Trellis Health Co-Founder and CEO Estelle Giraud
Two decades ago, some of the biggest names in tech attempted to transform how individuals manage their health data. Microsoft’s HealthVault and Google Health both launched with bold ambitions: to create centralized platforms where patients could control and curate their personal health records (PHRs). Yet, despite vast resources and early hype, both efforts fizzled. The world wasn’t ready.
But now the dream is back, resurrected by a new wave of startups and, surprisingly, by the very institutions that had arguably stood in its way. From consumer-focused companies like Trellis Health to institutional giants like Epic Systems, people seem to believe again in the promise of personalized, portable health data. And this time, they might be right.
What Went Wrong the First Time
When Microsoft HealthVault launched in 2007 and Google Health in 2008, the concept of a digital personal health hub was revolutionary. It would unite all of your health data in one place, under your full control. Unfortunately, the infrastructure of healthcare was simply not prepared to support it. Electronic Health Records (EHRs) were barely digitized. Meaningful Use, the government policy that nudged providers into the digital era, had only just begun. Consumer devices like wearables were rare, and systems to connect disparate data sources were nearly nonexistent.
Even more critically, these platforms demanded far too much from users. “They required so much work from the consumer,” explains Estelle Giraud, co-founder and CEO of Trellis Health. “You had to upload your medical records manually, scan documents, log information constantly. The average healthy person just isn’t going to do that.”
And so, despite the vision, the user base never followed. Google Health shut down in 2012; HealthVault was sunsetted in 2019. The personal health record was consigned to the graveyard of overambitious tech dreams.
Why Today May Be Different
So what’s changed?
First, the digital plumbing of healthcare is finally in place. “Everything is digitized today,” Giraud says. “We have global interfaces for wearables, insurance claims, and health systems. Technologically, it’s a completely different environment.” The transition from paper to pixels is no longer aspirational.
Second, the rise of consumer health consciousness has created a more engaged public. Wearables like the Apple Watch and Oura Ring have made health data personal. We now expect visibility into our steps, sleep, and heart rate. Why not our labs, diagnoses, or prescriptions?
Finally, AI offers a bridge between data and action. Where early PHRs were glorified filing cabinets, today’s tools can interpret, surface, and contextualize insights. This shift from data collection to decision support makes the work people put into their PHRs worth the effort.
Sharpening Focus
Trellis Health is an example of this new era. Giraud’s company is far more than a digital file cabinet. It’s a consumer-focused, AI-native health platform designed specifically for women in the pregnancy and postpartum periods—an intentionally sharp wedge into the broader market.
“Pregnancy is often the first time a healthy woman engages deeply with the healthcare system,” she notes. “It’s a moment of heightened awareness and motivation.” Trellis aggregates up to a decade of a woman’s health history from 50,000+ provider sites, re-architecting it around chronology rather than billing codes, then overlays intelligent support. By doing so, it strives to be not just a logbook but a personalized guide through a transformative life experience.
A PHR opens a range of related service offerings, as in the case of Trellis Health
The use case is timely and targeted. Trellis focuses on postpartum lab testing, for instance, which is often a glaring gap in care. Women with gestational diabetes or hypertension often receive little follow-up, despite significantly higher risks of future heart disease or Type 2 diabetes. By sending at-home test kits before a six-week checkup, Trellis empowers women with data they can take to their doctors. It doesn’t provide diagnosis, focusing instead on information and empowerment.
This consumer-first model sidesteps the bureaucracy of U.S. healthcare. At $96/year, paid out-of-pocket or via HSA/FSA, it’s an impulse buy for a motivated consumer—“almost chemical,” as Giraud puts it.
What the Incumbents Are Doing
Interestingly, EHR vendors are trying to build what they once broadly de-prioritized. Epic’s MyChart, for example, now includes interoperability features that allow patients to access records from various health systems. The 21st Century Cures Act of 2016 has played a role here, forcing providers to open interfaces and enable data portability.
Yet these systems remain fragmented. “Even as a patient, you’re with Epic 60% of the time, and with Cerner or others the rest,” says Giraud. “They still don’t get everything that happens in between visits.” Factors like wearables, environment, diet, and social determinants of health fall through the cracks. MyChart is a useful tool, but it still fundamentally lives within the four walls of the health system.
Why Health Plans and Providers Haven’t Solved This
Many wonder: why haven’t health insurers or large providers solved this problem? The answer lies partly in healthcare’s misaligned incentives.
“Healthcare is a black hole,” Giraud argues. “If you get too close, you get sucked in. The incentives, contracts, and bureaucracy are just too strong.” Payers struggle with member churn—why invest in long-term health when patients change plans annually? Providers, meanwhile, face tech stacks and billing structures optimized for volume, not value.
Still, the tide is shifting. Companies like Flexpa are giving consumers access to insurance claims. A current legal standoff between Epic and Particle Health reflects the growing pressure for openness, as well as continuing concerns about data security and privacy.
Lessons for Healthcare Entrepreneurs
Building a business in healthcare is not for the faint of heart. Giraud, a former population genetics researcher and Illumina executive, is both optimistic and cautious. “You can’t just be a Silicon Valley entrepreneur in healthcare,” she warns. “You have to understand the rules of the game, and which ones can be broken.”
She urges founders to study history. “So many companies failed not because their ideas were bad, but because they didn’t understand the playing field.” At the same time, insiders often become too entrenched to innovate. The trick is to hold both perspectives: respect for the system and the courage to challenge it.
Will It Work This Time?
The promise of personal health records has returned. Companies like Trellis Health are betting that a targeted entry point, consumer-grade design, and modern infrastructure can finally realize the long-held dream of patient-centered data.
This is not the same game as 20 years ago. The players are different. The tools are better. This time, it just might work.
