It is not a technical problem. It is an ownership problem, and in the United States it is not an abstraction.
If your employer chooses your insurer, your medical history is attached to your job. Change employer and it does not travel with you.
A record filed under the provider's data is really the employer's data.
And the one party with no claim on it is the person it describes.
That was the thing worth building against. Not better encryption, not a better portal. Move the record to the person, and let it follow them.
The competitor was not the insurers or the clinical software vendors. It was Apple Health, because in 2020 Apple was the only organization holding personal health data with a privacy commitment anyone believed. If you are going to name a competitive alternative, name the one your customer would actually use.
Under all of it was a piece of infrastructure almost nobody outside Canadian healthcare has heard of. An open-source patient management system out of McMaster University, forked and adapted so many times that there was no single version of it. Move between clinics and you move between subtly different software.
Canadian buyers read that fragmentation as a roll-up: acquire the clinics, acquire their systems, consolidate the doctor end.
Everybody was fighting over the supply side. So we went to the other one.
Then the actual problem, which was not strategy at all.
In 2020, end-to-end encryption, digital wallet and self-sovereign identity were vocabulary from cryptocurrency. Most people had no model for any of them.
You cannot sell someone a thing they have no word for.
Three words, and no cryptography in any of them.
It is worth saying what that name gives up. It says nothing about ownership, nothing about portability, nothing about how any of it gets paid for. It answers only the one objection that was actually stopping people, which was whether somebody could quietly change what it said.
A name that solves the live objection and ignores the interesting ones is a better example than a clever name would be.
Employers were already paying for the tests.
The record was free to
create.
So COVID testing was the way in. Encrypt the result, put it in the person's hands, and then teach them what they now own and why it matters.
The anchor customer was SAG-AFTRA, which was a harder product problem than it sounds. Members were making films in different places under different local rules, so testing had to be fenced by region.
A handful of mid-size customers alongside them and a few labs. The customer base doubled while I was there, from a small number to a slightly less small one, and I am not going to dress that up as a growth rate.
Then the uncomfortable part, which is most of why this page exists.
The wedge closed. Testing volume was a public health emergency, not a market. When the emergency ended, the thing creating records at no cost ended with it, and the second half of the plan, the part where a test result becomes the first entry in a permanent wallet, never got its run.
Strategic investment did arrive, and it arrived for the encryption and for the other end of that roll-up rather than for the consumer thesis. Which is a real outcome. It is also not the outcome we set out for.
I stopped working shortly after, because the company could no longer afford me and I could see it before they said it.
The call was right. I have the receipts for none of it.
British Columbia and Alberta both issue digital health cards now. Apple Health became the default place a person's health data lives. Consumer-held records went from a thing you had to explain to a thing nobody questions.
And I did not download a single file before I left, so there are no figures on this page and there never will be. That is my fault rather than a confidentiality rule, and it is worth saying out loud on a site that asks you to check everything else.
If the thing you are selling needs a paragraph before anyone understands it, the problem is usually not the thing.