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    Apple’s HealthKit: What physicians need to know

    Patient privacy a concern as new app connects hospitals, healthcare data

    Technology giant Apple unveiled its new operating system, iOS 8, on June 2, and a new platform called HealthKit has the healthcare IT industry abuzz with its possibilities.

    HealthKit will serve as a hub that enables health and fitness apps to communicate with one another. For example, an app that monitors heart rate or blood pressure can send information to a hospital app. Mayo Clinic will be syncing its app with HealthKit starting in September, and its patients will be able to send several types of health data directly to physicians.

    “We believe Apple’s HealthKit will revolutionize how the health industry interacts with people,” John Noseworthy, M.D., Mayo Clinic president and chief executive officer said in a statement. “We are proud to be at the forefront of this innovative technology with the Mayo Clinic app.”

    Apple also announced a collaboration with electronic health records company Epic, to connect hundreds of top hospitals to the HealthKit platform. Apple users will be able to decide what information is shared with which apps, but some healthcare experts are still concerned about the privacy of healthcare information.

    “I've talked with many tech people about the challenges of making an app reach the standards of the strict HIPAA (Health Information Portability and Accountability Act) compliance,” Mike Sevilla, M.D., said in a blog post, noting that patient privacy will be a big problem for HealthKit. “Not only does Apple want to hold health information on the phone, but also potentially have two way health information exchange with institutions like Mayo Clinic and Epic hospitals.”

    Sevilla says he is also concerned about the accuracy of medical data collected from third-party apps that will communicate with hospitals and healthcare professionals.

    “Blood pressure monitors have machine errors and user errors. How will they sort that out?” Sevilla says. “Unless I see more features and the patient privacy and integrations are answered, HealthKit may be as functional as the previously overhyped, but underutilized Passbook app. Remember that app?”

    Apple continues to make inroads in the growing mobile health, or mHealth industry, which could reach $11.8 billion by 2018, according to GlobalData Healthcare. In 2013, Apple released the iPhone 5 featuring the M7 coprocessor that continuously detects motion for apps that track running, walking and other physical activity.

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    • Dr. Voran
      Maybe HIPAA may have nothing to do with this. Under the regulations, as I read them, as long as the patient consents to to release and use of the information, HIPAA consents and regulations don't apply. In the case of wearable devices and self-monitoring apps the user is usually the one that's dictating the release of this information. Yes, it may not always be obvious to the end user of an app what all that app does with their data but in the print of the EUA (to which virtually everyone agrees), they are expressly allowing the app developer to use that data. In the case of devices like FitBit, Withings' scales and b/p monitors, it's the end user to chooses which "partners" FitBit and Withings can push their data to. This may be MS Healthvault, other apps, their employer or even some EHRs that are opening their API's and working with app developers. It's useful to remember that HIPAA privacy regulations as specified in the original act of 1996 were designed to prevent commercial exploitation of patient data for marketing. Sharing of patient information for patient Care, education, research and medical billing didn't require a signed HIPAA release. When the patient is controlling the information then HIPAA really doesn't apply. Yes, it applies to any use of that information to which the patient doesn't agree but that's relatively easily remedied by allowing patients access to their data on your systems and notifying them of where that data is going.
    • Dr. corkyjon
      Ironic that on a national level we are told (by Snowden) and shown (by the NSA) that no information can be kept secret, yet physicians are fined when information is released. Apple's customers, who on mobile devices share their every move and sometimes photos of their private parts, will be the first to scream "HIPAA violation" when healthcare apps talk to each other.

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