Apple loves to disrupt things. The iPod and iTunes disrupted the music industry. The iPhone disrupted the telecommunications industry. And so on.
Apple identifies inefficiencies in a market and rolls out a vastly improved model. Obviously, this strategy has paid off time and again.
HealthKit is just the beginning of what could be a major disruption. Jared Sinclair was a registered nurse, before switching gears and dedicating himself to iOS development. From his blog:
Until relatively recently, the vast majority of medical records in the US have been recorded on paper. From routine doctor visits to lengthy stays in critical care, every piece of data – lab results, medication orders, progress notes, etc. – were written or typed on paper and stored in massive warehouses. It wasn’t until the 1990s that electronic health records (EHRs) started to gain widespread traction. Doctors and hospitals were under no legal obligation to use EHRs, so the only providers to use them did so for organizational efficiency.
There are competing formats for electronic health records. Each format maintains its own silo, with no interoperability between competing formats.
It’s disappointing but unsurprising that EHR vendors would keep medical data trapped inside their silos. If medical data were distributed via a shared database, their products would be reduced to either dumb pipes or thin client apps. Being a dumb pipe is bad for business.
Is HealthKit the solution?
The first problem with HealthKit is that it can only model a tiny fraction of the spectrum of medical data. There is a very long list of things it can’t do: track medication doses, doctor’s orders, procedural notes, etc. But let’s assume for sake of argument that HealthKit eventually ships with model classes for every conceivable type of medical data. It still wouldn’t be able to bring about EHR interoperability.
I think the post is worth reading, though I think it is way too early to judge HealthKit as a medical solution and way too early to predict where Apple will be taking HealthKit. I think the future is wide open and I would definitely not bet against Apple disrupting the electronic medical records model.
He’s right that in it’s current model, Healthkit will have limited impact. I don’t think we have any idea what the roadmap for Healthkit includes. If Apple could open source HealthKit and make it available to other OSes, then I could see it making a huge impact. It will help the smartphone and tablet market continue to grow. If they have the best implementation/interface, it would ultimately help further their business.
Attention spans are short and Apple’s release schedules are far apart. New initiatives like these need to constantly be pushed forward in a visible manner in order to gain critical mass, not a major keynote one year and then forgotten the next. Will Apple spend the resources necessary to push HealthKit forward? The Jobs era Apple demonstrated that they were unable to do so, constantly moving resources around to focus on a single priority. Hopefully Gruber’s observations on the new Tim Cook Apple proves true and that they can continually push HealthKit forward alongside all their other priorities.
HealthKit is essentially open source sine you can feed your data into it. If you think hard and long, all it is, is a (few) DB tables and rudimentary info graphics. This is not to say HealthKit isn’t of value. But all it does is to aggregate data in a predefined form in one silo. So to get it out of “your” silo you only need to map it over to Apples “silo”. You can do exactly the same between other “silos”. As long as there is no world wide agreed upon DB structure for mapping, formatting and “tagging” data Apple won’t be the one who disrupts anything. Even today you can build an accessory which reads the data from IC monitors and then feeds it to a sqlite backed app on your iDevice & synch it with whatever you synch – there’s not magic involved. But as long as you sell a 50k monitoring device you’ll probably have a very low incentive to dumb yourself down to a company just providing a handful of sensors coming from a puck which feeds an iPod touch… Providing a DB & info graphics is not a disruption, but merely consumer level convenience. Disruption will happen the day the first medical company disrupts itself by providing the sensors mentioned previously. Counting steps and scatterplot them is one thing, an IC unit is a whole different thing even tho they’re doing essentially the same with different levels of complexity and reliability. And just naming something HealthKit does not automagically catapult it to forefront of the health industry. I know my post sounds dismissive, but it’s far from it. I think HealthKit will serve it’s purpose very very well (assuming Apple will provide us with accessible and affordable sensors in any form or how), but no – it’s not going to shake anyone in the MedCare industry TODAY.
While I don’t think that healthkit is THE answer I do think it is a key element in increasing the dialogue. We need these records to be electronic even if not in a central database so that patients can have access to older records which might have vital information in them. EHR are a lot easier to transmit back and forth between providers as you move, go off to school etc. We just need the infrastructure. And a movement like HealthKit and these programs like MayoClinic etc might get the ball rolling way faster.
In my mind, there are three questions with HealthKit & monitoring sensors.
(1) How are they going to deal with HIPPA regulations in the US, and international aspects of health privacy? If your doctor’s practice can download the information, so can a hacker who spoofs the same information.
(2) Can Apple deal with all the regulations around medical devices? There are tons of rules regarding marketing & indications, validation of results from devices, etc. Change in the industry is glacial compared to the rest of tech – you can see that based on modern hospitals still running Windows XP as front end to state-of-art patient monitoring in hospitals. Part of the reason for that slowness is that everything has to go through trials & regulatory review. Every time a new iPhone gets rolled out, does Apple need to amend their 510K for the new device? Will they have to run new trials to show equivalence with past phones?
(3) Since these are consumer devices, how will they deal with jailbroken iPhones? What are the legal risks with this? For instance, if someone has glucose monitoring information fed into the phone, there is a malfunction, and the result is a patient death or injury, will Apple be liable? What if the phone was jailbroken?
you mean like how Passbook was so badly “forgotten” after its keynote that every major airline and special event ticketer now uses it?
i think an annual release cycle for OSes is pretty darn aggressive.
maybe, but how specifically would releasing HealthKit to competitors help apple? apple’s business is, after all, in hardware margins.
All nurses and doctors had an iPhone with a battery pack when we had our son. They used it just for messaging but HealthKit would fit right in there if done right.
I don’t think comparing a new method to present a barcode for scanning with a method for overhauling the entire medical records industry is fair, but that’s just my opinion I guess.
Also, an annual release cycle for an OS is in fact pretty darn aggressive, but for a service? Not so much.
There are far too many regulatory restrictions around medical devices to allow HealthKit to ever become a serious medical solution. To be used in this manner the iPhone would need to be classed as a medical device which is an area Apple would certainly not be interested in taking its flagship product.
Also the vast amount of data it would have to track securely and reliably places it outside Apple’s interests in providing a simple, easy to use personal health monitor. I think too many people are expecting far too much out of this simple little app.
Before we bash Apple’s efforts, let’s see what it does. We know the Health Care industry doesn’t care about your health.
Why should it? Apple is looking at it from the patient side. Why should they be expected to handle the hospital side as well.
“overhauling the entire medical records industry”
Given the various factors, especially legal, I doubt that is Apple’s goal.
And why, I ask again, should it fall on them.
Just like why should it be Apple’s job to fix cell phone service, internet access, cable TV, etc
EMR software was originally pitched as something which would permit portability of medical information between providers. As this post details, EMRs have made medical information less portable than ever. Unlike the writer, I see this as bad for patients and as something which stunts the development of safer and easier to use EMR software. We need open standards for EMR data before we dump billions more in public funds into crappy and dangerous proprietary software. In the context of this colossal waste of money, worrying about what a small solution like HealthKit is going to do seems silly.
Well, for one, Apple themselves released something called HealthKit that stores health information…
The same way Apple contributing to USB 3.1 or webkit or HTML5 helps Apple. Supporting technological advancement helps with technology adoption. If you make the use of technology indispensable, users will need to buy devices and hardware. If Apple provides the best user experience, customers will choose them. So far, it’s worked for them.