Dr. Donald Voltz shares his insights on how Apple is poised to disrupt connected health with HealthKit and the Apple Watch changing the way patients engage with healthcare.
This week, many are talking about the announcement of a new iPhone 6 and the excitement about the payment system to protect our identity and finance. I think the bigger announcement pertains to the Apple Watch and the underlying platform targeting personal health and wellness management, HealthKit. Although HealthKit was announced in June, the release of the Apple Watch this week (along with their commitment to enter the healthcare arena) is exciting and likely to lead to changes in the way patients interact with the healthcare system.
Currently, healthcare is going through turbulent times. New regulations, business models, pay-for performance metric implementation and electronic health records brings angst and added complexity for both patients and providers. On a parallel tract is the development and integration of personal health and management devices and applications, trying to navigate these turbulent waters to bring value to both patients and healthcare systems. Projected sales from wearable devices are estimated to reach $6 billion by 2016. There is no paucity of devices for consumers to integrate into their lives, but none have found the sweet spot, the integration of personal wellness with health information technology. Many are waiting for EHR’s to drive collection and use of this information, but Apple is taking a different path. They might just bring the missing piece to the health and wellness puzzle.
Healthcare is a part of life but we often focus on office visits or hospital stays. For many years, preventative care and personal wellness have been touted as important components of acute and chronic disease management, but the system did not readily support this component of a healthy lifestyle. The science of medicine is founded on three distinct, highly inter-dependent and connected components that we all progress through as we go through life. The area one spends most of their time, with respect to healthcare, is in personal health and wellness activities. The other aspect of healthcare comes from out-patient screening, risk management and long-term treatment of both acute and chronic disease in an out-patient setting. The final division of healthcare comes from in-patient care. With HealthKit and the Apple Watch, Apple addresses the personal health and wellness component while providing a platform to integrate across the care continuum.
If we are to address all of the needs of patients, we need to move beyond intermittent visits seeking treatment for symptoms and acute illness. We instead need to develop a mutual understanding of physiology, risks of developing disease, and behaviors that can be addressed to maintain and restore a healthy and productive life. This involves not just the collection of more information such as heart rate, activity level and blood pressure but also turning data points into meaningful information that patients can use to better understand themselves while opening up a channel of communication between patient and healthcare providers. When we enhance health through engagement of patients who learn to understand both health and disease, we empower them to take control and join in healthcare decisions with physicians. This type of relationship requires a two-way sharing of information. Apple has introduced a platform that completes the circle of care, allowing patients to collect, interact with and choose how they want to share this data with their physicians and other healthcare providers. In the era of corporate data breeches, identity theft and outside snooping of personal information, HealthKit allows one to keep a personal health record while providing a framework that allows for easy sharing with healthcare providers.
Apple does not appear interested in becoming a healthcare device company. There are many regulatory hurdles that needs to addressed before moving into this area, but they have brought a mobile platform for others to connect medical devices for remote monitoring systems that interface with the iPhone and the HealthKit platform. This area is likely to open up possibilities not considered prior to Apple’s entrance into healthcare. Mayo Clinic has already entered into discussions with Apple to see how they can positively impact patient relationships and we are likely to see other models develop upon this platform. Evidence and validation of personal health monitoring technology has not yet been solidified, but the exploration and incorporation into disease management is likely to change how care is delivered. An area where I think Apple is more poised to impact is in opening new channels of communication with patients.
The next phase of the CMS EHR incentive programs focuses on patient engagement with their medical information. Providing patients with the ability to electronically view, download and transmit their medical data is not only a focus of EHRs, but required for building engagement and empowerment of our patients. If we can complete the loop between patient-collected and controlled information in a PHR with access to both their out-patient and in-patient medical care, we have a much better chance of providing high quality, timely and cost effective care where patients are engaged in their decisions and treatments. The problem with interoperability between current EHRs, supplied by numerous vendors, is not addressed by Apple. They bring PHRs to the mix, but we still require a switch to connect patient-collected health and fitness information with data collected and stored in EHRs. Apple’s platform opens up the possibility to connect the pieces and bridge the current gap between personal health and fitness monitoring, out-patient and in-patient care, but only if we are able to connect the three and provide a standardized, and well-designed user interface into this data for both patients and providers.
The insights provided by the proper display of information brings clarity and meaning allowing for better decisions and understanding of ones care and options. As patients transition between these phases of care on their road to recovery or during the management of chronic disease management, connecting all of the pieces is a requirement to optimal care. I think the ability to connect all of a patient’s health information coupled with the development of new channels for communicating between patients and physicians holds the greatest potential for Apple’s announcement. The challenge is to develop the interface to connect these various pieces of health information. Having worked with Zoeticx on a platform to connect in-patient and outpatient EHRs while making interoperability between disparate systems possible, Apple’s announcement allows the connection of the final component. Both patients and healthcare providers are looking to connect the various pieces. We now have the possibility to do so.
Based on the information released, we can’t know for sure of the direction Apple is heading with HealthKit and Apple Watch. As a physician, the possibilities presented are ways I think the progression should proceed. It is with this direction we have the potential to complete the circle since it is the missing link in healthcare, reaching beyond IT and bringing meaning to the data.
Dr. Voltz is a board-certified anesthesiologist, researcher, medical educator, and entrepreneur. With more than 15 years of experience in healthcare, Dr. Voltz has been involved with many facets of medicine. He has performed basic science and clinical research and has experience in the translation of ideas into viable medical systems and devices.
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