After a bungled release of iOS 8.0.1, Apple finally managed to get HealthKit into the hands of iPhone owners. I've been pretty open about the ways that I think technologies like fitness trackers and HealthKit can change lives (and for anyone interested in keeping score, my Fitbit-related weight loss is now up to 42 pounds) and, having worked in healthcare IT, I think there is an immense amount of potential in these technologies.
The challenge is getting HealthKit (and Samsung's upcoming SAMI health platform) and the data that it generates into the hands of physicians and other healthcare professionals. I've spoken to several healthcare workers over the past few days about HealthKit and while many of them are enthusiastic, many also have questions and concerns about how to integrate it into their practices.
One concern is the accuracy of the data. This isn't really a concern about HealthKit itself or iOS 8's Health app. It's a concern about the accuracy of patient generated data, which is a much bigger issue -- or rather two bigger issues.
First, patient generated data has traditionally been self-reporting, which means it isn't always accurate or complete. The second issue is a concern about the accuracy of the devices used to record that data. Doctors and nurses trust certain device brands and sometimes discourage patients from selecting a device from another company, particularly new companies. Both of these can be serious concerns and are valid.
Another concern is that while there's a significant value to monitoring metrics for people with certain conditions, particularly chronic health problems like heart disease, diabetes, and COPD, tracking a huge range of metrics for people that are essentially healthy could load too much unneeded data into a person's health record. This seems to be a particular concern for primary care physicians, who are generally ranked as the most overworked doctors in the country.
That sense of overwork brings me to the last two issues raised by the healthcare workers I spoke to. There's a real sense of of overwork and being inundated with new processes as the federal government has spurred the adoption of electronic records systems in recent years, and burnout among healthcare IT workers being charged with rolling out those systems. This is a particular concern as the electronic records incentive program moves forward with additional meaningful use requirements -- forcing healthcare organizations to demonstrate they're achieving a long list of metrics for these systems -- and with the anticipated switch to a more detailed medical coding system known as ICD 10 that was slated for implementation this year but has been pushed back.
None of these concerns was universal among the healthcare workers I spoke with. The concerns about workload seemed to vary significantly. I suspect that's because some healthcare organizations managed the adoption and rollout of electronic records earlier and more effectively than others.
Apple has been working with the biggest electronic records vendors in the all of North America. Epic, which Apple highlighted while introducing HealthKit in June, claims it cover more than a million individuals alone -- and Epic was one of the first companies that Apple identified as a healthcare partner, saying that its MyChart app that gives patients access to their medical records in an iPhone app will support HealthKit at launch.
That's great news. But just because a vendor offers a feature, no matter how great or how small, there's no guarantee that every -- or any -- organization that buys solutions from that vendor will implement it. Even if they do, there's no guarantee how long it will take for their internal review and testing process to be completed prior to rollout.
Apple's drive to disrupt healthcare may get off to an uneven start. Some organizations and healthcare providers will likely implement support for HealthKit quickly and encourage patients to make use of it. Others are likely to hold back even if HealthKit is a viable option for them right out of the gate.