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Launch HN: Medplum (YC S22) – Open-Source Firebase for Healthcare

251 点作者 brown超过 2 年前
Hi HN! Cody, Reshma, and Rahul here and we’re building Medplum (<a href="https:&#x2F;&#x2F;www.medplum.com" rel="nofollow">https:&#x2F;&#x2F;www.medplum.com</a>), an open-source platform that lets you quickly build complex healthcare applications. We provide a headless EHR (electronic health record) that supports common standards like FHIR, HL7 and more. You build whatever UI and UX you want, and we handle the infrastructure and give you lots of interoperability and automation tools.<p>The digital healthcare space has been hampered by proprietary tech, walled gardens, and vendor lock-in. Working as healthcare app developers ourselves, we kept seeing organizations developing the same infrastructure over and over. The question “how is this stuff not open source?” came up so often that we finally decided to just build it.<p>Out of the box, Medplum includes:<p>- Auth - An end-to-end identity solution for easy user authentication, sign-in, and permissions using OAuth, OpenID, and SMART App Launch<p>- Clinical Data Repository (CDR) - A back-end server that hosts your healthcare data in a secure, compliant, vendor neutral, and standards based repository<p>- A FHIR-based API for sending, receiving, and manipulating data<p>- SDK - Client libraries that simplify the process of interacting with our API or any FHIR server<p>- A web application where you can view your data, perform basic editing tasks<p>- UI Component Library - React components designed to help you quickly develop custom healthcare applications<p>- Medplum Bots - Write and run application logic server-side without needing to set up your own server<p>Our team has years of experience in healthcare technology. We were the founders of MedXT (YC W13) and have held engineering leadership roles at Box and One Medical.<p>Our repo is at <a href="https:&#x2F;&#x2F;github.com&#x2F;medplum&#x2F;medplum" rel="nofollow">https:&#x2F;&#x2F;github.com&#x2F;medplum&#x2F;medplum</a> and you can see a demo video here: <a href="https:&#x2F;&#x2F;youtu.be&#x2F;nf6OElRWOJ4" rel="nofollow">https:&#x2F;&#x2F;youtu.be&#x2F;nf6OElRWOJ4</a>. There’s a sample app at <a href="https:&#x2F;&#x2F;foomedical.com" rel="nofollow">https:&#x2F;&#x2F;foomedical.com</a>, with code at <a href="https:&#x2F;&#x2F;github.com&#x2F;medplum&#x2F;foomedical" rel="nofollow">https:&#x2F;&#x2F;github.com&#x2F;medplum&#x2F;foomedical</a>.<p>Medplum is under the Apache 2.0 license so any developer can use it for free with no strings attached. We make money through enterprise integrations, and by providing a hosted version and support. Compliance is a priority—we are SOC 2 and HIPAA compliant and are pursuing ONC and HITRUST. Our hosted service runs on AWS and uses cloud infrastructure similar to a typical SaaS application. This is also rare in healthcare.<p>We would love to know what you think - especially any recommendations or ideas you want to share, and would love to hear about your experiences developing healthcare applications!

27 条评论

w10-1超过 2 年前
It&#x27;s great to see (and to see you have fans here) -- Veeva for EHR?<p>If&#x2F;since this is a freemium model, can you talk about the kinds of features you would end up charging for?<p>The 2019 state of open-source EHR is reported here: <a href="https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pmc&#x2F;articles&#x2F;PMC6517630&#x2F;" rel="nofollow">https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pmc&#x2F;articles&#x2F;PMC6517630&#x2F;</a><p>It would be interesting if published an assessment of your status and plans using their criteria.<p>I&#x27;ve seen practices successfully using two of the recommended EHR systems. Technically most seem in the ballpark, but the key seems to be whether there is a robust community validating the code and providing timely support. In that respect, another open-source alternative is not necessarily a good thing. Do you have any community-building hires in mind?<p>As for clients: the adopters are often medical people who picked up enough technology to wire things together, and do so for their practice employees. They&#x27;re not super interested in sharing the secret sauce of their practice with consultants who will simply repurpose that knowledge for the competition. The most successful OS EHR&#x27;s seem to be configurable by these adopters.<p>But it seems medplum targets developers (not the practice professional). If (since) those developers may have a tough time, do you have designs to pivot to new low-code approaches for end-user?<p>Conversely, if you stick with the EHR-AAS back end, the trend of the last few years has been for private equity to buy practice groups. I don&#x27;t see yet the incremental value for the adopter or users of your offering over existing EHR&#x27;s. But equity would be super eager to buy practices with EHR&#x27;s ready to audit for due diligence before purchase and ready to integrate after. That could be a selling point for practice managers. Do you have any biz-dev plans to coordinate with the equity groups playing in the medical space, or investments from them, to tide you over the long process of gaining mindshare in a conservative market?
