Apple Aiming to Make iPhone 'One-Stop Shop' for Medical Info

[DeepIn2U]

I really like the idea behind this. It's always irked me how my doctor keeps a detailed history of my health which I don't have access to.

That's backwards.

I should have full access to all my health history, including all lab tests, X-rays and doctors notes on my visits and then I should be able to share it with relevant specialists or health institutions who are taking care of me. If I visit a hospital, I tap my iPhone or Apple Watch on a terminal to give them instant access to my history. If I stop dealing with that hospital, I can revoke access.

Dis is how it a go!

This is how it ahould be. I mean just how "healthy" are we all if the data that is from us is inaccessible to us?! Just how relevant is it?!

 

[WatchFromAfar]

It's a light-heated reference to the recent cyber attack on the NHS that only worked because they were running XP and hadn't installed the appropriate patch. I'd humbly suggest that if a computer system is needed to run vital equipment or hold personal health data it is either secured or not connected to the Internet directly. Anyway, I doubt will see that level of interaction with Apple Watch and health services in the UK unless it is with private companies who can make it a selling point. And before you now accuse me of NHS-bashing or whatever, I'd rather they spent their limited funding on frontline care such as nurses anyway.

OK, I'm sorry,I didn't want to come across as a jerk.

 

[ipedro]

It doesn't work that way. If you visit a hospital, the medical history you give becomes part of the chart the hospital creates for you - in other words, it's copied to their own records. There's no way to "revoke" access.

It doesn't work that way now. And that's the problem. I should own my own health history. It's mine. Why should a hospital retain access to my health history if I choose to stop dealing with them? Its my own health data and I should be permitted to choose who has access to it.

This isn't just a technological problem. It's a law issue. If Apple and other tech companies work with Congress to build a standard on how patient information must be managed, read and written to, this could become comparable to banking. Patient data is stored in the cloud and patients can give access to that data to whichever health professional they choose. And because it's in the cloud, access to it can be revoked.

In an era of hacking and privacy invasion, the last place I want my most personal information to be handled by is the severely outdated bureaucracy running on Windows 95 that most health institutions are know for.

 

[IllIllIll]

It doesn't work that way now. And that's the problem. I should own my own health history. It's mine. Why should a hospital retain access to my health history if I choose to stop dealing with them? Its my own health data and I should be permitted to choose who has access to it.

Simple answer: medicolegal reasons. Hospitals need to retain ALL documentation generated by a patient encounter, whether it's electronic or on paper, in case the institution gets sued and must supply this documentation for discovery.

Your health history may be yours, but what it's documented on is owned by the hospital, doctor's office, clinic, surgicenter, etc. If you've ever stayed in a hospital, I invite you to try going back and asking to have your medical records handed over. The hospital's HIS department would be happy to make copies for you, but you won't be walking out with the original documents. Period. Nor will they be deleting your chart from their EHR simply because you ask them to.

This isn't just a technological problem. It's a law issue. If Apple and other tech companies work with Congress to build a standard on how patient information must be managed, read and written to, this could become comparable to banking. Patient data is stored in the cloud and patients can give access to that data to whichever health professional they choose. And because it's in the cloud, access to it can be revoked.

This will never happen. Sorry. The most that will happen is that patients will be able to carry a summarized version of their medical records/hospital charts with them in some kind of encrypted format, which would be useful for some portability of a patient's health information, but that's about it.

You don't appear to have any idea how much data is generated by a patient and hospital staff in a single hospital visit.
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Because the data provided by these devices replaces the day-to-day need for an expensive primary care physician. Example:
-My wifi scale charts weight. There was a period where I started to gain weight and body fat, so I exercised more, ate less. No doctor needed.
-I ran an app that kept track of caffeine intake. It said I shouldn't drink so much in the afternoon. Did that, slept better. No doctor needed.
-One app keeps track of what you ate. I found I was getting too little iron and calcium and the multivitamin I was taking didn't have any. Switched to a different vitamin. No doctor needed.

I have a better view of my health than one weight measurement every 12 months and 60 seconds of "what's wrong?" can provide a physician. I only told him what I did after the fact.

Proper care should be encouraging people to take steps like this, not saying that technology is useless.

And there's nothing wrong with this. All I am saying is that the sensors on these consumer-grade devices are not accurate or durable enough to provide useful data to a primary care provider that may be following a high acuity patient.

