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Apple Considers Healthcare Services Crossover

Posted on October 23, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Typically, we cover stories describing how technology companies are pitching their products to providers. This time, in a move I predict we’ll see more often in the future, it looks like Apple has been pondering how it can enter the brick-and-mortar primary care business. This should concern both hospitals and primary care organizations, particularly hospitals that own physician clinics.

Apparently, Apple has been thinking about expanding into the clinic business for at least a year, according to an article from CNBC. Sources told CNBC that the tech giant was in talks to buy a startup known as Crossover Health, which helps big employers create and operate on-site medical clinics. The article reports that while Apple and Crossover talked for months, the two didn’t strike an acquisition agreement.

That doesn’t mean that Apple is backing away from buying a provider organization. The story also notes that Apple has reportedly approached national primary care group One Medical, which charges patients an annual fee for concierge-style care. It’s clearly no coincidence that One Medical also pitches its program to employers.

There’s an argument to be made that Apple can pull this kind of deal off. If nothing else, Apple has been very successful with its chain of brick-and-mortar retail centers, which have been a major sales channel for the company. Between Apple’s magic-touch history with the stores, and large medical groups developing increasingly strong retail chops, there’s a lot of potential there. It’s possible that if Apple acquires or partners with the right clinics, it could be the first major tech company to be a roaring success in the sector.

It’s also worth noting that Apple customers are some of the most fanatically loyal buyers in the world, with many having stayed with the company during all of it ups and downs. If it can mobilize these fans, some of whom are also invested in Apple smartwatches and phones, it could invent new ways to enhance their care experiences. And that could set its clinics apart.

That being said, healthcare is far from perfecting the retail experience for its customers, though there are standouts like One Medical on the map. (Full disclosure: I was briefly a patient in its Washington DC office and came away impressed with the way the care was delivered and packaged.) Few hospitals or clinics are getting it right just yet.

Perhaps more importantly, while Apple has been at the margins of the healthcare business, I doubt it has a deep institutional understanding of healthcare mechanics. This might not be a big deal initially, but as the dust settles on an acquisition it could be a culture clash. After all, healthcare delivery is different from retail operations in some very important ways, including but not limited the herky-jerky way providers are forced to collect on their bills.

My feeling is that even if Apple pours endless capital into such a venture, what will matter more is how well it comes to understand healthcare operations. I believe that it might do better if it partners with a health system with plans to expand its clinic presence. After all, working with the health system would provide Apple with much deeper resources, a deep bench of executive talent and the ability to partner directly on rolling out medical groups. Let’s see if things head that way.

Medical Device Vendors Will Inevitably Build Wearables

Posted on May 21, 2015 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

As we’ve reported in the past, hospitals are throwing their weight behind the use of wearables at a growing clip. Perhaps the most recent major deal connecting hospital EMRs with wearables data came late last month, when Cedars-Sinai Medical Center announced that it would be running Apple’s HealthKit platform. Cedars-Sinai, one of many leading hospitals piloting this technology, is building an architecture that will ultimately tie 80,000 patients to its Epic system via HealthKit.

But it’s not just software vendors that are jumping into the wearables data market with both feet. No, as important as the marriage of Epic and HealthKit will be to the future of wearables data, the increasing participation of medical device giants in this market is perhaps even more so.

Sure, when fitness bands and health tracking smartphone apps first came onto the market, they were created by smaller firms with a vision, such as the inventors who scored so impressively when they crowdfunded the Pebble smartwatch.  (As is now legendary, Pebble scooped up more than $20M in Kickstarter funding despite shooting for only $500,000.)

The time is coming rapidly, however, when hospitals and doctors will want medical-grade data from monitoring devices. Fairly or not, I’ve heard many a clinician dismiss the current generation of wearables — smartwatches, health apps and fitness monitoring bands alike — as little more than toys.  In other words, while many hospitals are willing to pilot-test HealthKit and other tools that gather wearables data, eventually that data will have to be gathered by sophisticated tools to meet the clinical demands over the long-term.

Thus, it’s no surprise that medical device manufacturing giants like Philips are positioning themselves to leapfrog over existing wearables makers. Why else would Jeroen Tas, CEO of Philips’ healthcare informatics solutions, make a big point of citing the healthcare benefits of wearables over time?

