Fasten Health [1] is an open-source, self-hosted, personal/family electronic medical record aggregator, designed to integrate with 100,000's of insurances/hospitals/clinics.

It's designed to automatically pull your medical records from your EMR -- but users can also enter their conditions, medications and procedures manually. We have plans to allow users to manually enter their lab results [2], however that feature has not been implemented yet.

Fasten is still a work-in-progress, but if you're willing to contribute we have a pretty active discord (linked in the README).

[1]: https://github.com/fastenhealth/fasten-onprem/ [2]: https://github.com/fastenhealth/fasten-onprem/issues/137

Awesome project. Was poking around to see how the sources are generated, but it seems like the repo doesn't exist (or was made private)? https://github.com/fastenhealth/fasten-sources-gen

ah, it's not super interesting. Most EMR systems provide an open list of FHIR endpoints for their customers. `fasten-source-gen` is basically an ETL repository which imports the endpoint metadata provided by these EMR systems and enriches it with data from NPPES, Google Maps, user contributed data, Mechanical Turk and elsewhere.

- Epic: https://open.epic.com/MyApps/Endpoints - Cerner: https://github.com/cerner/ignite-endpoints

It will be open sourced (eventually) -- once I've cleaned up some test credentials that were inadvertently committed to the repo.

Hope that answers your question?

This is probably specific to the US? It would be nice for the Readme to clarify that aspect.

Hey! It is definitely US-centric, however FHIR (the protocol that Fasten speaks natively) is an international standard. We're tracking international support in this github issue - https://github.com/fastenhealth/fasten-onprem/issues/42

However, we'll make sure to update the README to make it clearer that international providers are not supported yet.

If you're looking for a well-integrated web app product that isn't something you can run locally on your computer, Picnic Health [1] is really good at this. They import all your medical records from the providers who use electronic health record systems with APIs and collect your medical records from the providers that don't use those systems or aren't as technologically savvy. They digitize everything and put it in a timeline format. Their service is not cheap though.

[1]: https://picnichealth.com/

Note they misuse the term end-to-end encrypted, and apply it to mirroring "what banks do". I don't know anything else about their product, but this is sloppy and/or dishonest.

I’ve had so many doctors over the years and have lived in many different states. Does Picnic Health find my records even if I can’t recall my doctor’s names or do I have to tell them every office they need to contact? I’m not sure if doctors report patient records to some central authority, which would obviously make this work much easier.

I'm not sure. I used the service in the past and I'm considering using it again. Picnic Health is really great if you're seeing a lot of different doctors over a short period of time or you have a health issue that involves coordination of a lot of records. It's really a pain to deal with different offices to get your medical records exchanged.

However, I was surprised when I used it last. They were able to find doctors that I didn't report. Turns out a lot of doctors are part of networks in geographical areas that allow sharing of medical records. They might've also used my insurance provider. If you see doctors with insurance, the insurance company will also have a record.

I don't think doctors are required to report patient records to a central authority. The government is able to access medical records without a warrant though. They might have a centralized way of knowing which doctors a person has visited.

This looks fantastic. Thanks for sharing! Great demo here: https://demo.picnichealth.com/records

Came here to say this I love this service.

While a good looking service, it seems pretty expensive unless you’re willing to donate your data to research?

Yeah, when I used it in the past, that was the case. However, when I used it, they didn't have donating your data to research as an option. Look here: https://help.picnichealth.com/t/y4hh8lr/how-much-does-picnic...

It's free if you have one the conditions they're looking for or they accept you to be part of a research group

After noticing Apple Health doesn't let you track this data at all (very strange decision on their part) I contemplated building an app... But Excel is easier and serves the same function. Conditional highlighting, charts, trends, it's all there.

Apple Health tracks the data. It just doesn't provide graphs except for the most common variables. I'm not really sure why no one makes a graphing app that works off HealthKit data

<cynical view> Because that's totally a thing Apple will release (or bundle into an existing app) as soon as it gains any popularity...

<sightly less cynical view> There's been persistent rumours for a few years now that Apple are working on blood glucose sensing for Apple Watch. If those rumours are right (and a big part of me really hopes they are) then that'd likely come with built in apps that destroy every blood glucose related 3rd party app.

Edit: I just noticed the original post wasn't specifically blood _glucose_ related. My own "blood test" requirements made me jump to an erroneous conclusion...

A while ago I was looking for this and found “Heart Reports”. Despite the name, it can make graphs from several sources that it pulls from HealthKit.

https://apps.apple.com/ca/app/heart-reports/id1448243870

No affiliation with the app, just a user.