If you're using an app that's helping you lose weight or cut down on caffeine intake, that's great. I can see plenty of practical applications for these devices in health maintenance. For higher acuity situations, such as postoperative monitoring of blood pressures, pain scores, intake/output, etc., though - not good, accurate, or safe enough to provide useful data to a physician.
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i think Apple needs to pay strict attention to law changes goin forward in these areas of Health, Health Records and data access from 3rd Parties - anything beyond Apple + Doctors i consider 3rd parties.

Don't worry, Apple has absolutely no interest in getting into the health records and information business. Neither does Microsoft, Google, or any of the other big tech companies. They're all more interested in providing tools for third parties to develop informatics, analytics, and decision support systems. Why? Because they won't have to be the ones to jump through all the regulatory hurdles with government agencies like the FDA, which is VERY expensive.

 

[honglong1976]

"Important for diagnosis" of what? Disease states? Acute symptomatology?

I haven't found a single bit of "health" data from Apple, Fitbit, Garmin, etc. that has been useful in my medical practice. And not a single one of my colleagues has either.

We are a LONG way from having consumer grade devices that provide useful/meaningful health monitoring data to the clinician.

Seriously?

The 24/7 monitoring of steps and heart rate data, potentially years worth of data is not useful for diagnosing anything?

Obesity, heart irregularities? https://www.theverge.com/2017/5/15/...art-health-artificial-intelligence-monitoring

just the tip of the ice berg!

So many problems are resolved by a healthy diet and exercise. The more you monitor yourself, the more aware you are of your actions. Wow, yesterday I only did 500 steps, tomorrow I need to do more steps. So many people I know using Fitbit's have lost weight simply because they can see visually how much exercise they actually do and started to walk more.

We should be encouraging people to be responsible for their health, we only have one body and should look after it, rather than giving pills for any old symptom.

I had really bad migraines before. Once a week for years. Really bad ones. I explained to the doctor, I don't want any pills but want to know what's causing them. Doctor looked at me blank. Tried another 3 doctors in the same surgery. Same. I was offered more pills. Can I see a specialist? No. Eventually I got one and he fobbed me off. Everyone gets migraines, not much I can do and he was a specialist.

Went to Japan and my wife's cousin asked if I get migraines (he father was a cardiologist and he practices Chinese medicine). Yes, she replied. I asked how did he know? Apparently my posture is wrong. I am very skeptical and thought it was baloney but to prove him wrong changed my posture.

2 weeks later no migraine. Since 2014 I have had about 2 bad migraines. That's it. All the time it was my posture. I wish I had something to monitor my heart then to see if my heart rate changed when I got a migraine.

 

[IllIllIll]

Seriously?

The 24/7 monitoring of steps and heart rate data, potentially years worth of data is not useful for diagnosing anything?

Obesity, heart irregularities? https://www.theverge.com/2017/5/15/...art-health-artificial-intelligence-monitoring

just the tip of the ice berg!

Yes, seriously. All I am saying is that we are nowhere close to the point where the data being generated by Apple Watches, Fitbits, Vivosmarts, etc. is accurate or useful enough that physicians can base significant medical decisions on them. I'm in my 14th year of clinical practice and have taken care of well over 10,000 patients in that time. No way in hell would I rely on sketchy heart rate data being reported by a consumer electronic device. Sure we have a ton of data being generated right now by these things, but the fact remains that there are still serious questions about the accuracy and reliability of the data being generated. Combine that with the potential legal implications of making decisions based on this data and maybe you'll understand why doctors are hesitant about using it.

We should be encouraging people to be responsible for their health, we only have one body and should look after it, rather than giving pills for any old symptom.

Agreed.

I had really bad migraines before. Once a week for years. Really bad ones. I explained to the doctor, I don't want any pills but want to know what's causing them. Doctor looked at me blank. Tried another 3 doctors in the same surgery. Same. I was offered more pills. Can I see a specialist? No. Eventually I got one and he fobbed me off. Everyone gets migraines, not much I can do and he was a specialist.

Went to Japan and my wife's cousin asked if I get migraines (he father was a cardiologist and he practices Chinese medicine). Yes, she replied. I asked how did he know? Apparently my posture is wrong. I am very skeptical and thought it was baloney but to prove him wrong changed my posture.

2 weeks later no migraine. Since 2014 I have had about 2 bad migraines. That's it. All the time it was my posture. I wish I had something to monitor my heart then to see if my heart rate changed when I got a migraine.

