Apple aims to push more patient data to doctors. But what is that data good for?

Health systems have experimented with Apple's Health app, but it hasn't yet become central to treatment.

An Apple Watch on a person's wrist displaying a heart rate reading.

Apple announced recently that it will soon enable doctors to monitor health data from their patients' phones and watches between visits.

Photo: Apple

Sarah Kwon is a correspondent for Kaiser Health News.

Apple announced recently that it will soon enable doctors to monitor health data from their patients' phones and watches between visits, part of the push into health care that CEO Tim Cook has declared will constitute the company's greatest contribution to mankind.

Since 2014, health systems around the country have partnered with Apple to tap into the mountains of data the company's devices generate from patients. But most are still experimenting with these tools. While some doctors appreciate seeing records of home-monitored blood pressure, exercise and the like between visits, for others the data is more of a burden than an asset.

Apple stores over 100 types of data in the Health app, collected through iPhone, Apple Watch and third-party apps. In June, Apple said patients whose doctors work with one of the six electronic medical record companies participating in the new feature will be able to send them tracked data like heart rate, sleep hours, exercise minutes, steps, falls and menstrual cycle history.

Some see great promise in building pipes between a patient's phone and the health records viewed by their clinicians. Apple is "democratizing the flow of health data" between doctors and patients, said Anil Sethi, a former Apple health director and current CEO of Ciitizen, a startup that manages health data for cancer patients.

But Apple's announcement was shrouded in ambiguity and short on particulars. The company would not provide a complete list of the data patients can share with doctors and declined to comment for this article. Previous Apple moves to get more data into the hands of doctors have been announced with great fanfare, but questions remain as to how many health care providers are using the data and to what effect, and whether success stories are the norm or outliers. To date, rigorous studies showing clear health benefits from monitoring these types of data remain limited.

Although Apple has built pipes enabling patients to share growing amounts of data with medical professionals, it's unclear how much data flows through them.

In 2014, Apple released HealthKit, a tool enabling health systems to pull in patients' health data, with their permission, from their iPhones. At the time, then-Mayo Clinic CEO John Noseworthy said this would "revolutionize how the health industry interacts with people." But a Mayo spokesperson told KHN the system's use of HealthKit is now limited.

Cedars-Sinai Medical Center said in 2015 that, through HealthKit, more than 87,000 patients had been able to share their data, an arrangement Cook touted on a quarterly earnings call. A Cedars-Sinai spokesperson declined to comment on what became of this project.

Even Apple's attempts to use its own employees' app data to improve their medical care have yet to pan out. The Wall Street Journal reported that an Apple initiative testing a new primary care service for doctors to monitor Apple employees' health through their devices had stalled. The company said many of the story's assertions were inaccurate.

There have been a few reports of success. Ochsner Health in Louisiana reported that patients in a hypertension management program that provided health coaching while monitoring blood pressure data from mobile phones were more likely than a control group to get their blood pressure under control, follow their medication regimen and feel satisfied with their care. The health system now also has remote monitoring programs for diabetes, chronic obstructive pulmonary disease and expectant mothers, an Ochsner spokesperson said.

And Epic, the nation's largest health records company, said that over 100 of its large health system clients are using Apple HealthKit to capture data from home monitoring devices like blood pressure cuffs.

But patient-generated data has not been widely adopted in health care, said Dr. Benjamin Rosner, an associate professor of medicine at the University of California-San Francisco. He and others point out major hurdles. One, Rosner said, is that evidence is mixed regarding whether monitoring such data improves health. Another is that doctors generally aren't reimbursed by health insurers for reviewing data that patients collect at home.

"In America, we generally pay doctors and health systems to see patients in front of them and do things to them when they show up," said Matthew Holt, a health technology startup adviser. In instances in which doctors can be reimbursed for remotely monitoring patients, like those with certain chronic conditions, the payment is usually low, Rosner said.

And many doctors already feel inundated with patient health information and electronic health record tasks. "Primary care doctors are overwhelmed by their inboxes," said Dr. Rebekah Gardner, an associate professor of medicine at Brown University. "Before people start buying Apple Watches and sending all their sleep hours, let's show that this improves health." She said she wants to see more rigorous, independently funded studies showing that monitoring data from wearable devices makes people healthier or improves their care.

Liability concerns weigh on some doctors' minds. Dr. Oguchi Nkwocha, a community health center physician-executive in Salinas, California, worries he could be held liable if he missed something in "a diary of data," but said he might be more open to data that was analyzed and presented with predictive insights.

Apple isn't the only tech company that has struggled to make health app data-sharing mainstream. Both Google and Microsoft enabled patients to share their data in their personal health record products over a decade ago but shut down these businesses because of limited user adoption, Holt noted.

