie eater. How could I ever truly enjoy pie again?

What do you do after work? Video games. Ssshhhhh…

Where can people find you? noblepioneer.com is my blog about space, science, and the future of humanity. Less writing these days, but it’s a great way to get to know me. That and Twitter @thetylerhayes.

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Health Tech Interview with John Sung Kim of DoctorBase

I have a history of making products for consumers, so I wanted to get some insight into why hospitals aren’t meeting low-hanging government requirements to engage their patients online—why they seem not to be following the lessons of 20 years of successful web companies when they build their “patient portals”.

Fortunately John Sung Kim, General Manager of DoctorBase, a Kareo Company, wrote an article the other day for EMR & EHR that highlights an interesting perspective on why hospitals have struggled to reach the low requirements:

Yet, even the subsequently reduced goal [to get 5% of patients to use online hospital tools] was difficult to achieve for most organizations, especially smaller independent practices that were dealing with a confluence of changing competitive markets, new billing codes, and mandated technological updates. Any digital marketer with two years of experience running ad campaigns could have told us this would become the case.

In other words: if you want people to use your software you have to market it properly—and patient portals haven’t been marketed.

John was kind enough to answer a few follow up questions—thanks John!

Quick Aside: A Crash Course in US Health Tech Law

The federal government setup a series of incentives to help accelerate the pace of software tech adoption in hospitals.

These incentives are called “Meaningful Use” incentives, because they require hospital staff to meaningfully use their electronic medical record systems.

Stage Two of Meaningful Use just took effect and, among other things, requires providers get a percentage of their patients using the hospital’s online tools for health record management.

Q: It seems like hospitals should be able to solve the five reasons you outlined with a barebones marketing and design team on their website, is there a reason this hasn’t happened at practices?

John: Hospitals usually spend a lot of money on established marketing agency partnerships that go way back. There’s not much incentive for a mid to large agency to build a portal when they could be buying billboards and local tv spots. And you should see how much they spend on events.

Q: Do providers only care about portals as far as achieving MU2 incentives?

John: I think providers only care about Meaningful Use Stage II for now, because they see portals as creating more messages and more work – someone needs to show them portals can be time savers and money makers. Like someone needs to make the killer app for my Apple Watch.

Q: Is there a way to directly (or indirectly, but easy to explain to small practices) incentivize a portal that will help them prioritize better design?

John: Not really, but if you find one, lmk!

Okay, so that last question was somewhat leading, but considering John’s years of selling software to practices of every size, it seemed appropriate.

Thanks John for adding some more insight. I do expect we’ll get some Healthcare Horror Stories involving software soon, but it’s Friday so let’s stay positive…

How good of an experience have you had with your doctor’s patient portal? Did you message your doctor, easily find results? Let us know, join the discussion below!

John Sung Kim is the founder and founding CEO of Five9 (NASDAQ: FIVN), widely recognized as the leading company in the contact center industry. He’s acted as a consultant to numerous startups including LGC Wireless (acquired by ADC), Qualys (NASDAQ: QLYS), RingCentral (NYSE: RNG), Odesk (merger w/ Elance), 6connect (funded by Hummer Winblad) and M5 Networks (acquired by ShoreTel). Follow him @JohnSungKim.

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Paula Span of the New York Times: What If We Incentivize Family Caregivers to Go Pro?

Paula Span, of the wonderfully informative New Old Age column at the New York Times, is no stranger to the complexities of healthcare and caregiving in the U.S.

In a prescient piece about the woe of paid caregivers in our society—they’re underpaid, overworked, and don’t receive benefits—Span lays out an even bigger problem: we don’t have enough of them for our increasing elderly with their increasing needs. The solution? What if we re-enlist family caregivers after they’re finished caring for their own families?

[…]

Now a group of Northwestern University and Johns Hopkins health care researchers has come up with another idea, recently published in The Gerontologist: Recruit family members who already provide the bulk of elder care to join the ranks of paid caregivers after their responsibilities end (a euphemism for when the older people they care for have died).

The benefits could flow in both directions. “I see firsthand the link between illness and poverty,” said Melissa Simon, the lead author and an obstetrician-gynecologist who works in a clinic for low-income women at Northwestern’s Feinberg School of Medicine.

When a family member becomes ill or disabled, “if there’s not enough money or no insurance coverage for someone who’s paid, then someone in the family has to take care of that person,” Dr. Simon told me. When a low-income caregiver leaves the work force, cuts back hours or leaves school to provide care, “it’s an economic hit to a household that already doesn’t have much economic reserve,” a blow that can be hard to recover from even after caregiving ends.