Again - if this is what works for you, great. But don't assume this kind of approach to one's health works for everyone. If you want to rely on an app for your health maintenance or lifestyle improvement, there's nothing wrong with that until an avoidable negative outcome occurs and some sorehead decides to sue Apple for it. That's why these companies will continue to dabble in the healthcare space but will never dominate it.

 

[honglong1976]

Yes, seriously. All I am saying is that we are nowhere close to the point where the data being generated by Apple Watches, Fitbits, Vivosmarts, etc. is accurate or useful enough that physicians can base significant medical decisions on them. I'm in my 14th year of clinical practice and have taken care of well over 10,000 patients in that time. No way in hell would I rely on sketchy heart rate data being reported by a consumer electronic device. Sure we have a ton of data being generated right now by these things, but the fact remains that there are still serious questions about the accuracy and reliability of the data being generated. Combine that with the potential legal implications of making decisions based on this data and maybe you'll understand why doctors are hesitant about using it.

I understand what you are saying and while they not probably not as accurate as they could be, they are accurate to a degree and better than nothing. Could it still not be useful? A patient claims they had heart pains last night from 8-10pm. They go to the doctor, the patient has no wearable. There is no data just the patients word. Diagnosis begins.

Imagine the patient had a wearable. Although not 100% accurate it would show heart rate for 8-10pm and would surely be better than no data at all and help diagnose? Ok, the heart rate shot up to 180-190bpm i have proof that it went up, i feel sick, chest pains. No, not going to look at that ...sorry... Surely the more information you have the better the diagnosis? http://www.dailymail.co.uk/news/art...Christmas-present-revealed-pulse-tripled.html

Someone has been obese for a few years, they claim to do regular exercise and eat healthy. They wear an Apple Watch. It only shows they walk 500 steps a day. Even though they claim to wear it 24/7 and exercise.

Have you watch Medical Frontiers on NHK? Really interesting and I love that the Japanese try to find out the actual problem rather than operating or handing out pills. I wish the NHS was like this in the UK. From my experience, it isn't from those I have lost or my own experience. In Japan, building site workers stretch each morning before building (stretching before lifting heavy objects, great idea). In the west, the worker doesn't stretch, if he did, everyone would laugh, gets a bad back and is on a constant supply of pills.

I feel strongly because I feel so many problems can be fixed just by doing a few minor adjustments to how we work or live. Stretching before lifting something heavy, carpel tunnel syndrome, use the other hand at the computer and the pain will be reduced or disappear. I know I had it. No medicine, operations. Doctor suggested either cutting a nerve, various types of tablets. Why not just ask me what job I do? and advise me?

Bonkers! We live in a world of oversubscribed medicine! drives me crazy!

 

[mi7chy]

Apple can't even keep people's private pictures private without leaking it all over the internet so it's highly unlikely anyone would volunteer their confidential medical info.

 

[IllIllIll]

I understand what you are saying and while they not probably not as accurate as they could be, they are accurate to a degree and better than nothing. Could it still not be useful? A patient claims they had heart pains last night from 8-10pm. They go to the doctor, the patient has no wearable. There is no data just the patients word. Diagnosis begins.

Imagine the patient had a wearable. Although not 100% accurate it would show heart rate for 8-10pm and would surely be better than no data at all and help diagnose? Ok, the heart rate shot up to 180-190bpm i have proof that it went up, i feel sick, chest pains. No, not going to look at that ...sorry... Surely the more information you have the better the diagnosis? http://www.dailymail.co.uk/news/art...Christmas-present-revealed-pulse-tripled.html

No. A heart rate in and of itself is a pretty lousy metric and doesn't tell us much. If someone suddenly develops chest pain at home, it really doesn't matter if his heart rate at the time is 60 or 150 - the correct thing to do would be get your butt to an emergency room ASAP and get worked up for a possible heart attack. In fact, in the scenario you describe above, I would suggest that using an app to monitor heart rate for 2 hours from 8 to 10PM made things worse since it delayed the time one took to seek proper treatment. Can you guess the number one reason why people die from a heart attack or stroke? Delayed treatment.

Besides, you do not need a fancy iPhone or iWatch to check heart rate. Just put a finger over your wrist or over the carotid artery in your neck and count the pulsations for a minute (or for 15 seconds and multiply by 4). Simple and easy, and more accurate than what an iWatch can tell you.