Optimists believe that, eventually, research will show that more forms of data monitoring lead to better health and that technology could help make the data more digestible for doctors. Then, Apple might succeed in making its apps part of medicine — assuming the payment system changes in a way that gives providers more incentives to identify problems early and intervene before people get critically ill, Holt said.

"This is exciting for the future of chronic care management," Dr. David Cho, a UCLA Health cardiologist, said of the new feature. With data at his fingertips on risk factors like exercise, diet and blood pressure, he believes he could help his patients manage chronic conditions more easily. That data, combined with virtual visits, could mean fewer office visits.

Apple's announcement that it can integrate patient-generated data into the electronic medical record could be critical for doctors who want to see their patients' self-collected information but don't have time to hunt for it, said Dr. Seth Berkowitz, who leads a remote monitoring app pilot program at Beth Israel Deaconess Medical Center in Boston.

Some patients welcome a feature that would make it easy to share data with their doctors. Jen Horonjeff, a New York City-based autoimmune disorder patient and health care startup CEO, recently discovered by using an Apple Watch tracker that her heart rate, which doctors had described as irregular, registered as normal.

"I would absolutely send this to my physicians," Horonjeff said, noting that her data would give doctors an accurate baseline of her heart rate if she were hospitalized.

But Gary Wolf of Berkeley, California, co-founder of The Quantified Self, a movement of people who track their health and other personal data, said that finding a doctor trained to make decisions with "fine-resolution data" is impossible.

Without more evidence that getting health app data to doctors is clinically beneficial, it will be hard to assess whether Apple is succeeding, said Neil Sehgal, assistant professor of health policy at the University of Maryland. "Right now, we don't know if there are consequences if you don't put your Apple Watch data into your electronic medical record," he said.

If evidence ultimately shows a benefit to sharing this information with doctors, he said, "that benefit will be concentrated among people who can buy the $1,000 phone and $400 watch."

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

SKOREA-ENTERTAINMENT-GAMING-MICROSOFT-XBOX
A visitor plays a game using Microsoft's Xbox controller at a flagship store of SK Telecom in Seoul on November 10, 2020. (Photo by Jung Yeon-je / AFP) (Photo by JUNG YEON-JE/AFP via Getty Images)

On this episode of the Source Code podcast: Nick Statt joins the show to discuss Microsoft’s $68.7 billion acquisition of Activision Blizzard, and what it means for the tech and game industries. Then, Issie Lapowsky talks about a big week in antitrust reform, and whether real progress is being made in the U.S. Finally, Hirsh Chitkara explains why AT&T, Verizon, the FAA and airlines have been fighting for months about 5G coverage.

For more on the topics in this episode:

Keep Reading Show less
David Pierce

David Pierce ( @pierce) is Protocol's editorial director. Prior to joining Protocol, he was a columnist at The Wall Street Journal, a senior writer with Wired, and deputy editor at The Verge. He owns all the phones.

COVID-19 accelerated what many CEOs and CTOs have struggled to do for the past decade: It forced organizations to be agile and adjust quickly to change. For all the talk about digital transformation over the past decade, when push came to shove, many organizations realized they had made far less progress than they thought.

Now with the genie of rapid change out of the bottle, we will never go back to accepting slow and steady progress from our organizations. To survive and thrive in times of disruption, you need to build a resilient, adaptable business with systems and processes that will keep you nimble for years to come. An essential part of business agility is responding to change by quickly developing new applications and adapting old ones. IT faces an unprecedented demand for new applications. According to IDC, by 2023, more than 500 million digital applications and services will be developed and deployed — the same number of apps that were developed in the last 40 years.[1]

Keep Reading Show less
Denise Broady, CMO, Appian
Denise oversees the Marketing and Communications organization where she is responsible for accelerating the marketing strategy and brand recognition across the globe. Denise has over 24+ years of experience as a change agent scaling businesses from startups, turnarounds and complex software companies. Prior to Appian, Denise worked at SAP, WorkForce Software, TopTier and Clarkston Group. She is also a two-time published author of “GRC for Dummies” and “Driven to Perform.” Denise holds a double degree in marketing and production and operations from Virginia Tech.
Policy

Congress’ antitrust push has a hate speech problem

Sen. Klobuchar’s antitrust bill is supposed to promote competition. So why are advocates afraid it could also promote extremists?

The bill as written could make it a lot riskier for large tech companies to deplatform or demote companies that violate their rules.

