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Apple Trials Tech Offering Patient Access To Their Health Records

Posted on January 29, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

In recent times, tech giants have been falling over themselves in a race to offer consumers the best access to their health data, including even dark horses like Amazon. And it’s little wonder – it’s become increasingly obvious that he who controls patient health data access controls a critical sector of the entire healthcare industry.

The most recent stake in the ground comes from Apple, whose latest update to its Health app allows customers to see their medical records on their iPhone. The Health Records section of the Health app, which comes with the release of the iOS 11.3 beta, collects FHIR-based records from multiple sources and makes them available through its Health Records section.

The patient data display will pull together patient data from various healthcare organizations into a single view. The data will include lists of allergies, conditions and medications taken, immunizations records, lab results on procedures and vital sign information. When providers published new information, iPhone users will be notified.

To conduct its Health Records beta test, Apple has partnered with a number of high-profile health systems and hospitals, including Johns Hopkins Medicine; Cedars-Sinai; Penn Medicine; Geisinger Health System; UC San Diego Health; UNC Health Care; Rush University Medical Center; Dignity Health; Ochsner Health System; MedStar Health and OhioHealth.

As part of its launch, Apple told the New York Times that unless consumers specifically choose to share it with the company, it will never see the data, which will be encrypted and stored locally on the iPhone.  A recent (if unscientific) poll suggests that consumers trust Apple with their health data more than other top tech vendors, so this reassurance may be enough to ease their fears.

But security is hardly Apple’s biggest concern. How does the tech colossus expect to profit from its health data investments?  When I break the issues down, it looks like this:

  • Unlike hospitals and clinics, which can expect medium- to long-term ROI when patients manage their health better, Apple doesn’t deliver care.
  • Apple might want to sell anonymized aggregated patient data, but as far as I know, the company would still have to get patient permission, and that would be an administrative and legal nightmare.
  • If Apple or its competitors have some vision of selling access to the patient, good luck with that. Providers have a hard time attracting and keeping patients with nifty technology even if those patients live in their backyard.

While I could be missing something major, from what I see, Apple, Google, Samsung, Amazon and the rest are engaging in a series of preemptive patient data land grabs. My sense is that none of them know exactly what to do with this data, they’ll be damned if they’re going to let their competitors get there first.

That said, many in the industry are suggesting that this move is just another effort by Apple to sell more iPhones. The question I ask is how valuable will the information be to the patients? Certainly the beta hospitals and health systems are large and have a lot of data, but how is this going to scale down to the smaller providers? If you don’t have these smaller providers, then you’re going to be missing some of the most important health data.

Hospitals Should Give Smartphones To Sick Patients

Posted on June 1, 2015 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

As I see it, hospitals have developed a new and rapidly emerging problem when it comes to managing mobile health services. Not only do they face major obstacles in controlling staff use of tablets and smartphones, they’re right in the center of the growing use of these devices for health by consumer. It’s BYOD writ even larger.

Admittedly, most of the consumers who use mobile devices don’t rely that heavily on them to guard and guide their health. The healthiest of consumers may make a lot of use of wearable fitness bands, and a growing subset of consumers may occasionally leverage their phone’s video capabilities to do telemedicine consults, but few consumers base their medical lives around a mobile device.

The chronically-ill patients that do, however, are very important to the future of not only hospitals — which need to keep needless care and readmits to a minimum if they want to meet ACO goals — but also the insurance companies who finance the care.

After all, the more we dig into mHealth, the more it appears that mobile services and software can impact the cost of care for chronic conditions. Even experiments using text messages, the lightest-weight mobile technology available, have been successful at, for example, helping young women lose weight, change their diets, and slash their risk of cardiac problems. Just imagine the impact more-sophisticated technologies offering medication management, care coordination, blood glucose and pulse ox tracking could have on patients needing support.

But there’s a catch here. A long as mHealth services are delivered via the patient’s own device, the odds of successfully rolling out apps or connected health monitoring services are minimal. I’d argue that such mHealth services will only have a major impact on sick patients if the technology and apps are bolted to the hospital or clinic’s IT infrastructure.  And the operating system used by patients, be it Android or iOS, should be the same one the hospital supports among its employees, or maintaining apps, OS upgrades and patches and even firmware upgrades will be a nightmare to maintain.

Given the security and maintenance issues involved in fostering a connection between provider and patient, I’d argue that providers who are serious about advanced mHealth services absolutely must give targeted chronically-ill patients a locked-down, remote controlled smartphone or tablet (probably a smartphone for mobility) and lock out their networks from those trying to use connected apps on a rogue device.

Will this be expensive?  Sure, but it depends on how you look at costs.  For one thing, don’t you think the IT staff costs of managing access by various random devices on your network — or heaven forbid, addressing security holes they may open in your EMR — far exceed even the $700-odd retail price for such devices?

This might be a good time to get ahead of this issue. If you’re forced to play catch up later, it could cost a lot more.

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

Posted on January 18, 2012 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively 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.

Partners Brings EHR To Mobile Devices

Posted on August 4, 2011 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

This week, Partners HealthCare announced that it made its EHR available on mobile devices for the first time, a move which has already attracted 2,000 of its affiliated physicians to mobile use.  At first blush this seems like a true mobile support project, rather than slapping a crude mobile interface on a desktop-based product like some of Partners peers, but we’ll have to wait and see.

Partners, a Boston-based integrated delivery network, created an app for iOS and BlackBerry devices drawing on InterSystems CACHE object database.  According to mobihealthnews, it took Partners’ IT staff 90 days to implement mobile options. In the future, Partners IT leaders plan to support Android devices, as well as making it possible to view radiology images on iPads.

The event deserves notice given Partners’ huge scope, which includes teaching and community hospitals making 160,000 admissions per year, along with a network of more than 5,000 physicians. It will be interesting to see how much use doctors make of the “mEHR” over the long term, and even more intriguing if Partners can isolate specific clinical, financial or operational benefits from its mobile support effort.

That being said, it’s also worth noting just because it happened, given how few hospitals seem to have invested significant development dollars in mobilizing their EHRs. Sure, doctors can connect with hospitals using their iPads and Android phones, but sometimes that’s limited to using a somewhat limited mobile browser. The problem with browser-based interfaces, however, is that Firefox, Chrome or Internet Explorer developers control the experience. An app tied directly into the guts of Partners’ EHR makes a lot more sense in my book.

Yes, I realize hospitals have much more to do than enable mobile access. I also realize that if they’re frantically trying to support onsite access to their EHR system, meet Meaningful Use requirements, manage sprawling integration projects and more, native mobile access to the EHR may not seem like a priority.

I’m dying to see more mobile EHR applications emerge, though. Hey, they’re effective, convenient, useful in a crisis and, ok, I’ll admit it, pretty darned cool.  (You can’t beat bringing your EHR along in your pocket!) Besides, once doctors get used to having medical data at hand when they need it, they might be more comfortable with the EHR in their office. Who knows?