Health IT

Report: Health systems share Apple Health Records feedback

Responses from health systems touched on genuine excitement for how Apple's technology could improve the patient experience to anxiety over the potential risks of patients sharing their medical information with third party developers.

Earlier this year, Apple unveiled it had partnered with 12 healthcare organizations to beta test its Health Record feature as part of the latest set of updates to its iOS network. It has since moved beyond the pilot stage to adoption by more than 30 other companies and healthcare organizations, including the initial pilot partners. In its latest research report, KLAS interviewed executives and directors at the 12 early adopters and asked them a series of questions about their experience.

The most interesting responses were to questions focused on the potential of Apple’s health record technology, the experience so far coupled with hurdles providers face, challenges Apple faces and the likelihood of success.

Although half of the interviews were with CIOs, others included executives –25 percent,  CMIOs and CMOs — 17 percent, and directors — 8 percent.

The health systems that took part in the beta test included:

  • Johns Hopkins Medicine – Baltimore, Maryland
  • Cedars-Sinai – Los Angeles, California
  • Penn Medicine – Philadelphia, Pennsylvania
  • Geisinger Health System – Danville, Pennsylvania
  • UC San Diego Health – San Diego, California
  • UNC Health Care – Chapel Hill, North Carolina
  • Rush University Medical Center – Chicago, Illinois
  • Dignity Health – Arizona, California and Nevada
  • Ochsner Health System – Jefferson Parish, Louisiana
  • MedStar Health –  Washington, D.C., Maryland and Virginia
  • OhioHealth – Columbus, Ohio
  • Cerner Healthe Clinic – Kansas City, Missouri

The Health Record feature allows patients to access their record through a code for their iPhone that connects them to data from their provider’s patient portal. The idea is to help patients better understand their medical history, improve the quality of interactions with their physicians and family members, and make more informed decisions about their care. The hope is that Apple will be able to succeed with these personal health records where Google and Microsoft have not.

Most of the excitement around Apple’s move into health systems, beyond what it has already done with HealthKit, CareKit, and ResearchKit, has been around making hospital records more consumer friendly.

There has been a lot of discussion about the potential of Apple to advance interoperability but it assumes that certain things will happen such as if and when data integration with electronic medical records becomes bidirectional, allowing health information to flow back into EMRs.

Others expressed hope for the potential of upcoming versions of Apple Record, particularly for improving the patient experience.

“That is a huge leap from where we were three years ago,” remarked a CIO surveyed for the report, “and an even bigger leap from 10 years ago. I think upcoming versions will take the data that is now on the phone and, with the patient’s consent, import that into a designated EMR to close the loop.”

Another CIO observed that the combination of patient records and data from wearable devices could unlock value, particularly if there could be integration with other third-party app developers. The combination of EMR information with a mobile device and patient information with consumer data from fitness trackers and wearables could support precision analytics and predictive modeling, the CIO noted.

A chief medical officer said his organization’s biggest hurdle will be the culture of physicians themselves.

“When we look at national surveys, physicians, on the whole, are not interested in people having full transparency into their medical records even though they legally belong to the patients. The law says that I can get a complete copy of my medical record. However, we make it difficult for patients to do that. Apple’s concept takes the friction away and makes it easier for everyone to have access to their medical records.”

Despite Apple’s efforts to best Google and Microsoft in the personal EHR arena, the shadows of those two companies loom large, particularly in the minds of others in healthcare. For Apple, demonstrating in the near term why their product is better than Microsoft or Google poses the most immediate challenge, from the perspective of one CIO. And yet Apple’s move is well-timed, particularly with the FHIR standard in place given that Apple’s EHR technology is built off of it.

But perhaps the starkest challenge for Apple’s personal health record is that the number of Apple iPhone owners is much smaller than owners of phones on the Android network.

Giving patients the freedom to choose how to share their medical information is an exciting prospect for a healthcare industry that has made this task complicated at best, but it does come with a certain amount of concern about the complex implications for hospitals. One survey participant drew attention to this issue.

“I think several academic organizations will struggle a little bit with IRB approval processes and figuring out how to recruit patients for studies when all the EHR data is available in addition to other data we will be collecting. That opens up some issues and concerns about consent. Patients will be sharing data with app developers, and I think Apple does a good job of disclosing data sharing, but people will still take pause. Once patients have pulled their data, they are in control of it, so that puts it outside of HIPAA. But then when the data comes back to us, we are still a covered entity. That creates a complex relationship. We are working through what our consent obligations are to patients and whether they understand the process.”

 

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