Blood test results? I couldn't find anywhere to input the data manually. I track everything else there, like blood pressure, but serum iron, ferritin? Transferrin? Albumin? Etc. Nothing. Am I blind?

Sorry, let me clarify my fuzziness a bit...

You are right that you cannot enter the data yourself, as far as I know. But if your lab or physician uses a system that can let you download the records, they will be stored. So I have access to all my blood labs, but there is no easy way to graph them.

As far as I know, there is no App Store rule against making an app that lets you log the variables manually, nor is there a rule against making an app that graphs stuff. Keep in mind that there are a lot of Apple rules around HealthKit data to protect privacy, and writing such an app could be difficult.

Good to know, thank you!

You can make your own with Charty, which can pull data from HealthKit

Dashlabs.ai https://www.ycombinator.com/companies/dashlabs-ai

We work with diagnostic laboratories in the Philippines. Besides blood tests, we let users input results for clinical chemistry tests, x-rays, and more. We're also able to pull results straight out from hematology analyzers and other diagnostic equipment.

We also provide delta checking (comparison of your current vs past results), reference range checks, and unit conversion. We don't offer insights, but it is something we can build with a large enough dataset.

Hit me up if you're interested!

I built a platform called Iterate (https://www.iteratehealth.com) that allows you to track blood tests and other biomarkers including VO2 Max, DEXA Scan.

Some of the specific biomarkers you can input into the platform include LDL-C, HDL-C, Triglycerides, Non-HDL-C, VLDL-C, TG/HDL-C, Total Cholesterol, Lp(a), ApoB, ApoE, Homocysteine, hsCRP, Uric acid, Fasting Insulin, Fasting Glucose, OGTT, Hba1c, Campesterol, Sitosterol, Lathosterol, Desmosterol, TSH, fT4, fT3, rT3, ATA, ATPA, Estradiol, FSH, LH, SHBG, Testosterone, Free testosterone, PSA, ALT, AST, Total bilirubin, Cystatin C, eGFR - Cystatin C, Hb, Ferritin, Omega-3, and Vitamin D.

Once your blood test results are inputted, the system enables graphical representation of your historical records. This can help visualize trends over time, potentially revealing patterns or changes that might otherwise remain unnoticed. It also provides reference values for comparison, making it easier to understand where your results sit within the broader context (for things like gender/age).

It also tracks metrics across sleep, exercise, nutrition, emotional health using data from your wearables.

I made Free-to-use android (https://www.bit.ly/healome-one) and ios (https://www.bit.ly/healome-ios ) apps that can read (through OCR) the blood test results and plot the graphs. You can also enter the data manually if you can't access your pdfs. The app also connects with werables and plots correlations of the markers with the werable metrics. These apps are still under construction and have several bugs, but still usable. (More details at https://www.new.healome.one )

I had a similar requirement several years ago and I settled on the service provided by my test lab. They are a large chain in India and their reports plot the trend of all the test report indicators along with baseline reference values and interpretations. Very useful for me and my doctor.

Yes, it isn't a complete interoperable EMR solution, but I kinda manage it myself by downloading the PDF reports and maintaining in my local electronic filing system. There is always some esoteric test that the doctor could order which has to be done at a specialist lab. So, my low-tech solution settles on PDFs of the reports. It works for 99% of the cases.

At least the trend in India is to lock all of this data into proprietary data silos.

There is an initiative in India currently underway to provide a digital health ID and an ecosystem for healthcare participants to share data Ayushman Bharat Digital Mission (ABDM). It is yet to take off in a big way (and hopefully it does in the next 4-5 years) and achieves the same kind of success as the payments infrastructure by NPCI that brought the UPI network.

I found a provider (NYU Lagone) that uses Epic since early 2010s.

I've heard problems with people who use the tool but as a patient to be able go see a decade plus of my hospital visits, checkups, scans, and x rays is pretty amazing.

I've been using this one:

https://github.com/markwk/awesome-biomarkers#biomarker-track...

Here's my professional opinion. Why aside from Excel/Google Sheets? What's special about blood test results? If you don't quite know how to make spreadsheets do what you want, it's probably best to just learn that. If you go for something else, the app you chose might go away in a couple years, for many reasons. Many developers don't like working on the same thing their entire life. Or some API gets deprecated; guess how often developers like to implement the same thing over and over?

I mean, if you use open source apps that build on top of healthcare interoperability data formats like HL7 FHIR, you can get automated data pulls from EHRs while being able to just switch apps later.

