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How Apple Might Change Healthcare

If you’re in the healthcare world, it would be hard to miss the announcement that Apple is getting into healthcare. In a move that surprised a few and pleased many, Apple is moving toward a FHIR-based app that will allow iPhone users to take greater control of their personal health information.

Today, I wanted to take a look at some of the data that showcases a few of the problems in HIT and where I think Apple (or any of the other consumer-tech giants) may be able to move the needle. There are three major areas where a traditionally consumer-facing tech company might have an impact:

1. Consumerism

For a consumer-product company like Apple, it makes sense that this is where they will first plant their flag in healthcare. Even as a guy who just bought the Google Pixel 2, I will admit that Apple is arguably the world-leader in making accessible, easy to use technology.

Apple has a depth of talent and understanding behind consumer design that isn’t readily matched.

Their understanding of consumer products means we could finally see a solution to one of the big problems facing many health systems – consumer adoption of patient portals.

 Patient Portal Adoption

This data from KLAS’ 2015 Patient Portals report shows that, even for the highest-performing vendors in this space, patients’ usage of traditional patient portals remains below 40%.

Several factors contribute to this low adoption; everything from consumers traditionally being unengaged with healthcare, to the modern proverb, “too many clicks spoil the browse.”

In other words, if the access is too difficult, you’ll never get anyone to engage.

This will be the first great test for Apple in healthcare. They have 90 million people (over 40% of the US smartphone market) already trained on how iOS operates. Will they be able drive deeper patient engagement than past patient portals?

2. Interoperability

The biggest “missing piece” from the Apple PHR announcement comes when you realize that putting EMR onto your iPhone is all well and good, until you go to your next doctor appointment, show her your shiny new app and she responds, “that’s nice, what do you want me to do with it?”

I was happy to hear that Apple has referenced HL7’s FHIR in building this app, but after digging through the news, I haven’t seen much discussion of how or when exactly the health info Apple pulls into iOS will feasibly be pushed back into the EMRs where it can impact care.

It doesn’t take much of an imaginative leap to hope that, eventually, consumers will have access to; appointment scheduling, updating their doctor’s EMR with fitness data, and the ability to act as the “channel of interoperability” for healthcare all in the clean, sleek, user-friendliness we’ve come to expect of Apple.

3. Usability

KLAS recently dove head first into the complex and difficult problem of EMR usability. Working with over 70 (and counting) health organizations, we’ve begun gathering data on clinician-user satisfaction. Currently, the picture is less-than rosy.

At the time of publication for the EMR Advantage Report, of 7,609 end-users who had participated, 43% reported overall dissatisfaction with their EMR experience.

Stemming from problems like poor training (see below), low ongoing education and organization culture, anything that could help make the digital landscape for care providers easier would be a welcome boon.

 Satisfaction

With Apple’s new app, many in healthcare IT are declaring that “Apple is officially in the EMR business.” While we’re a long way off from an iOS EMR, it does make one wonder what kind of solutions Apple eventually might bring to the usability concerns of traditional healthcare IT systems.

Adoption

Time to address the elephant in the room: “Can Apple succeed where other consumer-tech giants have failed?”

Between Google Health’s short-lived run and the low-adoption of Microsoft’s HealthVault, it looks like the deck might just be stacked against Apple. However, the consumer landscape of today differs from the early 2010’s in a few key areas.

First, in 2017, 77% of US adults reported that they own a smartphone, up from 35% in 2011. That level of adoption means that the majority of healthcare consumers have access to and understand how to navigate phone-based interfaces. Where Google had to try and get people onto the computer, to their site etc. Apple will be able to give consumers their health data right in their normal device usage.

Second, the smartphone has opened the floodgates for a slew of fitness and health related apps/wearables. Everything from sleep data to swimming strokes can be tracked nowadays. While the jury is still out on how effectively that data will impact care, it does show that – for consumers – the demand for health-related information has increased.

Finally, rising healthcare costs have just begun to force consumers to engage with their health. This means everything from employers engaging in wellness-programs (currently trying to win the “steps challenge” at KLAS) to consumers beginning to price-shop for low-cost care. All of this means the average American has access to the necessary tech, an increased interest in health data, and the financial motivation to take control of their own health.

In the end, Apple couldn’t have picked a better time to throw their hat into the ring.