In a recent interview, Tas told the Times of India that the use of wearables combined with cloud-based monitoring approaches are cutting hospital admissions and care costs sharply. In one case, Tas noted, digital monitoring of heart failure patients by six Dutch hospitals over a four-year period led to a 57% cut in the number of nursing days, 52% decrease in hospital admissions and an average 26% savings in cost of care per patient.

In an effort to foster similar results for other hospitals, Philips is building an open digital platform capable of linking to a wide range of wearables, feeds doctors information on their patients, connects patients, relatives and doctors and enables high-end analytics.  That puts it in competition, to one degree or another, with Microsoft, Qualcomm, Samsung, Google and Apple, just for starters.

But that’s not the fun part.  When things will get really interesting  is when Philips, and fellow giants GE Healthcare and Siemens, start creating devices that doctors and hospitals will see as delivering medical grade data, offering secure data transmission and integrating intelligently with data produced by other hospital medical devices.

While it’s hard to imagine Apple moving in that direction, Siemens must do so, and it will, without a doubt. I look forward to the transformation of the whole wearables “thing” from some high-end experimentation to a firmly-welded approach built by medical device leaders. When Siemens and its colleagues admit that they have to own this market, everything about digital health and remote monitoring will change.

Cedars-Sinai Medical Center Rolls Out Apple HealthKit

Posted on April 29, 2015 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Racking up yet another win in a string of deals with prominent health systems and hospitals, Apple has won Cedars-Sinai Medical Center over to running its HealthKit platform. According to Bloomberg, the agreement which connects 80,000 patients to HealthKit is the largest integration project done with HealthKit to date.

Apple caught a lead in the patient health data game early on, snagging high-profile Ochsner Health System as its first customer in October of last year. And HealthKit has continued to see success. A Reuters story reported in February that 14 of 23 top U.S. hospitals contacted by the news organization had rolled out a pilot program testing the platform. In other words, while it has formidable competition, Apple seems to have already become the platform of choice for experimenting with patient generated data.

It has to have helped that HealthKit was already set to connect with a wide range of consumer health tracking apps. Within months of its summer 2014 launch, Apple could boast a family of more than 60 apps that connected to the platform, including Withings app HealthMate, Weight Watchers Mobile, a Panera Bread app allowing users to plan meals at the store, a  Mayo Clinic app, Epic’s MyChart portal app and more.

But Apple’s competitors in the consumer health space aren’t going to give up without a fight. With the wearables market reaching 21% of consumers, fellow behemoths like Samsung, Google and Microsoft will continue to challenge Apple for the patient-generated data crown.

Microsoft, for example, has launched a collection of wearables devices — including a fitness-tracking wristband, mobile health app and cloud-based health data platform called Microsoft Health. In Microsoft’s architecture, users store health and fitness data generated by wearables, which is, in turn collected by the Health app. And remember Microsoft’s HealthVault PHR?  It finds new life here, as another place for patients to store the data they personally generate.

Google also announced its a fitness and health tracking platform last summer, dubbed Google Fit. Google Fit is an open platform offering the platform SDK freely to developers. At launch, its partners included Nike+, Adidas, Motorola, Runkeeper and HTC.

Samsung, for its part, has positioned itself in more of a support role to the wearables revolution. Last May it introduced the Samsung Simband, a reference architecture for wearables. It also released open health data cloud platform SAMI (Samsung Architecture for Multimodal Interactions), which takes data from multiple sources and drills down on the data to analyze the health status of individual users.

But despite the massive firepower behind Apple’s competitors, Apple seems to have slipped ahead and taken the marketing high ground. Expect to see lots of hospitals announce that HealthKit is their patient-generated data platform of choice over the next few years. It seems like Apple is doing the right thing at the right time.

Is Apple HealthKit Headed For Hospital Dominance?

Posted on February 12, 2015 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Even for a company with the cash and reach of Apple, crashing the healthcare party is quite an undertaking.  Not only does healthcare come with unique technical challenges, it’s quite the conservative business, in many cases clinging to old technologies and approaches longer than other data-driven industries.

Of late, however, Apple’s HealthKit has attracted the attention of some high-profile healthcare institutions, such as New Orleans-based Ochsner Medical Center and Stanford Healthcare. All told, a total of fourteen major U.S. hospitals are running trials of HealthKit. What’s more, more than 600 developers are integrating HealthKit tech into their own health and fitness apps.