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bluepuma77超过 2 年前
Wow, what a coincidence. Yesterday I attended an e-health event in EU and found several business opportunities for small FHIR applications for hospitals. We already have SaaS hospital customers, so I began my research.<p>We are working with HL7v2 ADT, FHIR seems like a very different more complex beast. Nice that they use JSON, but it reminds me a lot of those XML days with lots of namespaces, you always needed an editor.<p>There is a fhirbase&#x2F;fhirbase Docker container that wasn&#x27;t updated for 3 years, they focus on AidBox now, it&#x27;s closed source, no public pricing.<p>There is even an ibmcom&#x2F;ibm-fhir-server Docker container, 2 months old, but their project page <a href="https:&#x2F;&#x2F;ibm.github.io&#x2F;FHIR" rel="nofollow">https:&#x2F;&#x2F;ibm.github.io&#x2F;FHIR</a> is gone.<p>Then I came across this article from better.care CTO talking about how openEHR and FHIR should be used in a combined system, which seems to make sense. Product seems to be closed source, no public pricing, made in the EU. <a href="https:&#x2F;&#x2F;medium.com&#x2F;@alastairallen&#x2F;fhir-openehr-2022-53716f837340" rel="nofollow">https:&#x2F;&#x2F;medium.com&#x2F;@alastairallen&#x2F;fhir-openehr-2022-53716f83...</a><p>There is ehrserver, open source, but not a single word about FHIR <a href="https:&#x2F;&#x2F;github.com&#x2F;ppazos&#x2F;cabolabs-ehrserver" rel="nofollow">https:&#x2F;&#x2F;github.com&#x2F;ppazos&#x2F;cabolabs-ehrserver</a><p>So there is a lot happening, will check out Medplum, FHIR seems the future :-)
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xcskier56超过 2 年前
Very cool and impressive work! One question I have is how you think about handling custom data fields. FHIR has the `extension` attribute on all DomainResources that allows you to store any non-standard information, but building code and value sets to properly map this data can be cumbersome and time-consuming.<p>Do you have any happier&#x2F;easier paths for extending the core data model to handle custom data?
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yawnxyz超过 2 年前
Ok I never thought I&#x27;d see the day an open source compliant DB for healthcare would ever see the light of day.<p>As a solo software engineer on a hospital-based clinical trial and having to build everything from scratch, I&#x27;m beyond excited for this product!!
xenospn超过 2 年前
That&#x27;s fantastic - I just spent 8 months bringing a health-tech startup to market, and the amount of random vendors who have managed to position themselves as a &quot;must have&quot; by building a single API and charging $30k&#x2F;year for it is insane.
adunsulag超过 2 年前
As someone who just got helped get OpenEMR (another OSS EHR) certified via ONC, I don&#x27;t envy your journey through certification and wish you the very best of luck.<p>Looking through your documentation what version of FHIR are you targeting? Are you using SMART on FHIR v2? or v1?<p>What version of USCDI are you using for your data model? Have you decided whether you&#x27;ll hit US Core 3.1 or are you going to go through the SVAP purpose for ONC?<p>One of the biggest questions we get all the time from people is lab integration, and e-prescribe. Is this something you are punting to your customers or do you plan on supporting that out of the box?
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fabk超过 2 年前
The OHDSI OMOP CDM (OHDSI Observational Medical Outcomes&#x27; Partnership Common Data Model -- <a href="https:&#x2F;&#x2F;ohdsi.github.io&#x2F;TheBookOfOhdsi&#x2F;CommonDataModel.html" rel="nofollow">https:&#x2F;&#x2F;ohdsi.github.io&#x2F;TheBookOfOhdsi&#x2F;CommonDataModel.html</a>) is huge for healthcare observational research and data science. It would be nice if you kept an item on your list to integrate with it (import&#x2F;export CDM data) at some point.
