Yesterday, Apple made a big, long-awaited announcement in healthcare: the company is entering the personal health record space with Apple Health, a new feature that will interface with EHRs at 12 hospitals.
The news prompted immediate and vibrant feedback on Twitter, much of it centered on whether or not Apple could succeed where numerous others have failed. WeGo Health Chief Strategy Officer David Goldsmith kicked off the conversation, piggybacking on our coverage of the news.
I agree with @JonahComstock in @MobiHealthNews: Apple has advantages no other company has ever had in the #PHR space.
Penny for your thoughts @john_chilmark @naveen101 @garyleethompson @healthythinker
https://t.co/JqoxSja2uT— david goldsmith (@dsgold) January 24, 2018
One point that was brought up many times, missing from our initial coverage, is that many patients are Android users. Chilmark Research founder John Moore was the first to highlight it, but digital health strategist Naveen Rao and Open Health Network CEO Tatyana Kanzaveli also made the point.
But he misses a key point, less than half the US population use iOS.
What I'd be interested to see is how Apple might move to address the countless challenges in PHM/reducing risk via this PHR. Will they close care gaps, will they facilitate Rex refills, etc
— John Moore (@john_chilmark) January 25, 2018
Epic & Cerner should step up & provide similar functions. Anything patients facing has to be hardware agnostic. We see 50/50 split between iOS & Android users across all mhealth
— Tatyana Kanzaveli (@glfceo) January 25, 2018
Late to the party!
1. Lots riding on assumption that it will "just work." Don't believe it till you see it, even w Apple.
2. I'm an Android user, along w half of US, disproportionately minorities. How far can Apple PHM get?This *might* be a 1st down. Def not a TD. & Go Pats.
— Naveen Rao (@naveen101) January 25, 2018
Rao's comment also addresses the other major theme of the conversation: that the thing that's held back PHRs isn't primarily technical. Instead, making the platforms usable and worth using, and providing an actual benefit to patients, is necessary, and Apple hasn't proven that it will fare any better at that challenge. Moore articulated that point well in response to a tweet from CLOUD, Inc. founder Gary L. Thompson.
Exactly, the big challenge for Apple will be: getting the Ave consumer to give a damn. No one wants a digital file cabinet of their health records, they want actionable insights & ways to more easily interact & receive care
— John Moore (@john_chilmark) January 25, 2018
What Apple has going for it in that regard, Goldsmith pointed out, is buy-in from hospitals and EHRs as well as an extensive product ecosystem. I added, in response to Moore, that Apple has also shown a willingness to play a longer game in terms of profitability than smaller players can afford.
Does the avg consumer have to buy in? If this tool ends up being used primarily by those with chronic conditions & above avg interaction with the healthcare system, it's still a big and valuable change for those patients -- and those patients contribute most to healthcare costs.
— Jonah Comstock (@JonahComstock) January 25, 2018
For small companies, scaling is important to stay afloat. Apple has lots of money and lots of other business, can afford to take a hit for a long time for altruism/good PR. Cook even says in interviews, not everything they do in HC has a business model. https://t.co/F8fWxhkz4B
— Jonah Comstock (@JonahComstock) January 25, 2018
But Moore's question — Can Apple make the PHR worthwhile? — still looms large. Stephen Kraus, a healthcare investor with Bessemer Partners, and Dr. Bijan Salehizadeh, an investor at NaviMed, also tackled the engagement question. Kraus pointed out that Apple doesn't have to solve that problem all by itself.
1/ it may not be apple that figures out the actual engagement with the end data. They may just be the platform that allows you to access... https://t.co/rc43oPS84W
— Stephen Kraus (@stephenkraus) January 25, 2018
2/ in this new world, what if consumer is able to easily “push” their data to say another app that makes engagement worthwhile ... https://t.co/BukVqZoiDB
— Stephen Kraus (@stephenkraus) January 25, 2018
3/ e.g., a beautiful designed digital Rx discount card app that ingests this data on regular basis & offers consumers better deals on drugs! https://t.co/U1oDzeWdYO
— Stephen Kraus (@stephenkraus) January 25, 2018
4/ that’s a value prop (as drugs are first dollar for most consumers with HDHP) that would resonate & lead to ⬆️ engagement this time round https://t.co/cgBkA3tDuw
— Stephen Kraus (@stephenkraus) January 25, 2018
5/ to complete the argument none of this happens w/o ubiquity of iPhone. Yes I am dreaming a little. But hey a kid can dream, right? https://t.co/wLDfwahYdy
— Stephen Kraus (@stephenkraus) January 25, 2018
Totally agree w you. 1) stunning indictment of patient portals. 2) key question is did bad PP design drive low engagement or is engagement fixable with Apple ubiquity and design. This will be the definitive experiment - do people care about their health records.
— Bijan Salehizadeh (@bijans) January 25, 2018
Several tweeters, including Evidation Health President Christine Lemke, wondered whether patients will truly own or control the data with Apple's Health records.
Love all of this, but we should include "consumers should CONTROL" their data as part of the whole "consumers should own data" issue. "Ownership" should imply control, but it doesn't actually work that way with data: https://t.co/lZcccZAl3X
— Christine Lemke (@cklemke) January 24, 2018
Having another, cleaner window into my various repositories is an evolutionary, not revolutionary step. Imagine if iTunes didn't have $.99 songs back in the day, it would have simply been a digital shelf for a flawed music distribution system. 1/2
— Gary L. Thompson (@garyleethompson) January 25, 2018
Cerner, Epic and Athena are in essence the music labels of #healthdata The data is not theirs. It is the patients, with value added by #HCPs They are the artists, and iTunes was meant to bring power back to the artists. This doesn't shift power. 2/2
— Gary L. Thompson (@garyleethompson) January 25, 2018
Just one day past the announcement, it's too early to definitively answer any of these questions. But they're good ones to be watching, and conversations like these will likely be happening for a while, especially with HIMSS18 so close on the horizon. In the meantime, head over to Twitter to join the conversation. You can follow the MobiHealthNews team at @MobiHealthNews, @JonahComstock, @lauralovett7, and @dave_muoio.
