A corporate announcement was made this week that really could revolutionize healthcare consumers’ engagement in their electronic health records. And therein lies a tale.
At the outset, I should clarify that I have no desire whatsoever to promote any particular vendor solution—patient-facing or otherwise. And that goes double for any gigantic global software or device vendor. Indeed, the vendor involved here—the Cupertino, California, based Apple Inc.—has no need for my promotion of its products, or anyone else’s.
That having been said, something has happened that might possibly be a game-changer when it comes to patients’ engagement around their health records. For decades now, industry observers have predicted that the PHR—personal health record—concept would emerge fully and thrive. I’ve been in healthcare publishing for nearly three decades now, and that prediction has been around as long as I’ve been in the industry.
But the reality has been years of frustration and struggle. While no one is “against” PHRs, the question has been, who will create them, maintain them, and ensure their accuracy, availability, and interoperability? And, largely, the answer has been, “almost no one.” Physicians in practice, and their staffs, simply don’t want to deal with the hassle and the time investment involved. Doctors are already overwhelmed, and simply don’t want the responsibility; and neither do their staffs. Hospitals and health systems are in a bit better position, but even they continue to face problems maintaining PHRs. Meanwhile, health plans would like to manage PHRs, but let’s be honest: most healthcare consumers don’t rust their health plans enough. Consumers also keep getting pulled around from one health plan to another by their employers, so there’s that problem, too. And, on top of everything else, consumers/patients have found working with PHRs to be confusing, awkward, and frustrating. So a phenomenon whose success was predicted 25 years ago, has remained mired in a welter of practical and process issues.
So Wednesday’s announcement that Apple is launching a feature that will allow consumers to see their medical records right on their iPhones, offers the potential to become a true game-changer when it comes to consumer/patient engagement around healthcare consumers’ own records.
As Managing Editor Rajiv Leventhal noted in a report published on Wednesday, Apple executives released an announcement that day that stated that “The updated Health Records section within the Health app brings together hospitals, clinics and the existing Health app to make it easy for consumers to see their available medical data from multiple providers whenever they choose. Johns Hopkins Medicine, Cedars-Sinai, Penn Medicine and other participating hospitals and clinics are among the first to make this beta feature available to their patients.”
“Indeed,” Leventhal noted in his report, “Apple is testing this feature out with 12 hospitals in all, inclusive of some of the most prominent healthcare institutions in the U.S. The tech giant said it has “worked with the healthcare community to take a consumer-friendly approach, creating Health Records based on FHIR (Fast Healthcare Interoperability Resources), a standard for transferring electronic medical records.” As a result, he reported, “Now, consumers will have medical information from various institutions organized into one view covering allergies, conditions, immunizations, lab results, medications, procedures and vitals, and will receive notifications when their data is updated. Health Records data is encrypted and protected with the user’s iPhone passcode, the company stated.”
In making the announcement, Jeff Williams, Apple’s COO, said in a statement on Jan. 24, “Our goal is to help consumers live a better day. We’ve worked closely with the health community to create an experience everyone has wanted for years — to view medical records easily and securely right on your iPhone. He added, “By empowering customers to see their overall health, we hope to help consumers better understand their health and help them lead healthier lives.”
So, how is this all going to work? Christina Farr, in a report on Jan. 24 in CNBC online, put it this way: “If you've ever struggled to access your medical information, like a lab test or immunization, Apple is trying to make your life easier. On Wednesday, the company is releasing the test version of a new product that lets users download their health records, store them safely and show them to a doctor, caregiver or friend. It all works,” she wrote, “when a user opens the iPhone's health app, navigates to the health record section, and, on the new tool, adds a health provider. From there, the user taps to connect to Apple's software system and data start streaming into the service. Patients will get notified via an alert if new information becomes available.”
The key to all this? It fits into consumers’ normal device use processes. That’s the equivalent of integrating alerts and other elements into physicians’ and nurses’ clinician workflows. And that’s all-important. In addition to the structural and other issues around PHRs, the key reason they’ve not taken off in any significant way is that accessing and working with one’s PHR, as an consumer, has involved engaging in a set of processes that is outside one’s normal activity flow. How many busy consumers want to engage in processes completely separate from their normal interactions with technology?
Meanwhile, it’s very important to note, as Natasha Singer did in a Jan. 24 article in The New York Times, that “Apple’s personal medical record feature is hardly a new idea. With much fanfare about a decade ago, both Google and Microsoft introduced free services—called Google Health and Microsoft HealthVault—that helped consumers centralize their personal health data. But the concept of the personal medical record,” she noted in that article, “did not generate widespread adoption in that era, which predated the popularization of the iPhone and mobile apps. Google shut down Google Health in 2011. Microsoft still offers its HealthVault service.”
Which is precisely why both the Google Health and Microsoft HealthVault initiatives faltered. They stood apart from healthcare consumers’ day-to-day lives, and the normal flows of their uses of technology. Google and Microsoft also failed to excite the leaders of patient care organizations in their trajectories.
In contrast, Singer noted in her Times article, speaking of this new “Health Records” feature from Apple, “The feature is to become part of Apple’s popular Health app. It will enable users to transfer clinical data—like cholesterol levels and lists of medications prescribed by their doctors—directly from their medical providers to their iPhones, potentially streamlining how Americans gain access to some health information.” What’s more, she noted, “A dozen medical institutions across the United States—including Johns Hopkins Medicine in Baltimore and Cedars-Sinai in Los Angeles—have agreed to participate in the beta version of the new feature. Apple plans to open the beta test to consumers on Thursday.”
That, too, is key. Indeed, the list of patient care organizations involved in this initiative is quite impressive: Johns Hopkins Medicine (Baltimore), Cedars-Sinai Medical Center (Los Angeles), Penn Medicine (Philadelphia), Geisinger Health System (Danville, Pa.), UC San Diego Health (San Diego), UNC Health Care (Chapel, Hill, N.C.), Rush University Medical Center (Chicago), Dignity Health (San Francisco), Ochsner Health System (New Orleans), MedStar Health (Columbia, Md.), OhioHealth (Columbus, Oh.), Cerner Health Clinic (Kansas City, Mo.). Many of these organizations are absolute leaders in the industry; their being on board with this will both bring it attention and also make sure that some really smart people in some really smart organizations help to figure out how to optimize this capability.
Most of all, though, it’s the ingenious simplicity of this solution that will probably help it to revolutionize how healthcare consumers interact with their own health records. Nothing is for sure in healthcare, as we all know, but what we do know in the consumer electronics world, is that if a capability syncs with how consumers live their lives, it has great potential for success.
And in the end, could this capability actually lead to a new era of consumer/patient engagement in healthcare? That’s hard to say. But this really is an interesting development, and one with great potential. Certainly, we’ll all need to stay tuned, as this evolves forward.