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yz_coding超过 2 年前
Impressive work! I used to work at a tele-health startup that spent the majority of R&amp;D building in-house EHR. We couldn&#x27;t find any EHR solution that works out of the box, and is extendable enough to build custom features for our need. We totally would have tried Medplum if you guys launched earlier.<p>Congrats on the launch!
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greazy超过 2 年前
Do you have plans to target other countries in regards to meeting laws (similar to hipaa)? I&#x27;ve heard horror stories in rural hospitals in Australia. They&#x27;re paying millions for absolutely horrible databases with constant crashes.
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idealmedtech超过 2 年前
We were just discussing how to do this today! How would you say your offering compares to, eg, Redox Engine, in terms of pricing and overall compatibility? Will you be open sourcing the entire stack, or keeping some parts proprietary?
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mberg超过 2 年前
Hi MedPlum team - congrats on the launch! We&#x27;ve been working on the FHIR space pretty heavily for the past two years. Our main focus is building native FHIR apps for Android currently.<p>I see a lot of value in some of the components you are adding from an ecosystem standpoint. Quick q - are you building a server or focusing on the components on top? I guess I&#x27;m trying to understand the value prop vs. a system like HAPI of Google Health API? How robust is your support for data extraction eg. with StructureMaps, etc?<p>Congrats on the launch! Look forward to digging in more and my reach out.
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gowings97超过 2 年前
I think you guys hit the exact technical and business intersection where you can carve out some success and federate a challenge to Epic. Great job!
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imnotjames超过 2 年前
It&#x27;s so awesome to see the medplum team here!!<p>Medplum is a truly amazing solution to so many problems of building healthcare apps quickly. Before I had started chatting with the Medplum team it felt like an insurmountable task to experiment in the EHR area - the amount of infra &amp; prep work we&#x27;d have to do made it so even for a proof of concept we&#x27;d have months before we could see anything useful.<p>It&#x27;s really awesome to have so much of the hard part of handling health records done for us - and the depth of knowledge of the Medplum team is bar none when it comes to this area.<p>Y&#x27;all rock, congrats on the launch.
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jahsome超过 2 年前
I don&#x27;t miss HL7 or FHIR one bit. Would have loved a tool like this back when I was doing EHR work.<p>It&#x27;s encouraging to see stuff like this moving into the OS realm, and I genuinely hope this type of competition and collaboration will lead to tangible benefits for patients (cost) and providers (ease of use) alike.
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tuxguy超过 2 年前
Congratulations team medplum. Sounds really neat !
blueyes超过 2 年前
Congrats on the launch! Big fan...<p>Anyone who believes that healthcare is broken and could be vastly improved should look at Medplum&#x27;s open-source projects. This is how you accelerate healthcare getting better software and breaking the stagnation that EHR companies have locked us into.
dtran超过 2 年前
Congrats on the launch Rahul, Cody, and Reshma! A headless EHR sounds so cool! Why did y&#x27;all decide to describe it as Firebase, and has that description resonated well with potential users&#x2F;customers?
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syllableai超过 2 年前
Hi, is your CDR storing clinical data as FHIR objects natively?
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midislack超过 2 年前
Can you give me a quick run down on Firebase? I don’t know anything about it so to understand your product a bit more, please clue me in on what Firebase does and how people use Firebase. Thank you. Sounds like Firebase is pretty interesting and popular, I feel kind of like a boomer for not knowing what it is.<p>Anybody know what Firebase’s competitors are? Help me out here.
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all_iv超过 2 年前
Congrats for the launch! I&#x27;m currently building FHIR adapter for my startup and this product is making me super excited.
rman666超过 2 年前
This sounds really great. Checking things out today :-)
jjnoakes超过 2 年前
Congrats!<p>What kind of dependency vetting and monitoring is required for something like this where compliance is part of the picture?
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maxthegeek1超过 2 年前
Congrats! You all have a really great product and team.
ijustwanttovote超过 2 年前
congrats guys
TruthWillHurt超过 2 年前
&quot;Medplum aims to provide a well-known technology to a very buzzwordy sector, thus mooching off government funds.&quot;
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dwiner超过 2 年前
Congrats Medplum team!
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poulpi超过 2 年前
Congrats team!