Someone has been obese for a few years, they claim to do regular exercise and eat healthy. They wear an Apple Watch. It only shows they walk 500 steps a day. Even though they claim to wear it 24/7 and exercise.

Have you watch Medical Frontiers on NHK? Really interesting and I love that the Japanese try to find out the actual problem rather than operating or handing out pills. I wish the NHS was like this in the UK. From my experience, it isn't from those I have lost or my own experience. In Japan, building site workers stretch each morning before building (stretching before lifting heavy objects, great idea). In the west, the worker doesn't stretch, if he did, everyone would laugh, gets a bad back and is on a constant supply of pills.

I feel strongly because I feel so many problems can be fixed just by doing a few minor adjustments to how we work or live. Stretching before lifting something heavy, carpel tunnel syndrome, use the other hand at the computer and the pain will be reduced or disappear. I know I had it. No medicine, operations. Doctor suggested either cutting a nerve, various types of tablets. Why not just ask me what job I do? and advise me?

Bonkers! We live in a world of oversubscribed medicine! drives me crazy!

This is all well and good, but to date there has not been one single peer-reviewed study published that has shown that these fitness bands/monitors have done anything to improve outcomes or overall health of a population.

 

[honglong1976]

Delayed treatment.

This is all well and good, but to date there has not been one single peer-reviewed study published that has shown that these fitness bands/monitors have done anything to improve outcomes or overall health of a population.

In the UK you have to wait absolutely hours before anyone sees you in A+E so you'd be dead anyway, at least you'd have the data to help show the cause of death!

Yet!

As wearable become more accurate and more sensors are put inside, they will be used for diagnosis. The hard part is convincing people.

Just curious, do you wear a fitness band/monitor?

 

[IllIllIll]

In the UK you have to wait absolutely hours before anyone sees you in A+E so you'd be dead anyway, at least you'd have the data to help show the cause of death!

Yet!

As wearable become more accurate and more sensors are put inside, they will be used for diagnosis. The hard part is convincing people.

Just curious, do you wear a fitness band/monitor?

No, the hard part is convincing doctors, not people. As a doctor who works in healthcare IT/bioinformatics/analytics/data science in addition to clinical anesthesiology, from personal experience the only thing I'm convinced of is that consumer-grade biosensors have a LONG way to go before becoming clinically useful.

And yes, I do wear a fitness band - I wear a Garmin Vivosmart HR and have gone through various other bands (Jawbone Up, Vivofit, etc.) over the years. No way would I trust the data coming out of it for anything more than telling me I need to walk a little more today.

 

[Tech198]

Is there such a thing as a phone being too personal ?

I think the ones already in the industry would want to control it,, why should they allow Apple in on our medical data? when its not a broken system,, Apple just wants to control it to make life simpler for users. Apple's taking the security of their iOS devices to new heights... They will throw everything they can at it because they developed it..

When all it takes it security to break in a "one stop shop" and your gone.

Wow..... i'm sure glad i am not that far gone yet.

 

[wolfaaron]

I'd be willing to share this info with my health insurance as long as they could give me discounts when I met certain goals. But I wouldn't share it with them if our healthcare system goes back to how it was before Obamacare. They'd just use the info to deny you coverage if it went back to pre-Obamacare.

 

[cuestakid]

I'm guessing there is some HIPAA regulation on records standardization. The data might be on a proprietary device, using a proprietary application, but the data is easily exported as needed because it is required to be formatted a certain way.

This. For all of apples alleged corruption (depending on how you see it) and want to have all our data HIPAA will not let people access any and all data and I'm sure there will be an opt out. HIPAA will be a bigger hurdle than the implementation.

 

[maflynn]

Personally I don't feel comfortable about keeping my health data on my phone. I work in the healthcare industry and the heights that we have to take to ensure the data is safe, is extreme. I'd rather not keep my highly personal data on the cloud/phone. We've already had instances where people's icloud information was compromised.

 

[The Mercurian]

Personally I don't feel comfortable about keeping my health data on my phone. I work in the healthcare industry and the heights that we have to take to ensure the data is safe, is extreme. I'd rather not keep my highly personal data on the cloud/phone. We've already had instances where people's icloud information was compromised.

Would you trust the health data on your phone without uploading to the cloud ? i.e. as the iOS10 version ?

 

[maflynn]

Would you trust the health data on your phone without uploading to the cloud ? i.e. as the iOS10 version ?

I don't want any of my personal health information on the phone at all.