“On the job as a caregiver, you actually learn a lot of skills – whether it’s giving medications on a schedule or learning to transfer your loved one or bathe them,” Dr. Simon said. “You also learn how to interact with a health care team. You learn how to navigate the system.”

She and her colleagues envision programs that would help family caregivers turn those experiences into marketable job skills by assessing their abilities, providing additional training and credentials, and connecting caregivers with a health care industry that will need hundreds of thousands of new employees.

Though initially family members might transition into entry-level positions as certified nursing assistants, they could also train for more technical jobs — as X-ray technicians or phlebotomists, say — or work in insurance and billing. Some might become community health workers or patient advocates, or advance to nursing and social work programs.

“We’re interviewing folks about this right now,” Dr. Simon said. “People are saying they’d be interested if there really was a pathway to employment.”

Let’s acknowledge that for now, entry-level positions in elder care remain economically unattractive to those who have other options. But higher wages, benefits and a career ladder that encourages advancement could make those jobs more desirable. Indeed, as the job market slowly improves, it’s hard to see how to fill these slots without such changes.

Besides, many people enjoy interacting with older adults, another skill they have acquired as family caregivers, and take satisfaction in helping them have good lives. And as the country’s ethnicity changes, having skilled caregivers from many cultures who speak many languages represents a bonus.

While Dr. Simon and colleagues continue to investigate how such programs might operate, I’ll ask those of you who have been in the elder care trenches: Do people who have spent long periods as family caregivers really want to do more of it? Perhaps make a career of it?

For now, it’s just an idea. But we are going to need lots of ideas.

What do you think? As a family caregiver, would you do this? Do you know others who would? Join the discussion below.

p.s. If you liked this post you should subscribe to Span’s twice-monthly New Old Age column in the New York Times.

This post largely quotes a column originally posted at the New York Times and has been selectively quoted with permission from its author.

photo credit: AutoPulse, Hawaii State Respiratory Conference, Photo Gallery of Lifescience Resources Hawaii September 2013 (license)

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That Time I Got A Nightmare Misdiagnosis

Healthcare Horror Stories are a weekly post of horrible healthcare experiences. They are posted anonymously. Submit your story; if you’re selected, you get a free Prime t-shirt. The best comment gets the same prize! This is the debut post of the series and, as you’ll see, even we couldn’t believe what we were reading.

So, imagine the most comical ridiculous thing a bad doctor could do after your first visit. Now imagine something 1000x worse… that’s what happened to me.

The doctor literally told me I tested positive for HIV.

I went in to get a standard round of STI tests. I was changing partners, and it had been a while.

“I know that’s a lot. Are you breathing? Are you okay?” he asked

“What are the chances of a false positive?” I asked. I was dumbfounded.

“Well, I’ll say this: the tests are good. We’ll get another round of tests to be sure, but in the meantime I want to start talking about treatment as well,” he said.

He was wrong. I didn’t have HIV. Many HIV screens are known to have a high false-positive rate. But this doctor didn’t know that. And neither did I.

As I tried to piece together what was happening, I found studies and diagnostic flowcharts based on different HIV tests. But I didn’t know exactly which test I had been given. The doctor hadn’t told me. He hadn’t posted the results on his practice’s web portal because “it could be an insurance liability.” I called the lab and they wouldn’t tell me anything about the tests I had taken–I had to go through my doctor.

The philosophy behind that, as I understand, is that patients should have their results explained by a physician who can contextualize them. But of course in this case the physician totally messed that part up. I would have done better reading the results and researching what they meant myself.

Ultimately it’d be cool if I could “self-serve” stuff like labwork. Maybe I can’t order the tests myself, but I can at least get the raw result data as it comes in.

It’s cool now. But those were a stressful couple days, to say the least.

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Default Health Apps Are Coming

Healthcare is being disrupted, you just can’t see it. Yet.

A year ago I thought it bizarre how we have so many default apps replacing real-world tasks—Yelp for checking restaurant reviews, Tinder for finding a date, Etsy for handmade goods for your sweetie—yet we don’t have decent apps like this for our interactions with healthcare.

Over the last year since starting Prime, though, I realized these apps do exist. Healthcare is being disrupted, you just can’t see it yet.

Consumer services in healthcare are fast being unbundled from the outside:

Need a quick immunization for your upcoming trip? Minute Clinic.

Need a quick lab test done? Theranos.

Need medications delivered regularly? PillPack.

Want to know your genetic risk factors? 23andMe.

Kid got a fever—want a doctor to swing by and check it out? Pager.

… or just a quick video visit? Doctor On Demand.

… or just a quick text chat? First Opinion.

