News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel

News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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Apple Updates Its Mobile Health Apps, While Microsoft Shifts Its Focus to Artificial Intelligence. Both Will Transform Healthcare, But Which Will Impact Clinical Laboratories the Most?

While Apple recently debuted features to bring personal health records and protected health information to its mobile devices, Microsoft shuttered HealthVault in favor of focusing on AI-powered healthcare advances

As clinical laboratories and anatomic pathology groups know, lab testing data comprise more than 70% of the average patient’s health record. Thus, creating a universal platform on which consumers can share or review health information and medical histories with caregivers is a critical, yet elusive goal for most major tech companies, including tech giants Apple (Nasdaq:AAPL)  and Microsoft (Nasdaq:MSFT).

Apple has big plans for patient health records and is working to bring protected health information (PHI) and healthcare advice to iPhones, iPads, and Apple Watch. Meanwhile, Microsoft is reducing its footprint in the mobile device healthcare market. Instead, it appears to be banking on its Artificial Intelligence (AI) platform. How these two diverging paths play out could have ramifications for the pathology and clinical laboratory industries.

HealthVault Insights versus AI versus Apple Health Mobile Apps

Launched in February 2017, Microsoft’s HealthVault Insights combined machine learning and AI with patients’ PHI and mobile activity tracking. The intent was to create an accessible, interactive platform for patients to monitor important health trends.

However, as of January 2018, Microsoft pulled the mobile app from Android, iOS, and Windows App stores. While summary information that draws on previously collected data is still available from the HealthVault website, new data and detailed insights are no longer available.

“We launched HealthVault Insights as a research project … with the goal of helping patients generate new insights about their health,” states Microsoft’s HealthVault Insights website. “Since then, we’ve learned a lot about how machine learning can be used to increase patient engagement and are now applying that knowledge to other projects.”

According to ZDNet, the closing of HealthVault Insights does not impact the Microsoft Health platform or the HealthVault patient-records system.

However, Microsoft’s shuttering of HealthVault Insights, and Google’s shuttering its Google Health platform in 2012, does seem to make Apple the last major tech company developing apps target at healthcare consumers designed to help them exchange private health information with caregivers through mobile devices. Dark Daily reported on Apple’s update earlier this year. (See, “Apple’s Update of Its Mobile Health App Consolidates Data from Multiple EHRs and Makes It Easier to Push Clinical Laboratory Data to Patients,” March 21, 2018.)

AI Will ‘Dramatically Transform Healthcare’

Shuttering HealthVault highlighted Microsoft’s shift away from consumer-facing health efforts and toward assisting medical laboratories, physicians, and research groups discover and implement treatments driving modern personalized medicine.

In a Microsoft blog post, Peter Lee, Corporate VP of Microsoft Healthcare, stated that Microsoft hopes its Healthcare NeXT platform will “dramatically transform healthcare, will deeply integrate Greenfield research and health technology product development, as well as establish a new model at Microsoft for strategic health industry partnerships.”

HealthVault Insights was one of several projects in Microsoft’s Healthcare NeXT initiative. Run by Microsoft’s AI and Research Group and partnering with major healthcare and research facilities across the country, other projects in the Healthcare NeXT initiative include:

Speaking with Business Insider, Lee noted that healthcare is becoming a “very large business” for Microsoft. “We don’t talk publicly about the dollars, but it’s large,” he concluded.

Microsoft’s EmpowerMD website states the eventual goal is to use the system to connect conversations with the growing trove of healthcare data available. “Our long-term vision is a learning system that incorporates data from longitudinal medical records, medical devices, genomics, population health, research papers, and more.”

AI a ‘Sleeping Giant for Healthcare’

“AI can be viewed as a sleeping giant for healthcare,” Eric Horvitz, PhD, Director of Microsoft Research Labs, told Nasdaq, when discussing Microsoft’s view of technology and healthcare. “AI methods show promise for multiple roles in healthcare. [This includes] inferring and alerting about hidden risks of potential adverse outcomes, selectively guiding attention, care, and interventional programs where [they are] most needed and reducing errors in hospitals.”

One such project involves a strategic partnership with the University of Pittsburg Medical Center (UPMC), which is a “$13-billion Pittsburgh-based system, comprising more than 25 hospitals, a three-million-member health plan, and 3,600 physicians, [that] will be a core partner in our efforts to improve healthcare delivery through a series of projects, beginning with a focus on transforming clinician empowerment and productivity,” according to Microsoft.

“Despite UPMC’s efforts to stay on the leading edge of technology, too often our clinicians and patients feel as though they’re serving the technology rather than the other way around. With Microsoft, we have a shared vision of empowering clinicians by reducing the burden of electronic paperwork and allowing the doctor to focus on the sacred doctor-patient relationship,” Steven D. Shapiro, MD (above), Chief Medical and Scientific Officer of UPMC and President of UPMC’s Health Services division, stated in the Microsoft blog. [Photo copyright: University of Pittsburg Medical Center.]

