DrChrono, the maker of an open, mobile-friendly EHR platform and other practice management software, has launched an open FHIR API that will allow a seamless transfer of patients' data from the company's OnPatient personal health record (PHR) to Apple Health, the iPhone-based PHR launched by the tech giant in 2018.

Now, patients using the two platforms won't need to download and log into the OnPatient app to consolidate their health information, Daniel Kivatinos, COO and cofounder of DrChrono, told MobiHealthNews.

"You go into Apple Health, you search for your doctor, you type in your login once for OnPatient, and then it simply looks like an iPhone product designed by the Apple team," he said. "Instantaneously, those health records and the elements in those records like blood pressure are pulled into the iPhone-native product."

These transfers are conducted securely and, once downloaded, are stored on the iPhone itself, Kivatinos said. The information is protected by Apple's on-device data encryption, but can be accessed using the same passcode, Touch ID or Face ID verification that users rely on when unlocking their device every day, he said.

WHAT'S THE IMPACT?

DrChrono has been privately beta-testing these new capabilities among several providers, Kivatinos said. It will now be available to all iPhone-owning patients whose providers use the DrChrono EHR platform.

That's a hefty portion of the nearly 23 million patients Kivatinos said his company is currently supporting. The Apple Health Records feature, meanwhile, was supported by more than 500 institutions across over 11,000 care locations, as of the most recent update in October. The update also marked the platform's expansion to U.K. and Canadian providers.

"There are so many iPhone users we are instantaneously empowering," Kivatinos said. "We have thousands of providers in DrChrono and we are doing 400,000 appointments a week, which is easily 3% of the appointments in the U.S.

"If you take all of that, and you take all these iPhone users, they're getting all that information for their care – and they can just look at their phone. It unlocks; they know where to pull it up; and they can show it to their provider."

The impact of that immediate access and data consolidation can be stark for patients conditioned over the years to juggle lengthy printouts and data release requests, he continued. The Health Records feature houses a wide swath of medical information, such as lab results, medications, diagnoses and immunizations alongside the fitness and wellness metrics delivered through Apple Watches and other compatible devices and sensors.

To give an idea of the impact this could have on consumer behavior, Kivatinos highlighted the tight, system-level integration and comprehensive design Apple brought to the Apple Card, its substitution for a traditional credit card.

"[Apple Card] is so seamless – the iPhone is the credit card and the credit card is the iPhone," he said. "There's no logging in, there's no fumbling for another thing. The phone becomes the one product, and the one login."

Apple Health Records is the healthcare equivalent of this same concept: "show your face and pull up the health record," he said. With adequate support, he believes that type of simplicity can drive consumer adoption, patient engagement and even demand.

"Patients are going to start to push this into the doctor's office," he said. "I would say most iPhone users are consumers. Consumers expect what they expect, and they're going to start to just expect their health records to be available from that device. We're going to see a massive shift over the next five years where, like the Apple credit card, when there's an emergency or you need to check something you'll be able to look at that information in a quick snapshot."

Not to be lost in the user experience argument are the benefits a comprehensive PHR can provide during care. A single convenient tool will help patients log and report their full medical history to the doctor – not always a given when appointments could be years apart, Kivatinos noted.

Both an open API and a handheld digital record can be especially helpful when patients hop between different provider organizations and EHR platforms, he continued. Apple Health Records includes a clear way to view when and who uploaded new information, maintaining accountability and protection for doctors basing their clinical decisions on another provider's data entries. And even when an organization doesn't support DrChrono's OnPatient platform, the iPhone can be a resource for patients and providers during intake, according to Kivatinos. 

"DrChrono is a platform for DrChrono users, which is great, but when a provider wants to see a patient that's coming from someplace else, generally there's some friction there," Kivatinos said. "Now if all of that data is consolidated into the iPhone and people start getting used to Apple Health, they can give this to the medical assistant, ... and that allows the provider to just give better care."

Last but not least, Kivatinos also noted that open FHIR APIs are generally a boon for health researchers. Should patients consent to share their information, data can more easily be transferred and consolidated for analysis.

THE LARGER TREND

DrChrono has hitched its wagon to iOS for more than a decade, having gotten its start as the developer of an EHR platform built from the ground up to work with iPads. The company added user experience features such as fingerprint scanner and facial recognition support over time, and Kivatinos highlighted the company's participation in the Obama administration's Sync for Science initiative as a precursor to the new open FHIR API enabling these functionalities.

Apple Health Records has also picked up steam in its nearly three years of operation. Alongside the aforementioned international expansion, the company has seen support from major public organizations like the Department of Veterans Affairs, major EHR platforms and other digital health startups like One Drop and Heal.

Outside of the Apple ecosystem, December saw an announcement from The Commons Project that CommonHealth, its free PHR system built for Android users, supported by 230 U.S. health systems and was on track to add another 110 or so providers before the end of 2020. And all of these developments come while the U.S. Department of Health and Human Services prepares the July enforcement of new rules regarding the establishment of a Patient Access API.