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October 5, 2016

Healthcare is not Apple enough, Apple expands in healthcare

Apple is gathering partners in health systems and they’re hiring numerous healthcare professionals. They appear to be making a giant step into the health care industry. As their platform at the moment consists of mainly fitness and clinical trial enrolment apps, they seem to be expanding to FDA-approved sensors, advanced clinical decision support and electronic health records. The company is not opening up about their plans yet, but the fans hope that Apple will turn the world of health and turn patients instead of providers or HER vendors into the curators of health data.

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In 2014 Apple hired a number of prominent biomedical executives and experts, according to a report from that year. Looking at their employees there are at least 98 professionals active in some sort of health care, amongst whom 22 staff members with expertise in medical devices, 17 medical sensor experts, a designer who made a package of sensors and software to assess whether the sounds of one’s joints indicate osteoporosis and an individual with expertise in atrial fibrillation.

Glancing at the company’s current job listings also suggests they’re about to design better record software, as they also hired ten EHR experts. A Bloomberg report from last week confirms this assumption. The listings also include a business development executive with experience in corporate wellness; a data visualization expert to create software that “respects users’ privacy while giving them the ability to gain insights from health data;” and a “transformation business executive” to package Apple (and partners’) products as health care solutions. Only last week they sought a legal counsel specializing in health care data privacy and FDA compliance.

ResearchKit

Notes from a meeting in 2013 with the FDA indicated that Apple is gathering information on how to release useful products that would not be subject to regulation. The fact that they released their ResearchKit last year implies that they’re looking for partnerships with academic medical centers and big hospitals. It also allowed investigators and companies to build clinical trial apps into the iPhone.

 “I’m not sure they knew ResearchKit would take off like this,” said Ray Dorsey, a University of Rochester neurologist working on the mPower study. Some senior academics in health IT are curiously mum about Apple’s evident expansion, citing partnerships with the Cupertino, Calif.-based company. Eric Topol of Scripps Translational Science Institute said his institute had a partnership with Apple related to the Precision Medicine Initiative, but wouldn’t go into further detail. John Halamka, CIO of Beth Israel Deaconess, said he was under a non-disclosure agreement when asked about a clinical trials partnership.

Like a car signalling

As a car signals when in need of an oil change, so can an app signal various health problems to patients, according to Apple CEO Tim Cook, but their ultimate vision is still a little blurry. Because in order to have your device signal these problems it would require sensors that are not available at the moment, but the indications stated above do suggest so.

Looking closely into LinkedIn also gave away clues. One employee , coder at the company said on his LinkedIn page that he was building “a platform, a set of API’s, and a simple product that will bring what we believe will be a disruptive consumer healthcare application to the U.S. for the first time.” Another clue was given by Paul Silva, on his page he spoke of “providing insight and perspectives regarding what is lacking in the IT world of medicine.”

Apple already took measures about personal health record storage. You can download record summaries from your provider onto your iPhone. The software however does not yet allow for the records to be divided into distinct elements. It downloads each record in one gulp, and doesn’t sort out new and duplicated data.

It’s not appealing enough

Some consumer advocates and health IT advocates are asking for systems for better recordkeeping. A product that collects patient health and fitness data and offers nudges when needed is demanded on by policymakers. Patients are not as in need of this so far, however. An October 2015 data brief from ONC showed that 38 percent of patients had been offered access to their record, and 55 percent of that group followed up on the offer at least once. Experts argue about whether patients just don’t care, or the technology isn’t appealing enough to draw them in.

The policymakers want to move fast to the next stage: HER Vendors need to certify their use of open APIs, essentially contracts allowing users to get to their data, with the goal of facilitating patient access to records they can then transport to favoured apps. There is some concern about standardizing these contracts, but representatives from Epic, Cerner and Allscripts announced that their APIs would use the FHIR standard — meaning they would be open and standardized, according to former U.S. Chief Technology Officer Aneesh Chopra.

“Those kinds of APIs would enable interoperability in a clinical setting and speed the Precision Medicine Initiative,” Chopra said. This would allow President Barack Obama’s wish to come true: everyone being able to sign up from anywhere and contribute their data remotely, something the smartphone would make a lot easier to do.

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