A medical record can be perfectly digital and practically missing. It sits in a hospital’s computer, while somebody elsewhere needs it for a referral, an insurance review or a research project. The difficulty begins between those two facts. Ciox Health made that interval its business: finding the record, managing the request and getting information into authorized hands. The chart had acquired a hard drive. It still needed a travel agent.
- Ciox combined established record-management businesses with a large provider network.
- It paired software with people who could handle requests beyond digital connections.
- Its 2021 Datavant merger joined record access with privacy-preserving data linkage.
01 Four companies, already inside the hospital
Ciox arrived with a past. HealthPort, IOD, Care Communications and ECS combined in 2015; the new brand launched at HIMSS in March 2016. At launch, the company reported more than 18,000 provider sites, 100 health plans and one million unique requesters. Most startups must persuade someone to open the door. This one inherited quite a collection of doors.
Its expertise included release of information, record retrieval, clinical coding and health information management. The customers were hospitals, physician practices and health plans; the people depending on the work also included patients and other authorized requesters. Clinical coding gave the company another role in turning medical documentation into information healthcare organizations could use.
02 The last mile had a desk
Release of information sounds like a button. In practice, it is a workflow. Someone asks for records, the request is checked, the relevant documentation is located, and the information is delivered. Ciox’s proposition was to manage that work for institutions whose main business was treating people.
In 2018, Ciox introduced HealthSource, using optical character recognition, natural language processing and machine learning alongside a workflow engine. Clarity tracked release requests. Smart Chart extracted information into a longitudinal patient profile. Vault provided a repository. The product names were tidy; the material they handled was not. Structured fields, free text and scanned pages required different kinds of attention.
- 01RequestDefine the records needed
- 02CheckReview access and scope
- 03RetrieveDigital route + services
- 04DeliverSend securely and track
COVID-19 supplied an immediate reason to change the front door. In July 2020, Ciox made HealthSource Patient Request generally available: patients could request records through a provider’s website and receive instructions for electronic retrieval. A multilingual online form replaced a trip to the records counter. The announcement named Nicklaus Children’s Hospital as a user. Convenience suddenly had a public-health dimension.
03 Two halves of a chart
Datavant approached the same fragmented landscape from another direction. Its technology helped organizations link de-identified datasets while protecting patient privacy. Ciox handled access to identified medical records across institutions. One business helped obtain the chapters; the other helped connect information across collections.
The companies announced their merger in June 2021 and closed it on July 28. The announced transaction value was $7 billion. The combined organization took the Datavant name, with Ciox CEO Pete McCabe becoming CEO and Datavant CEO Travis May becoming president. The announcement put combined revenue above $700 million - a historical combined-company figure, not Ciox’s current revenue.
May’s merger essay compared the intended infrastructure model to Visa: connective machinery supporting many other businesses. That helps explain the attraction. Provider relationships and retrieval operations complemented linkage software. The combination offered a broader route through the problem than either set of capabilities alone.
04 The paperwork had a price
Ciox’s commercial work sat in enterprise agreements and record-fulfillment operations. The request journey also included tracking, delivery and payment. A hospital buying operational help and a health plan buying access to clinical documentation were purchasing related services from different sides of the same exchange.
In April 2023, Oscar Health renewed and expanded its Ciox agreement to use Datavant Switchboard for digital requests, retrieval and delivery. The companies projected a 25% reduction in total spending over the agreement’s term. That was a contract forecast, not a measured outcome or a discount promised to every customer. Nevertheless, it gave the abstract problem an admirably concrete unit: money.
Projected reduction in total spend over the contract term
Price had also placed Ciox in court. In the 2020 Ciox v. Azar decision, a federal court limited parts of the rules governing third-party record requests. HHS said individual access rights and their fee limitations remained undisturbed. The distinction matters: who requests a record, and where it is going, can affect the rules around the transaction.
05 A human route around the broken connection
By October 2022, nearly 600,000 patients had used Patient Request, according to Ciox. The company expanded the application with interfaces to electronic medical record systems. Yet its explanation contained a useful admission about the industry’s limits.
“no single EMR or digital-only connection can access all of a patient’s data”
Pete McCabe / Datavant CEO / October 2022
Ciox paired those connections with services-based retrieval for requests the digital route could not complete. Read as a design lesson, this is the interesting part: keep a workable path for exceptions. A system that performs beautifully only when all the records are in the expected place has a rather selective understanding of healthcare.
There are alternatives. MRO and Verisma also offer release-of-information and retrieval services; institutions can maintain their own teams. Ciox’s distinction was the combination of provider relationships, operational services and, after the merger, Datavant’s linkage capabilities. Choosing among them still requires attention to completeness, turnaround, privacy and cost. Network size alone settles none of those questions.
06 The fax is still in the room
The successor business continues to work on the same stubborn handoffs. In August 2026, Datavant launched Provider Exchange for provider-driven record retrieval, tracking and digital delivery. Its announcement described workflows still relying on fax, phone calls, mail and manual follow-up. In February, it had announced a Thermo Fisher collaboration connecting real-world data with clinical research.
September brought an agreement for Neuberger and KKR to acquire a significant minority stake, with New Mountain retaining control and closing expected in the fourth quarter. Those are Datavant developments. Ciox’s official profile now directs readers to Datavant, although its old name remains familiar to record requesters.
The lesson a reader can copy is modest enough to be useful: follow the actual request, automate the repeatable steps and give the awkward cases an owner. It depends on access permissions, reliable matching and institutions willing to participate. Ciox’s story suggests that the unglamorous journey between systems can deserve a business of its own.
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