This special blog post is written by a member of the Brigham Digital Innovation Hub. The opinions and viewpoints expressed by the author do not necessarily reflect the opinions and viewpoints of Brigham and Women’s Hospital.
By Chen Cao
While the Apple Worldwide Developers Conference (WWDC), colloquially referred to as “dub-dub”, has come and gone, the excitement over the forthcoming releases and new features for the fall still lingers. For developers in the Apple ecosystem, WWDC is the once-a-year week-long event dedicated to providing them a sneak peak of what’s to come. In more recent years, however, this event has broadened its reach as its focus has expanded beyond just software and hardware developers.
As the in-house Apple fanboy at iHub, an event like “dub-dub” is akin to Christmas morning. The hype is not overrated. Given the fact that I am a part of a digital innovation hub at an academic medical center, of course I needed to assess and provide some analysis into the health and healthcare-related features that were announced this year.
My key takeaway on healthcare-related releases from this year’s keynote is that Apple’s continues to double down on enabling consumer health experiences, privacy, and security. This certainly makes sense: as a dominant consumer technology company, Apple has a large captured audience of iOS users to work with – all who could eventually benefit from more awareness and control of their own health on Apple hardware and software.
Since the introduction of Apple Watch in 2014, Apple has devoted more research and development in the health and wellness sector. Especially evident in recent years, Apple has progressively dedicated more presentation time during its flagship keynote events to healthcare—in particular, features and services to access one’s personal health information.
Notably, with the introduction of Health Records in 2018, open medical studies through its Research app in 2019, and collaboration with the White House and the CDC to provide an up-to-date information on Covid-19 and screening tools through the App Store and website during the pandemic, it’s apparent health and healthcare is a focus for the California-based company.
New health-related enhancements at WWDC 2021
This year at WWDC, Apple is going further in health and wellness by introducing new features such as: 1) selective health information sharing, to privately share data with a family member or trusted caregiver and even back to their providers electronically; 2) walking steadiness, to provide information to a user on fall risk; 3) health trends dashboard to highlight changes to one’s health over time in an easy-to-understand view; detailed information into lab results; and 4) storing of immunization records, even for providers and health systems that do not support Health Records.
Let’s look at what this could mean for patients and caregivers:
- Solidify the iOS ecosystem as a hub for personal health information
The iPhone—specifically the Health app—is becoming more powerful and useful as a central wallet for consumers. Notably, the inclusion of immunization records and test results from providers and other healthcare settings that do not support Apple Health Records, more granular and better presentation of lab results, and highlighting of trends in one’s health status all help iPhone users gain more insights on their health. Compiling these functions into one health-focused app will enable easy access to this important information, as well as more reliance and usage over time.
While these additions help to keep personal health records in one place, a potential negative implication is further widening the gap between Apple and non-Apple users. For example, Android users will miss out on these health-related features, disrupting the parity with their Apple counterparts, centralizing Apple’s dominance in the consumer technology sector, and further widening the digital divide between those who have access to these high-end technologies and those who do not.
- Maintaining privacy and security
Of course, with increased availability and curation of one’s health information into the iOS ecosystem, it inevitably increases the risks with regards to privacy and security.
On the privacy side, Apple maintains that access to a user’s health information is under their control. There appears to be much greater control for users to tailor access. This plays out both for sharing with family members or other caregivers, as well as with their provider. A potential downside is that patients may not understand the implications of giving this control to others—in fact many may not want to do so, if they realized what giving unfederated access to other individuals actual meant.
On the security front, encryption of the data both at rest and in transit is essential. For Apple Health Records, the company is relying on FHIR (Fast Healthcare Interoperability Resources) industry standard APIs to obtain data such as allergies, immunization, lab results, and medication. It also uses OAuth 2.0 to authenticate and connect with different EHRs (Electronic Health Records) from health systems. How Apple will connect and authenticate health information with providers that do not support Apple Health Records remains to be seen.
- Translation of evidence-based research into features
With the forthcoming iOS update, we will see the translation of health-related research into meaningful new features for Apple. The walking steadiness measurement is a great example. The algorithm is based on real-world data from Apple’s Heart and Movement Study, led by Dr. Calum Macrae at Brigham and Women’s Hospital. Started in 2019, this virtual study, which recruited over 100,000 individuals to study fall risk, produced the largest data set ever used to study fall risk.
This feature is interesting given that the iPhone’s built-in motion sensors are used to track the length and timing of steps. Over time, it can inform a user of changes in balance, stability, and coordination. In fewer than two years, results from a medical research study were able to be incorporated into a feature that hopefully will help to reduce fall risks of iPhone users, as well as encouraging one to meet stability goals and promote exercise to increase one’s mobility.
Of course, besides these highlighted Health features, there were also other features announced that have impacts on health and wellness. Features such as focus will eliminate distractions from notifications to help users better manage work at hand; the mindfulness app includes deep breathing exercises to slow down and encourage being present; and even Siri is updating its processing capabilities to analyze information on-device as opposed to sending audio recordings to Apple’s servers, which could open future use cases in healthcare.
WWDC is always an exhilarating time for an Apple fanatic, but especially even more exciting given the strong focus on use cases in health and healthcare. All these new features and updates to the Apple ecosystem portends even more health-related hardware updates, which we will see this fall.
While the announcements were not targeted specifically towards healthcare and health systems, these updates highlight Apple’s focus in health by giving consumers more insights and trends into their own health data, as well as maintaining privacy and security to ensure individuals will want to keep their own health information all on one device. Given iPhone’s strong on-device security, and Apple’s overall stance on security and privacy, I am cautiously optimistic about the company’s approach to give more control and access to the consumer to manage their own health data. All of this health information was not previously accessible and available, so it is a great win to see a large consumer-facing technology company devoting resources to health and enabling these health-related functionalities.