Apple “Health” App Review: What It Means For Healthcare and mHealth

Today during its annual Worldwide Developer Conference, Apple unveiled iOS 8, the newest mobile operating system for iPhone and iPad. Tech media, including HIStalk Connect, had been speculating that Apple would use the opportunity to launch its highly anticipated new health app, and Apple did not disappoint. The new app, simply called Health, brings more to the table than most imagined it would, and represents a significant shift in the way that consumer devices will interact with consumer health data, and with enterprise health IT systems, in the not to distant future.

Here is HIStalk Connect’s complete review of Apple’s new Health app and the implications it may have on healthcare and health IT.

Health, Apple’s First Contribution to Health IT

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Leading up to today’s announcement, rumors had pegged the new health app as being similar to the Passbook app, but for your health. The concept stuck, to the extent that tech reporters nicknamed the new app Healthbook. While the media got the name wrong, much of the rumored functionality turned out to be true.

Health is an app designed to centralize health data, collecting information from third party apps, medical devices, and activity trackers. The app consolidates fitness data, nutrition data, sleep patterns, blood glucose readings, cholesterol levels, heart rate, blood pressure, the list goes on and on. Individual users are able to customize what gets tracked and what doesn’t in a user interface that bears a striking resemblance to the iOS 7 Passbook.

The new app also offers users the opportunity to create a digital “emergency medical card” which will convey basic health information, such as current medications, chronic conditions, and emergency contact information. The card will be accessible from the lock screen so that in the event of an emergency health providers will be able to access the information, which means that iOS-based emergency medical cards will begin appearing in ER’s soon.

It’s important to note that Health was not designed to compete with apps like RunKeeper or LoseIt, apps that focus on helping users achieve personal health goals. Health is a tool that brings health data ownership and controlled health data sharing to the health app ecosystem.

Apple did not reveal a complete list of apps and medical devices that would be able to push data to the Health app, but digital blood pressure cuffs, glucometers, and an array of fitness apps were briefly displayed. Integration with the NikeFuel ecosystem was also promised, perhaps a hint that Nike’s decision to exit the activity tracker market may have been prompted by an offer to collaborate on Apple’s iWatch project, as recent rumors have suggested.

HealthKit: an API Into Personal Health Metrics

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By itself, Health does not seem particularly useful as an end-user app. It captures information already being captured in other apps, and presents that data in likely a similar manner that the originating app would have. However, Apple adds value by introducing HealthKit, a software developer kit that will change the nature of mHealth development in the iOS ecosystem.

HealthKit provides third party apps access to the entire content of a users Health app. Access is controlled on an app-to-app basis in the privacy settings of Health. Currently, health apps create data silos, as does most health IT software, where apps are only privy to information that they generate themselves, or that the phone’s hardware creates for them. In some instances, third parties have partnered on their own to exchange data, but with the introduction of HealthKit, Apple is leveling the playing field and removing the need for third-party partnerships, making a centralized repository of personalized health data that all mobile health app developers will be able to access and integrate into their solutions based only on end user authorization.

Use cases for enhanced access to health data abound, nutrition tracking apps could calculate daily calorie allowances based on actual daily caloric burn, rather than having users self identify as “sedentary” or “active,” dietary recommendations could be adjusted based on cholesterol levels or blood pressure readings, fitness apps could be enhanced to adjust workouts based on target heart rate. Providing broad access to personal health data, all while putting privacy control in the hands of the user, will undoubtedly help the mHealth market mature and will allow advanced alerts and self-monitoring features that would be impossible in today’s environment.

Mayo Clinic and Apple, Bringing Clinical Judgment to the mHealth Ecosystem

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Apple also announced a new real-time health monitoring app being developed by the Mayo Clinic that uses HealthKit connections to provide feedback as new health metrics are entered into the Health app.

While unveiling iOS 8 the Craig Federighi, Apple’s SVP of software engineering, explained that by adding, for example, a high blood pressure reading to the Health app, the Mayo Clinic will automatically evaluate the new entry against existing personalized thresholds established for that particular user. Next, the app will take action. Whether it be pushing patient education material to the user regarding their high blood pressure reading, or when warranted, reaching out to a local health system and alerting them of the concerning results.

Apple is building an ecosystem that not only centralizes health data, but also monitors it and responds with clinically sound health guidance.

Enterprise EHR Integration

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Integration with the traditional healthcare delivery infrastructure does not end with Apple’s Mayo Clinic partnership. The unveil of Health and HealthKit also came with a surprise name drop: Epic Systems. Epic has been recruited to connect the Health app with local health systems. By bringing Epic into the fold, Apple has introduced a partner that can connect many of its users with their own medical records and local clinical care team.

There aren’t many details on exactly what data will pass between Epic and Apple’s new Health app, but the decision to partner with Epic sends a clear message: Apple is building an infrastructure that it hopes will not only be used to centralize and track health data, but also actively monitor it, and ultimately integrate it with the local healthcare systems responsible for these consumers.

Conclusion

Apple is building an ecosystem that centralizes health data for the benefit of developers and users alike by putting that data, and the decision to share it, in the hands of the consumer, and then creating deep integration points that converge with traditional, local, health care delivery networks.

Everyone expected that Apple would unveil a health app today. Most predicted that it would resemble a hybrid between Passbook and Moves, the smartphone-based activity tracker. No one predicted real-time health monitoring from the Mayo Clinic, or health data integration with Epic Systems.

The foundation of Apple’s health ecosystem has been laid, and the stage is set for Apple’s next big health-related unveil, the iWatch, a device that will likely sit on top of Health and provide a steady source of real-time health data for this new ecosystem to consume. Stay tuned.


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  • Pillguy

    We should probably mention Samsung had their S Health module out before Apple’s announcement, and they even have a heart rate monitor built into the device (not a solution using the camera and flash as on current iPhones). It is exciting to see Apple jump on this in a big way, because their relationships with industry often help change the way we do things. I really like their “all in” approach to solving these complex problems we create in our industries (not to say IT itself is without its own issues hehe). Hoping for big announcements in the Fall! Thanks for the article Lt Dan!

  • Lt.Dan

    @Pillguy – I agree, Samsung has been more active in the health space. Not only were they first to market with a core health app (S Health) but they also narrowly beat Apple to market with a developer ecosystem for health apps, Samsung’s SAMI. They also beat Apple to market with a health focused wearable device, the Gear Fit, and recently announced a new fitness tracker that they are working on (Simband) that looks promising. Here is a recent story we did on Samsung’s Simband announcement: http://histalkmobile.com/samsung-unveils-next-generation-wearable-backed-by-open-source-algorithms/

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