Why Apple HealthKit in iOS 10 Makes View/Download/Transmit Real

John HalamkaBy John Halamka, MD
Twitter: @jhalamka

Meaningful Use Stage 2 has a requirement that I’ve always considered to be the “cart before the horse” – patients must be able to View/Download/Transmit their data. Viewing is great – we’ve done that at BIDMC since 1999 for all patients and all data. Download makes little sense since at the moment there is nothing a patient can do with a download. Of the 2 million patients at BIDMC, not one has ever requested a download. Transmit makes even less sense since there is no place to transmit the data to.

All of this will change with Apple iOS 10. What has Apple done? As an extension to HealthKit, they’ve built a CCDA viewer which can display transition of care documents in a patient friendly format. They’ve modified Apple mail and the Safari browser to understand CCDA XML headers and automatically offer to open the documents in HealthKit.

The end result is that developers can easily enable download since a URL to a CCDA or email attachment works seamlessly. BIDMC developed the code in minutes. Here’s what a BIDMC medical record looks like in iOS 10.

Halamka screen shot 1
Halamka screen shot 2Once the CCDA is in the Healthkit database, enabling an app to transmit it is also easy. We’ve already done that with HealthKit data like blood pressure, glucose and weight.

So although View/Download/Transmit made little sense when it became a requirement (and no one used it, requiring Meaningful Use requirements to be reduced to ONE patient instead of 5% of patients), HealthKit in iOS 10 will enable an ecosystem of apps to provide patients and providers with a highly usable workflow for data exchange.

CareKit, another Apple development, enables care plans, patient-facing subjective data gathering (what is your mood, how is your wound healing), progress dashboards, and secure communication. With objective data integration, subjective data gathering, CCDA viewing, care plan dashboards and communications, the suite of Apple tools empowers developers to create the next generation of patient engagement products.

I have no stock in Apple and no financial relationship with them, so I say this purely as a developer -Apple’s tools are likely to have a very significant impact on the healthcare ecosystem in the years to come.

John D. Halamka, MD, MS, is Chief Information Officer of Beth Israel Deaconess Medical Center, Chairman of the New England Healthcare Exchange Network (NEHEN), Member of the HIT Standards Committee, a full Professor at Harvard Medical School, and a practicing Emergency Physician. This article was originally published in his blog Life as a Healthcare CIO and is reprinted here with permission.