A number of hospitals have already rolled out pilots that take advantage of the integration between Apple HealthKit and Epic. But Cedars-Sinai Medical Center in Los Angeles has taken an interesting approach: opening up HealthKit functionality to all of its patients, and letting them tell doctors what data they want to share.
"For this particular tool, it made more sense to follow the patient, whereas in other areas it might make a little more sense to be nurse or physician-driven," Darren Dworkin, Senior Vice President of Enterprise Information Systems and Chief Information Officer of Cedars Sinai, told MobiHealthNews. "...To be perfectly candid, we’re not sure what we’re going to do with that information. I think some of it will be patient-directed, they’ll tell us as they meet with clinicians throughout the health system. We’ll study the information and we’ll learn from there. But I think the fundamental aspect to this type of go-live is that we’ll learn where patient interest really is. There’s been a lot of conversations about what patient engagement is and what it isn’t, and I think the only way to sort of get to the bottom of it is to allow the patients to decide for themselves what they want to share."
Initially, any Cedars-Sinai patient who uses the Epic patient portal will be able to upload data from their devices to the weight, blood pressure, steps, pulse, glucose, and SpO2 fields in HealthKit and have that information sent to the EHR. More than 87,000 Cedars-Sinai patients are active users of the patient portal, and will now be able to integrate their health records with HealthKit. As in previous implementations, the data will be stored in a special part of the EHR that won't overwhelm doctors who aren't looking for the information.
"We picked a group of what we think to be popular ones that patients have an interest in," Dworkin said. "Our commitment is, as patients begin to gather more information about themselves and wish to include that information in shared decision making, we’re looking for all the right ways to enable that."
Dworkin praised Apple and Epic for making the implementation pretty easy on the technical side, and hospitals like Duke and Ochsner for blazing the trail. At Cedars Sinai, Dworkin said, patients are definitely interested.
"Within 24 hours of us turning this on, we had hundreds of patients connecting their devices, which for us reinforces that there’s an interest," he said.
But that's not surprising, he went on, when you consider that patient-generated data already exists in the hospital in many forms. HealthKit provides a technical framework for something a growing number of active and engaged patients have been itching for.
"In reality, diabetic patients have been sharing patient-generated data for years with their endocrinologists," Dworkin said. "It’s how they manage their medication, it’s how they manage their course. In a way, one way to think about it is all this really is, is an automation of the same piece of paper patients would have brought into their appointment. Instead of bringing it in, it’s digitally uploaded and they have a conversation together around the information that’s sort of been pre-loaded."
A number of hospitals have conducted pilots with HealthKit, including Duke University and Ochsner Health System, whose CIOs led a panel on the technology last December at the mHealth Summit. In February, Stanford University Medical Center launched a new patient app with HealthKit integration. Reuters reported this year that at least 14 hospitals, including Cedars-Sinai, were pursuing the technology, and Beth Israel Deaconness CIO John Halamka has also spoken at length about implementing HealthKit at his hospital.
In a recent Q2 earnings call, Apple CEO Tim Cook highlighted Cedars-Sinai's implementation as an example of HealthKit adoption.
"Just this past weekend, Cedars-Sinai in Los Angeles turned on the largest HealthKit integration to date, giving more than 87,000 patients the ability to share their health and fitness data seamlessly with their MyCS link app, which syncs with their electronic medical record," he said.
Cook also shared that there are now more than 1,000 HealthKit-connected apps and more than 60,000 iPhone users participating in Apple ResearchKit trials. More than 1,000 researchers have approached Apple about launching ResearchKit studies of their own, Cook said.