Fasten Health (mentioned in a previous comment) is probably your best bet. It automatically syncs with your EMR and pulls your lab results automatically. You can manually upload your own data in a bunch of cases.

If you’re looking for another open-source and free alternative, I’m building Mere Medical which is not quite as developed as Fasten but takes a local-first approach and still connects to 2000+ healthcare institutions.

www.meremedical.co www.github.com/cfu288/mere-medical www.demo.meremedical.co

What's an EMR? Where is it stored?

EMR = Electronic Medical Records a.k.a your hospitals computer system.

Mere is a PWA stores all of your records in localStorage in your browser, data is not stored on any server.

If this is localStorage then it is hardly persistent. A cleanup of the browser will zing all the data without a warning.

Sorry, I meant indexeddb not localStorage, but yeah a cleanup would clear it as well. Mere supports data export/import though, and data loss hasn’t been much of an issue yet in practice.

The goal is to be able to back up and restore encrypted blobs to external storage (s3, Dropbox, etc) to mitigate this and enable sync across devices, but this isn’t implemented yet.

SelfDecode [0] does that. They're a lot more though - they're mainly focus on DNA analysis. Also it's a subscription so be aware if you don't like that.

They do a lot of analysis. You can send them a PDF and it will (try to) OCR it and auto-fill which in my experience is 80-90% good so you still need to check and fill out a couple blanks but it mostly works.

[0] https://selfdecode.com/

Apple health does a lot of this

Can you entire results directly? I thought another app had to enter the data for you.

I have my Apple Health app synced with my health provider (Kaiser). Test results auto-sync as Kaiser updates it.

Same. But I can’t enter results directly into Apple Health.

Same here. Works really well.

You can enter data manually, but there are also apps that will import data in various formats if you have them. If somehow you already have the data as CSV, you can use a third party app to import it.

Yes, you can directly enter the results. Go to Health->Browse->Vitals->Blood Pressure and hit "Add Data".

That’s blood pressure— I think the OP means CBC results.

Yea you can sync cbc results directly from the lab.

You can also add weight, vitals, and some other data (eg glucose) but I don’t see how to add lab results manually.

I recall Dr. David Sinclair mentions a company that specializes in biometrics insights and tracking in his book Lifespan.

It may have been InsideTracker (https://www.insidetracker.com/) or Tally Health (https://tallyhealth.com/).

I don't think it has been done yet due to the difficulty in syncing the data in there (manual entry sucks). I think companies like Forward (https://goforward.com/) offer this to their patients via their app.

That’s exactly what my company, https://functionhealth.com does.

We haven’t built historic import yet, but our members get to see all labs over time in a slick web interface.

What do you all think about the pricing and product from our homepage?

There isn't as far as I can tell, perhaps quest diagnostics might have something, but what's so interesting is how fundamental blood work like a CBC is in diagnosing and monitoring any disease or health conditions.

Apple health connects to my hospital and I have all test results there. It’s great

Wellnessfx.com is ok and free.

Thanks for sharing, trying it out now.

Not knocking it - as a non American I got a kick out of seeing imperial units being used out in the open :laugh:

EDIT: Oh, cannot sign up without a US address.

i'm non-US and somehow managed to sign up for their dashboard only. There's a sign up button on the login screen that leads you to here: https://www.wellnessfx.com/registration/new

Something basic wouldn’t be that hard to put together

Its not hard to put together something basic, a personal electronic health Record is actually super easy. The adoption is the problem. Here is why:

1. People are far more likely to store and curate their vacation pictures than healthcare data. There is a behavioral aspect to this. There isn't a lot of 'feel good' attached to storing a good HDL/LDL reading. Quite the opposite when it's bad.

2. Most countries develop their own version of a EHR, sometimes controlled by patients. Success rates vary but they remain a very useful tool for managing chronic conditions and patient peri-operative journeys. Once governments (local or national level) take over, there is very little incentive for anyone to develop.

3. There have been many attempts to create a patient-led EHR by companies but it is difficult to get off the ground and sustain due to data ownership, security, sharing and commercial complexities.

4. Storing the data itself is trivial. FHIR covers this well and within haematology at least, the support for standardization is strong. LOINC, SNOMED and UCUM are well established. Just be careful to store the initial units and reference ranges.

5. My personal take is that personal EHRs will take off once a good open source p2p toolkit implements superb encryption-led access control across workflows with top institutions comes into play. This is unlikely because of how EMRs lock up provider data.

If it was me, I would go the Excel route for input and a little mashing of the data, and then use PowerBI desktop to visualize and play with it.