… or maybe a more general question about yourself? Better.

… and maybe just specifically about your skin? Spruce.

Moved and need to book an appointment with a new doctor? ZocDoc.

Need insight into your sleep? Sleepio.

… or your food choices? Lark.

… or your blood sugar? One Drop.

… or your blood pressure? Hello Heart.

These all could be categorized as solutions that give you the ability to do yourself what previously only physically visiting a doctor could do for you.

There are also plenty of solutions disrupting healthcare by creating wholly new experiences, typically enabled by inflection points in new technologies:

Need to coordinate care for a family member? Prime.

Kids are sneezing; wondering if anything’s going around? Sickweather.

Want medication reminders on-the-go? Mango Health.

And healthcare is even increasingly taking on the task of disrupting itself:

Want your doctors to do house calls? Medicast.

Want another doctor’s opinion on your diagnosis? Figure 1.

Want to network with other doctors? Doximity.

Want to connect your doctors with diagnostic labs? Health Gorilla.

None of these are household names yet. But they are moving fast.

And I haven’t even mentioned another huge category: the fast-increasing number of solutions available to software developers every day. A quick glimpse: Validic for interfacing with wearables, Bloom to search and compare clinicians, athenahealth to build on their provider data set. But there are so many it really a deserves its own post1(http://Hint.).

Default apps

I like the idea of default apps — apps that become synonymous with tasks.

When talking about default apps, people often remark on how interesting it is that some technologies become so default they even earn a spot as a verb in our vocabulary. (“Google it.”) What’s more interesting to me is that it’s human nature to want default apps. Our brains don’t handle complexity well so we prefer simplicity.2 For example, instead of being able to switch between 50 food-finding apps that are each subtly right in different contexts, we just use GrubHub. This is why brand affinity is a thing.

Quickly and surely this is happening in healthcare too. A year ago you could barely see it. Today it’s less hazy; every so often you hear a friend or coworker name one of the companies on this list. Next year, well… more.

There are no market leaders yet. But many of the companies that will become the market leaders in the new healthcare have already been started.

Market leaders will emerge, winners will take all, products will be verbified.

—Tyler

Hint. ↩︎

Cf. Analysis paralysis ↩︎

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Introducing: Messages for Prime

Since the beginning of Prime, we’ve believed communication brings peace of mind. When family and health information are side-by-side, things no longer get repeated, misunderstood, or even worse: lost.

Today we’re introducing Messages, a major update to Prime that enhances the communication experience by adding free-standing messaging.

To understand why free-standing messaging is important, imagine you’re 35. Your 65-year old mom has congestive heart failure and diabetes (both of which are sadly quite common). Mom still lives at home and is perfectly capable but appreciates a helping hand. You’re a good kid, you go with her to weekly doctor visits. She gets her blood drawn, medications updated, future appointments scheduled, every week.

You use Prime to keep track of all of this and keep the family updated — your life is a little bit easier.

But now your sister just texted asking who’s calling to reschedule the next appointment. And your brother’s emailing to ask how mom’s dizziness is doing in all the traveling to and from doctors. And mom is calling because her home meal delivery service forgot to bring low-sodium meals, which she needs because of her heart condition.

Family life is peppered with these little intricacies. Now Prime helps you with these raw in-between moments just as much as the medical stuff.

This hypothetical story is not unique. This is life for the 60 million of us unpaid caregivers who take care of a family member, and the even more massive 140 million Americans who have a chronic condition. These are big numbers. And they’re getting bigger every day.

As Prime continues to be used by more people, any little change we can make increasingly has the potential to save time and prevent agony. Big changes all the more so. Messages is a pretty big change so we rolled it out to some of our beta testers early. I think one of them sums it up best:

From a Prime user today ❤️ pic.twitter.com/09I62uJYQL

— Tyler Hayes ✮ (@thetylerhayes) April 22, 2015

We hope Messages + Prime lets you live life just a little bit more.

❤ Tyler, Owen, and Will

Taking care of a family member? You’re not alone—60 million Americans do. We’ve got your back. Sign up free for Prime today.

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Prime + iOS 8 Health: Send Your Vitals to Health

Prime now supports the iOS 8 Health app. If you have an iPhone with iOS 8 installed1 starting today you can send your vitals—height, weight, BMI, blood pressure, pulse—right from Prime to your Health app, seamlessly and securely.

How easy is it? Put on the coffee (because you're gonna need something hot to drink after you see just how easy it is):

Simply open any of your vitals in Prime → tap the "Send to Health" button → grant permission (only required the first time). Now your vitals are available in your Health app.

