Friday, June 27, 2014

What is HealthKit, exactly?

On June 2nd I had the opportunity to sit in the Moscone Center in San Francisco to listen to Apple's Craig Federighi announce one of the many new features of iOS 8, HealthKit.  For me, as a physician who specializes in integrating mobile technology into healthcare, this was the biggest announcement of the event, and possibly the year (yes, that "Woohoo!" you hear at the 68:30 mark in the keynote was ... me.  I'm not kidding).  Yet, despite the excitement this announcement generated in the popular press, it amounted to less than 3 minutes of the almost 2-hour presentation.


That question has an answer, but first, I've lost count of the number of misconceptions I've read regarding HealthKit, and they all center around how Apple is going to use "all that data!"  This assumption seems logical.  Every HealthKit precursor, including Google Health and Microsoft HealthVault, centered around aggregating patient data to both 1) provide value and convenience to the patient and 2) to live up to the promise of big data applied to healthcare (a promise Larry Page just made again).

But I have a little secret I'll let you in on.  Just between us, ok?  You might want to sit down first.  Ready now?

Apple doesn't want that data.

Go ahead, pick yourself up off the floor.  I'll wait.  Let me repeat: Apple doesn't want all that incredibly valuable data that will inevitably be facilitated by the new HealthKit APIs.  In fact, the system has been architected so that Apple can't access the data.  Guess who can?  That's right, only the user!  HealthKit, via the Health app, puts complete control over this data in the hands of the user.  Access can be granted or revoked at any time.  This, my friends, is why HealthKit is going to succeed where the others have failed.  Apple fully understands their responsibility in ensuring this data is secure and private.  It's no secret they met with the FDA in December 2013, and via a FOIA request we learn that the meeting was only remarkable for the fact that it was ... utterly unremarkable, rehashing well established guidelines regarding mobile apps in healthcare.

Getting back to HealthKit's paltry 3 minutes of fame earlier this month, is this indicative of the importance of healthcare to Apple?  Absolutely not.  Apple sees this as a key growth market, but is content to stir this regulatory pot as little as possible.  They are and always will be in the consumer market, where healthcare regulations are wholly unappealing.  By avoiding the data like the plague, Apple hopes to stay immune from the complications that killed PHRs of years past (see what I did there?).

And that's not even the best part.  Because this is intentionally not a data free-for-all, and users must deliberately grant access to each data-thirsty app, the onus is now on app developers and healthcare innovators to give users a reason to share their innermost health secrets, which will inevitably lead to more creative and useful apps.  That, coupled with the game-changing partnership of Epic Systems, ensures that the lofty promises of mHealth are finally on the path to realization.

Sounds like just what the doctor ordered.

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