Photo: Photo by Elizabeth Frantz-Pool/Getty Images

The antitrust bill that passed the Senate Judiciary Committee Thursday and is now headed to the Senate floor is, at its core, an attempt to prevent the likes of Apple, Amazon and Google from boosting their own products and services on the marketplaces and platforms they own.

But upon closer inspection, some experts say, the bill as written could make it a lot riskier for large tech companies to deplatform or demote companies that violate their rules.

Keep Reading Show less
Issie Lapowsky

Issie Lapowsky ( @issielapowsky) is Protocol's chief correspondent, covering the intersection of technology, politics, and national affairs. She also oversees Protocol's fellowship program. Previously, she was a senior writer at Wired, where she covered the 2016 election and the Facebook beat in its aftermath. Prior to that, Issie worked as a staff writer for Inc. magazine, writing about small business and entrepreneurship. She has also worked as an on-air contributor for CBS News and taught a graduate-level course at New York University's Center for Publishing on how tech giants have affected publishing.

Boost 2

Can Matt Mullenweg save the internet?

He's turning Automattic into a different kind of tech giant. But can he take on the trillion-dollar walled gardens and give the internet back to the people?

Matt Mullenweg, CEO of Automattic and founder of WordPress, poses for Protocol at his home in Houston, Texas.
Photo: Arturo Olmos for Protocol

In the early days of the pandemic, Matt Mullenweg didn't move to a compound in Hawaii, bug out to a bunker in New Zealand or head to Miami and start shilling for crypto. No, in the early days of the pandemic, Mullenweg bought an RV. He drove it all over the country, bouncing between Houston and San Francisco and Jackson Hole with plenty of stops in national parks. In between, he started doing some tinkering.

The tinkering is a part-time gig: Most of Mullenweg’s time is spent as CEO of Automattic, one of the web’s largest platforms. It’s best known as the company that runs WordPress.com, the hosted version of the blogging platform that powers about 43% of the websites on the internet. Since WordPress is open-source software, no company technically owns it, but Automattic provides tools and services and oversees most of the WordPress-powered internet. It’s also the owner of the booming ecommerce platform WooCommerce, Day One, the analytics tool Parse.ly and the podcast app Pocket Casts. Oh, and Tumblr. And Simplenote. And many others. That makes Mullenweg one of the most powerful CEOs in tech, and one of the most important voices in the debate over the future of the internet.

Keep Reading Show less
David Pierce

David Pierce ( @pierce) is Protocol's editorial director. Prior to joining Protocol, he was a columnist at The Wall Street Journal, a senior writer with Wired, and deputy editor at The Verge. He owns all the phones.

Workplace

Ask a tech worker: How many of your colleagues have caught omicron?

Millions of workers called in sick in recent weeks. How is tech handling it?

A record number of Americans called in sick with COVID-19 in recent weeks. Even with high vaccination rates, tech companies aren’t immune.

Illustration: Christopher T. Fong/Protocol

Welcome back to Ask a Tech Worker! For this recurring feature, I’ve been roaming downtown San Francisco at lunchtime to ask tech employees about how the workplace is changing. This week, I caught up with tech workers about what their companies are doing to avoid omicron outbreaks, and whether many of their colleagues had been out sick lately. Got an idea for a future topic? Email me.

Omicron stops for no one, it seems. Between Dec. 29 and Jan. 10, 8.8 million Americans missed work to either recover from COVID-19 or care for someone who was recovering, according to the Census Bureau. That number crushed the previous record of 6.6 million from last January, and tripled the numbers from early last month.

Keep Reading Show less
Allison Levitsky
Allison Levitsky is a reporter at Protocol covering workplace issues in tech. She previously covered big tech companies and the tech workforce for the Silicon Valley Business Journal. Allison grew up in the Bay Area and graduated from UC Berkeley.

The fast-growing paychecks of Big Tech’s biggest names

Tech giants had a huge pandemic, and their execs are getting paid.

TIm Cook received $82 million in stock awards on top of his $3 million salary as Apple's CEO.

Photo: Mario Tama/Getty Images

Tech leaders are making more than ever.

As tech giants thrive amid the pandemic, companies like Meta, Alphabet and Microsoft have continued to pay their leaders accordingly: Big Tech CEO pay is higher than ever. In the coming months, we’ll begin seeing a lot of companies release their executive compensation from the past year as fiscal 2022 begins.

Keep Reading Show less
Nat Rubio-Licht
Nat Rubio-Licht is a Los Angeles-based news writer at Protocol. They graduated from Syracuse University with a degree in newspaper and online journalism in May 2020. Prior to joining the team, they worked at the Los Angeles Business Journal as a technology and aerospace reporter.
Latest Stories
Bulletins