It's almost too easy. (Thanks Apple!) We also plan to support sending more types of medical information, like allergies and medications.

What a wonderful day for health and therefore of course the world.

<3 Tyler

See the iOS 8 Wikipedia page for a full list of iOS 8 supported devices. ↩︎

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Should I Raise Angel, Seed, or Series A?

What can be said about fundraising that hasn't been said already?

A lot.

Let's talk about who to raise from and how to raise from them, depending on the stage of your company.

The answers are actually quite simple and well-known. It's getting to the answer that is the tricky part because it requires being brutally honest with yourself.

When raising funds, be brutally honest with yourself about specifically which stage you're at—one of three:

Are you pre-traction? Raise an angel round. Strategy: sell the dream. You don't have numbers to sell so don't even try to sell investors on traction at this point. You will only end up with dumb investors. You're raising money to prove people will use what you make.

Do you have early traction? Raise a Seed round. Strategy: sell the traction. Show off your traction. You're raising money to figure out how to convert this traction into repeated, up-and-to-the-right growth.

Do you have repeatable, up-and-to-the-right growth? Raise an A round. Strategy: sell the growth. You're raising money at this point just to cover costs because you're not generating enough revenue yet, but everything else is up and to the right. "We've got a fire; let's pour gas on it."

It's simple. Be honest.

Then go raise the money. That's also simple: just talk to people until you find out who fits with your vision.

Why focus on traction? There's no easier way to prove you're right than traction. Not to mention: if you're contrarian, it's the only way.

Worth saying: sometimes you can be in between these stages. E.g., pre-product, post-product without product-market fit, and post-traction without repeatable growth. The answer is still simple: tell investors what stage you are and find investors who are OK with that. For example: if you have a product but not product-market fit, still go after angel investors and just double down on selling the dream. Another example: hardware startups often raise money pre-product.

Fundraising isn't mysterious. It's a lot of work.

<3 Tyler

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Data Doesn't Talk

We learned recently only 1/10 new Prime users were successfully importing medical records. That was much lower than we wanted.

Our first instinct was to look at the code. "There must be a bug somewhere." It's easy in software development to jump to the conclusion of: bad code must be causing something to break.

In reality, the cause was much more innocuous: people simply weren't verifying their email addresses. And Prime requires you to verify your email before you can use Prime to get your medical data.

So why weren't people verifying their email addresses? And why didn't we notice this earlier? We learned our second big lesson there and it's quite simple actually:

We have a healthy number of app downloads.

We have good sign-up conversation rates.

We saw a large amount of data being synced from medical systems.

In other words, we saw most of our numbers increasing and no red flags.

We measure almost every non-personal metric possible. Despite that, data doesn't talk—we hadn't set up an alert for this metric specifically (email verification). We never anticipated it'd be a problem.

But it was also the fact we measure all those metrics that saved us. We were augmenting our Ideal User Funnel and only then did we happen to notice, despite what looked to be good absolute numbers, the percent of users getting medical records was only 10%.

We learned two lessons:

We should make no assumptions and always start with a beginner's mind.

Data doesn't talk. Data only gives answers when we know which questions to ask and then ask them.

When building software, usage data is always important. In this case it even ended up informing our design—we shipped an updated onboarding design and after just 24 hours of looking at the numbers we saw almost 100% of people verifying their email addresses.

You can't know if you don't look.

<3 Tyler

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Prime: More Capable, More Colorful

Take a look at the release notes from version 2.1 of Prime and you'll see some exciting things.

The first item in the list: improved timeline design. Whether you're looking at the main timeline of all your family's health, or an individual's profile, health events have been re-designed to look even better, be easier to read, and most importantly: be easier to sort through as you scroll.

You'll see these changes in the image below: each item has a label and is surrounded by color, which helps when you have a complicated record and need to find things quickly. You might also notice that the words all have more space around them, this breathing room helps make scanning your medical info faster and easier.

We've also done away with the menu in Prime. In it's place you'll find a settings icon, where you can quickly add more doctors, change your email address, or contact Prime. This means there's even less standing between you, your medical record, and your family's health.

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We made a little video showing how families use Prime.

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The Reinvented Health Record, Now with Family

Family is fundamental, and never more important than when it comes to your health.

Now with Prime, connect your whole family in one place and keep everyone on the same page.

Plus, Prime gives you modern privacy controls. Share individual health events. Fully control who sees what. Nothing ever leaves Prime.

Simply open Prime and tap the + button in the Family Ribbon at the top of your timeline to add your family members. Keep them automatically up-to-date without any extra work, and get notifications about their health too.

Enjoy!

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Prime is currently being featured by Apple in the App Store!