If You’re an iPhone User, We Want Your Data!

Apple’s HealthKit and Health app, despite a lackluster showing at the last Apple event, continues to chug along with new press in the industry. The most recent news was about Ochsner going live with HealthKit feeding data to Epic through MyChart.

My understanding is that clinicians, care navigators, or whoever the Epic customer decides can put in orders for patients to use HealthKit. These patients, assuming they use MyChart and iOS 8, then have a new activity in MyChart that gives them the option of connecting to HealthKit to import HealthKit data into MyChart and then Epic. Alerts can be set for each individual. That’s a much more interesting integration than I expected from Epic and Apple.

What Epic and Apple are doing is enabling health systems to start prescribing digital health apps and devices to patients. These orders are coming through Epic. As far as I know, Apple is not validating any of the data HealthKit is receiving, at least in terms of quality and consistency. It is not requiring that biometric tracking apps and devices have FDA clearance in order to write data into HealthKit. I don’t think Epic is screening any of the data coming in through HealthKit. I presume this means that Ochsner and health systems that follow are responsible for the  quality of the data they are choosing to integrate though HealthKit.

But what’s particularly interesting about Apple as a health data aggregation and EHR feeding platform — and I’ve written about this before — is that Apple is a notoriously closed system. Apple dictates strict terms in its App Store, which is understandable since it’s the Apple App Store and is not known as being open to other hardware and OS platforms.

Take productivity suites as an example. Apple’s applications (Keynote, Pages, and Numbers) are still not available on Windows. It was jokingly big news when Steve Jobs announced iTunes for Windows. Even Jobs knew he needed to support Windows to increase the adoption and success of mobile Apple devices. Apple is already in pissing contests with consumer health companies that aren’t playing ball with HealthKit. Fitbit announced it would not integrate with HealthKit and Apple is now apparently going to stop selling Fitbit products in its stores.

Apple is not for everyone and it never will be. Apple doesn’t seem to care that much — it has the customer demographics it wants. But hospitals can’t operate like that. Maybe concierge practices can.

What does it mean for patients, like those who get care at Ochsner, who don’t have Apple devices with HealthKit installed (meaning they are running iOS 8)? When a clinician or care navigator asks a patient what version of mobile iOS they run and they say Android or iOS 7,what happens? I was joking with a friend about documenting iOS version as a metric for Meaningful Use Stage 4.

Implementing a unified, single system within the enterprises, much like systems do when they install an EHR like Epic, is different from launching patient engagement and patient-reported data initiatives that require specific technologies that only a minority of the population uses. You could make the same argument against smartphone apps like MyChart, but hose can at least reach the majority of patients, where iOS-only tools cannot.

The question comes down to what health systems are trying to accomplish with a HealthKit + Epic integration. High level means health systems and clinicians want to collect data from patients to gain additional insights into patient conditions. With that data, they want to be able to set certain triggers for alerts on an individual basis (maybe a care navigator wants to get alerts when a patient records a glucose over 200). This hopefully means resources have been dedicated to respond to those alerts.

If vendors are not going to validate the quality of data coming in, then why only trust Apple (which is only in use by a minority of the population) to aggregate it? There are other aggregation services that can be trusted to take data from consumer health apps and connect to HealthKit.

Validic is a great example. It also opens the door to a whole new set of users who don’t use Apple devices. There are differences between Validic and Apple HealthKit, but both can accomplish the same thing, assuming the goals are what I outlined above. Validic expands the reach that hospitals have for collecting patient data.

On a mostly unrelated note, I surprised myself and bought the iPhone 6+ without seeing it. I’d never thought I’d want a phablet, but I figured I’d give it whirl. The battery life and camera made it seem more appealing than the 6.

I’ve had it a few weeks now and have to say I’m very happy with it. The battery life is awesome. I find that two-handing the phone works well and I actually type faster. You can use it with one hand, but buttons at the top and the keys at the far end of the keyboard are a bit of a challenge. My pants aren’t quite as tight as seems to be the male trend these days, so pocket space isn’t an issue. My wife thinks the phone is absurd (and it is for her hands), but she likes her iPhone 6. What do you think?

Travis Good, MD/MBA, is co-founder of Catalyze. More about me.

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