The Institute for Healthcare Improvement (IHI) released its Triple Aim Initiative in 2008, challenging the healthcare industry to undergo extensive systematic change, with the following goals:1
- Reduce the per capita cost of healthcare;
- Improve the patient experience of care, including quality and satisfaction; and
- Improve the health of populations.
The first two aims are difficult enough, but the third involves engaging and empowering patients and their families to take ownership of their own health and wellness. This is much more than just understanding what your diagnoses are and which medications to take; it is about getting and staying well. Keeping patients and their families well is a goal that has eluded the healthcare industry since before Hippocrates and is an extremely challenging one for hospitalists, whose time with patients is usually limited to an acute care hospital stay.
Naturally, when one industry cannot figure out how to do something well, another industry will develop a breakthrough innovation. Enter Apple Inc., which has officially moved into the health and wellness business. Apple Health is a new app that will share multiple inputs of patient information in a cloud platform called “HealthKit.” HealthKit will allow a user to view a personalized dashboard of health and fitness metrics, which conglomerates information from a myriad of different health and wellness apps, helping them “communicate” with one another.2
The breadth and choice of health and wellness apps available to users is astounding. In a five-minute browse through the app store on my iPhone, I found the following free options to help patients track and understand their health and wellness:
- MyPlate Calorie Tracker, Calorie Counter, and Fooducate help educate and monitor caloric intake.
- iTriage, WebMD, and Mango Health Medication Manager, which can answer questions about symptoms you may be experiencing, will save a list of medications, conditions, procedures, physicians, appointments, and more, and can help you manage your medications.
- Nexercise, MapMyRun, MapMyRide, MapMyFitness, Pacer, and Health Mate track physical activity.
- Fitness Buddy and Daily Workout allow users to view daily workout options and target muscle groups for appropriate exercises.
- ShopWell allows you to scan food labels and evaluate ingredients, calories, gluten, and so on in most store-bought food products.
What Apple proposes to do with its new HealthKit is coordinate the input of these types of apps to synthesize a patient’s health and wellness onto a single platform, which can be shared with caretakers and healthcare providers as needed. The company, as only Apple can, actually declared that its app might be “the beginning of a health revolution.”
A New Day
What HealthKit offers is truly unique from a data security standpoint, which will appeal to Orwellian paranoids. Traditionally, when customers use services such as Google or Yahoo, these services use your personal identity—gathered in pieces of data such as your location and your browsing histories—and then use that data to collect, store, or sell such information on their terms. But Apple promises to help manage health and wellness data on the users’ terms. The purpose is to enable easy but secure sharing of complex health information, which can be updated by users or by other devices. Apple has coordinated with other developers to import information to HealthKit from multiple platforms and devices (such as Nike+, Withings Scale, and Fitbit Flex), acting as a central repository of personalized information.
With this technology, it’s easy to envision hospitals, clinics, pharmacies, laboratories, and even insurers integrating bilaterally with any patient information housed on HealthKit, at the discretion of the user. Mayo Clinic, Cleveland Clinic, Kaiser Permanente, Stanford, UCLA, and Mount Sinai Hospital are all rumored to be working with Apple to figure out how to exchange relevant patient information to enhance the continuity of a patient’s care. In addition to these potential collaborators, electronic health record providers Epic Systems and Allscripts are rumored to be working with Apple in some sort of partnership.3,4
Not only will HealthKit be a secure repository of information, but it will constantly monitor all the metrics and can be programmed to send alerts to key stakeholders, such as family members or healthcare providers, when any of the metrics veer outside predetermined boundaries.4
This “new revolution” in healthcare and wellness should prove extremely helpful to hospitalists, who are often caught in the crosshairs of disjointed patient care delivery systems, and patients who need someone (or something) to track their health and wellness. Imagine a late afternoon admission of a patient who knows exactly what medications she is taking, who can outline several months’ history of caloric intake, physical activity, and basic vital signs, who has an accurate and updated inventory of laboratory exams from other medical centers, and who has a list of all recent physicians and appointments. Although this may seem too good to be true, such an admission may not be too far in the future.
What would be even better is if a patient’s health and wellness tracking keeps him out of the hospital altogether. After all, an Apple a day keeps the doctors away.
Dr. Scheurer is a hospitalist and chief quality officer at the Medical University of South Carolina in Charleston. She is physician editor of The Hospitalist. Email her at firstname.lastname@example.org.
- Institute for Healthcare Improvement. IHI Triple Aim Initiative. Available at: http://www.ihi.org/Engage/Initiatives/TripleAim/Pages/default.aspx. Accessed August 31, 2014.
- Apple Inc. Healthkit information page. Available at: https://developer.apple.com/healthkit/. Accessed August 31, 2014.
- The Advisory Board Company. Daily Briefing: Apple in talks with top hospitals to become ‘hub of health data.’ Available at: http://www.advisory.com/daily-briefing/2014/08/12/apple-in-talks-with-top-hospitals-to-become-hub-of-health-data. Accessed August 31, 2014.
- Sullivan M. VentureBeat News. Apple announces HealthKit platform and new health app. Available at: http://venturebeat.com/2014/06/02/apple-announces-heath-kit-platform-and-health-app/. Accessed August 31, 2014.