What’s particularly interesting is that some of these healthcare organizations are integrating Apple’s new patient-facing, iOS HealthKit app with Epic EMRs and the HealthKit enterprise platform.  If this works out, it could vault Apple into a much more lucrative position in the industry, as bringing together health app, platform and EMR accomplishes one of the major steps in leveraging mobile health.

According to MobiHealthNews, the new app allows patients to check out test results, manage prescriptions, set appointments, hold video visits with Stanford doctors, review medical bills — and perhaps most significantly, upload their vital signs remotely and have the data added to their Epic chart. This is a big step forward for hospitals, but even more so for doctors, many of whom have warned that they have no time to manage a separate stream of mobile patient data as part of patient care.

For Apple leaders, the next step will be to roll out the upcoming Apple Watch and integrate it into its expanding Internet of Apple Healthcare Things. CEO Tim Cook is pitching the Apple Watch as a key component in promoting consumer health. While the iPhone gathers data, the smart watch will proactively remind consumers to move. “If I sit for too long, it will actually tap me on the wrist to remind me to get up and move, because a lot of doctors think sitting is the new cancer,” Cook told an audience at an investor conference recently.

All that being said, it’s not as though Apple is marching through healthcare corridor’s unopposed. For example, Samsung is very focused on becoming the mobile healthcare  technology provider of choice. For example, in November, Samsung announced relationships with 24 health IT partners, including Aetna, the Cleveland Clinic and Cigna.

At its second annual developer conference last December, Samsung introduced an array of software tools designed to support the buildout of a digital health ecosystem, including the Samsung Digital Health SDK and Gear S SDK, which lets app makers create software compatible with Samsung’s smart watches. Also, Samsung is already on the second generation of its Simband reference design for wearable device design, as well as the cloud-based Samsung Architecture for Multimodal Interactions, which collects sensor data.

And Microsoft, of course, is not going to sit and watch idly as a multibillion-dollar market goes to competitors. For example, late last year the tech giant launched a fitness tracking wristband and mobile health app. It’s also kicked off a HealthKit-like platform, imaginatively dubbed Microsoft Health, which among other things, allows fitness band users to store data and transfer it to the Microsoft Health app. Microsoft isn’t winning the PR war as of yet — Apple still has a gift for doing that — but have no doubt that it’s lurking in the swamps like an alligator, ready to close its powerful jaws on the next right opportunity to expand its healthcare presence.

Bottom line, Apple has captured some big-name pilot testers for its HealthKit platform and related products, but the game is just beginning. Having users in place is a good start, but Apple is miles away from being able to declare itself the leader in the emerging hospital mobile health market.

Apple Security Issues Linger, Raising iPad, iPhone Concerns For Hospitals

Posted on January 18, 2012 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

To date, few hospital IT administrators have made a big investment in supporting Apple devices, though many facilities are testing them out. Most testers have found that neither the smartphone nor the tablet work well as clinical data entry devices, and some have actually ended i-whatever pilots when doctors refused to use them.

But it seems that this is far from the worst problem iPads and iPhones pose for your hospital. In fact, in a recent case, one application downloadable directly from the company’s App Store was compromised to such an extent that it completely exposed the device to attackers.  According to a recent story in Forbes magazine, former NSA analyst and high-profile Apple hacker Charlie Miller sneaked an app onto the Store which, among other things, allowed Miller to execute commands on an iPhone. The program, Instastock, appears only to list stock tickers. (It’s not hard to imagine an app like this popping up on physicians’ iPhones/iPads, is it?)

While this might be old news to some of you, I was surprised to learn that the mobile Safari browser used on iOS devices seems to have some serious security flaws, too.  In fact, Safari doesn’t seem that sound overall. A report published six months ago concluded that while Explorer 9 blocked 100 percent of malicious URLs (with Application-based filtering enabled), Safari 5 blocked just 13 percent.

I am a huge fan of Apple devices, mind you. I think that EMRs would be in place in every hospital in the U.S., more or less, if vendors produced an interface one-tenth as elegant and streamlined as that of Apple products.  And it’s easy to understand why hospital IT leaders might want to go with the times and support the devices physicians already use.

But given the extent of these vulnerabilities, and the fact that Apple seems surprisingly slow to patch them, I’m actually surprised that so many hospital IT departments are continuing to  consider (or even offer) EMR access via iOS devices.  Maybe they’re not being irresponsible — after all, any OS can be hacked in time — but they seem to have one heck of a security challenge on their hands. It would definitely make me nervous.