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Apple Health Records 2018
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Apple Health Records 2018
Early Participants Weigh In

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On January 24, Apple announced Apple Health Records, a new iPhone feature for downloading, aggregating, and viewing patient medical records. The revelation created a stir for at least a few reasons: (1) Apple is a consumer-oriented healthcare outsider; (2) Apple is attempting to make inroads where peers Google and Microsoft have failed; and (3) the feature has the potential to impact millions of patients given the iPhone’s broad customer base. Many articles and blogs about this announcement have already been written, but this report goes deeper. KLAS interviewed executives at all 12 of the early adopter health systems that partnered with Apple through the beta process to ask: How real is this capability and what is the expected impact? How soon might it make a difference? What is the experience like so far and what hurdles do providers face? What challenges does Apple face and how likely are they to succeed where others have flopped?

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Participants Say Apple Is Not Overstating Their Case


Early participants say that Apple’s move is not just a marketing ploy and that it has both short-term benefits and long-term potential to impact how provider organizations interact with patients and how patients manage their health. Immediately, Health Records is expected to help solve the intractable challenge of interoperability by allowing iPhone users to store their health records on a device that is already omnipresent in their lives. This convenience is expected to increase patient satisfaction and also engender in patients an expanding sense of self-ownership and self-involvement in their own care. In the long term, making health records available on the iPhone promises to speed innovation by breaking down the door between healthcare and consumer fields. Respondents say that non-healthcare vendors understand patients in a different way and that out-of-the-box research and development from these vendors may result in efforts that motivate and direct patients better than the methods that have historically been available.




The Time Is Right for Apple to Leap Over Healthcare Hurdles


One reason Apple’s entry into healthcare raises eyebrows is that the healthcare industry is notoriously complex and thus unfriendly to vendors without deep experience in patient care, health data, and government regulation—even well-funded giants like Google and Microsoft have stumbled. Apple’s early provider partners say Apple has a good chance of not repeating history and that the timing is right—EMR adoption has never been higher, and thus electronic records have never been as available; smartphones are more entrenched than ever; and interoperability standards (like FHIR) have never been as advanced. More importantly, healthcare now needs Apple’s creativity and proven success with consumers more than it needs entrenched healthcare perspectives. With historical attention to privacy and a business model that isn’t dependent on selling consumer data, Apple has earned consumer trust. Additionally, their Health Records solution sidesteps most HIPAA concerns because Apple never takes possession of patient data. Finally, Health Record participants say Apple has no need to rush development and has wisely adopted a strategy of starting small, then learning and evolving over time.


Optimistic Participants Choose a Strategic Back Seat


While participants say Health Records has visionary potential, most organizations’ formal plans for it are limited to its most immediate benefit—allowing patients to download their patient records, a benefit that requires relatively little time, effort, or cost from healthcare providers. Most participants view Health Records as an add-on for patient convenience that does little to alter their patient engagement strategy. Some even expect Apple to drive most patient adoption. Beyond data portability, most participants feel they lack the experience and expertise needed to pursue creative uses, such as consumer app development. Instead, they will let third-party developers from outside healthcare take the reins while they watch and learn from the sidelines.


Next Steps: Can Apple Scale?

Short term or long term, participants say that Health Records’ impact will depend on Apple’s ability to scale education, adoption, and data complexity. Both patients and clinicians need to figure out how Health Records compares to other patient engagement options that already exist. On March 29, Apple more than tripled the number of participating health systems (from 12 to 39), but there are over 2,000 hospital-based health systems in the US. In order to reach more than one-third of these, Apple will need to expand to EMR vendors beyond their current partners (athenahealth, Cerner, and Epic). In terms of capabilities, participants say that being able to upload data back into the EMR will be vital and that eventually Health Records’ data model will need to support more detailed data than the C-CDA data elements handled today. Eventually, if this general capability is going to benefit all patients in the US, it will need to expand beyond Apple to other smartphone vendors: "If an Android version becomes available," said one CIO, "that will be a home run for a lot of people."

5% of Hospitals Down, 95% to Go


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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2018 KLAS Enterprises, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.