Originally published 9.10.2014
We finally have the iPhone 6 and the Apple Watch. Once again, Apple has delivered a physically stunning set of hardware designs that deserve the “oohs” and “aahs” that are now being heaped on them. And, for sure, I can’t wait to get my hands on both devices myself. But the beautiful designs, displays, and hardware/software interaction innovations are the obvious part of the story. There is a much bigger story here whose headline was buried in all of the excitement of this week’s announcement.
THE MISSED HEADLINE:
“Apple just announced Consumer Healthcare!”
Tuesday’s announcement put a critical piece in place for their healthcare play, whose potential impact is so transformative in nature that it will accelerate the industry shift sought by the ACA and described by Dr. Eric Topol in is book, The Creative Destruction of Medicine.
“'Consumer healthcare?' I thought it was a phone, a watch, and a fitness app!”
Most people will point to the Apple Watch, with its heart monitor integration with HealthKit, as the big health play. And these two elements are critical, for sure. The ability to passively and actively capture biometric and behavioral data from both the watch and the phone is crucial to successful patient engagement. Having the ability to marry that data with data from other sources within one platform that can then be shared through HealthKit is foundational. But, Apple is not the first company to build a digital health data platform that streamlines integration and creates great accessibility. Validic (validic.com) has been doing this very successfully for some time with a huge roster of top names as partners. So, what is it that makes Apple’s play so different?
HealthKit, the upgraded M8 motion co-processor, and Apple Watch are just the tip of the iceberg. To get a full understanding of what makes Apple’s play so huge, we have to look at yesterday’s announcements in context with the bigger picture, which includes some events outside of Apple’s direct ecosystem. Here is a quick look below the waterline:
1. MBANS (MEDICAL BODY AREA NETWORK)
In 2012, the FCC set aside a portion of the wireless spectrum to be used specifically by a class of wireless medical devices and sensors in order to transmit patient vital health data safely without fear of interference. This frees up patients from the clutter of wires in the hospital. But, it also enables the patient to be liberated in their everyday life while still being remotely monitored by their healthcare team. This sets the stage for the wireless Internet of Things to move into healthcare safely. (See http://fcc.us/1lTWvJn for more info.)
2. APPLE BEGAN PRO-ACTIVE DISCUSSIONS WITH THE FDA AND THE FDA DEREGULATED MEDICAL DEVICE DATA SYSTEMS (MDDS)
In a timely manner, the FDA surprised the industry by announcing a decision to deregulate MDDS (medical device data systems) such as Validic’s platform. Then, the FDA went further to define a specific additional category of MDDS that is incredibly similar to what we now know as HealthKit. (See http://bit.ly/UHVMyJ for more info.)
The ability for consumers to centralize, display, and then make actionable health information from a wide array of previously disparate and unrelated health information sources is crucial. We have heard some of our colleagues and quantified-selfer friends express disappointment that we didn’t see more biometrics outside of heart-rate sensors show up on the Apple Watch. But, this is where the flexibility and power of HealthKit will come into play, combined with the MBAN specification designated by the FCC. Off-the-shelf wireless health devices are already available to generate the data we seek. iHealth has wireless blood pressure monitors, wireless scales, pulse oximeters, and glucometers. AliveCor’s AliveECG is FDA-approved to monitor heart rate with an algorithm that can accurately identify Atrial Fibrillation to encourage a patient to seek medical help. What is missing is the platform (HealthKit) and each company’s decision to utilize the API to share the data. (See http://www.ihealthlabs.com and http://www.alivecor.com/home for more info.)
The competitively triumphant and differentiating factor (coup de grace, anyone?) is Apple’s proactive discussions with the EMR companies in order to make HealthKit’s data usable as integrated data in the EMR system by healthcare providers. This takes the data out of niche geekdom of quantified selfers and puts it squarely in to actionable, operational territory for everyday consumers. This single move is what will make Apple different from Microsoft, Google, FitBit, BodyBugg, and all of the other competing vaults and fitness data trackers. Other companies will now follow suit...but they will be doing so using Apple’s template. (See http://reut.rs/1q6j3Tc for more info.)
SO, HOW DO ALL OF THESE THINGS ADD UP TO APPLE ANNOUNCING CONSUMER HEALTHCARE?
Let’s look at the converging factors (buzzword alert: superconvergence!). Apple’s announcement leverages:
- Growing patient participation in their own healthcare.
- The wireless data security of the MBAN spectrum.
- Todd Park’s rallying cry with the ONC to have healthcare data liberated for patients to own.
- A platform that can unify fragmented healthcare data from previous silos into one data stream and can integrate with EMR systems to enable greater patient/physician collaboration.
- And, most notably, it does this with the weight of Apple and all of its customer base, which means we have a potentially large enough scale to be practical and viable for adoption by the healthcare industry at large.
Launching the Apple Watch and iPhone 6 alongside HealthKit now puts all of the foundational pieces together to truly launch an entirely new movement in patient-driven healthcare partnership towards better outcomes. We are super-stoked on the brand new infrastructure for healthcare delivery that was (and wasn’t) announced yesterday. And you thought you were just getting a killer new phone and watch…
Never fear! We are always here to help you thread the needle!