Today, patients can directly interact with their PHI to analyze trends and take a proactive role in their own healthcare, while researchers tap into the computational power of Cloud computing and correlate data across vast sources using AI. Both trends highlight how technology continues to play a critical role in improving access to healthcare. And how tech researchers continue to develop more efficient and effective treatments.

Medical laboratories and anatomic pathology groups may soon contribute health information to databases that one day will power AI systems. These trends highlight opportunities to both educate physicians on the tools available to utilize patient health data in an effective manner, and on new platforms that clinical laboratories could use to further streamline operations, reduce costs, and boost efficiency.

—Jon Stone

Related Information:

How Microsoft Is Using Advanced Technology in Healthcare

Microsoft Scrapping Personal Health Data App-Based Research Project

An Update on HealthVault Insights

How Microsoft’s Top Scientists Have Built a Big Business in Hacking Healthcare and Helped a Lot of People Along the Way

Microsoft Abandons Its Own HealthVault App: Is This Part of Something Larger?

Here’s How Microsoft Is Investing in AI

Microsoft Rolls Out More AI-Infused Healthcare Services, Software

Microsoft and Partners Combine the Cloud, AI, Research and Industry Expertise to Focus on Transforming Health Care

In Healthcare Push, Microsoft Launches Genomics Service on Azure Cloud

Apple’s Update of Its Mobile Health App Consolidates Data from Multiple EHRs and Makes It Easier to Push Clinical Laboratory Data to Patients

Apple’s Update of Its Mobile Health App Consolidates Data from Multiple EHRs and Makes It Easier to Push Clinical Laboratory Data to Patients

January’s press release confirmed the tech company is working to integrate critical medical data into its mobile devices, while further promoting interoperability and patient access

While interoperability has improved since the earliest electronic health record (EHR) systems, today’s active patients often need to sort through multiple healthcare portals—including those of clinical laboratories and anatomic pathology groups—to get a comprehensive view of their medical history. Not only can this be time consuming, but also inconvenient if the patient lacks access to a computer.

Thus, it’s no surprise that in a January 24 press release, mobile technology giant Apple announced plans to enter the development ring and create an improved EHR for its mobile device users by updating its existing “Health” mobile application (app). The iOS 11.3 update, among other things, is designed to enable Apple iPhone owners to receive critical medical data, such as medical laboratory test results, directly on their devices.

“Our goal is to help consumers live a better day. We’ve worked closely with the health community to create an experience everyone has wanted for years—to view medical records easily and securely right on your iPhone,” said Apple COO Jeff Williams in the press release.

Jeff-Williams-COO-Apple

Jeff Williams (above), COO at Apple, notes that, “By empowering customers to see their overall health, we hope to help consumers better understand their health and help them lead healthier lives.” (Photo copyright: Apple.)

The new features are already available to developers in the latest iOS 11.3 beta 3 release. However, release to the public is expected soon with the issuance of the iOS 11.3 final release. This means that patients will not need to download extra apps—or remember to use them—to take advantage of the feature.

New Way to Improve Patients’ Access to Health Data or Just Another Data Silo?

The Apple Health Records platform adheres to Fast Healthcare Interoperability Resources (FHIR) protocols for transmission of data. Providers send information to Apple which then aggregates the information, transmits it to patients’ iPhones and notifies them of the updates.

All information stored on the device is encrypted in storage and protected from unauthorized access by the user’s password.

Through the new Health Records interface, users view this aggregated data as a timeline, conduct searches, and share information with other parties as they deem appropriate.

Current medical information listed in the press release includes:

  • Allergies;
  • Conditions;
  • Immunizations;
  • Clinical laboratory results;
  • Medications;
  • Procedures; and,
  • Vitals.

Currently, the platform integrates data from three major EHR developers:

  • Epic;
  • Cerner; and,
  • AthenaHealth

Apple-health-records-ios-11.3-Update

Apple’s update to the Health app makes it easier for people to access and control of all of their health records and data. This included medical laboratory tests. (Image and caption copyright: Apple.)

Apple is also working with 12 health institutions across the US in the first phase of the project, including:

In the Apple press release, Stephanie Reel, CIO at John Hopkins Medicine in Baltimore, stated, “Streamlining information sharing between patients and their caregivers can go a long way towards making the patient experience a positive one. This is why we are excited about working with Apple to make accessing secure medical records from an iPhone as simple for a patient as checking email.”

Previous Attempts at Mobile Health Record Devices Got Mixed Results

This isn’t the first time a major technology company has attempted to enter the mobile health market. Google Health was shuttered in 2011 citing low adoption. Wearable fitness trackers, such as Fitbit (NYSE:FIT) enjoyed a bubble, but are now seeing mixed success in terms of long-term adoption and use, according to The Motley Fool. More to the point, they’ve never quite become the holy grail of monitoring and data collection that some experts predicted, Huffington Post reported.

However, Apple’s investments and interest in healthcare-related technologies has led to wide speculation that they would enter the health market this year. (See Dark DailyApple May Be Developing Mobile Device Technology to Monitor User’s Health and Transmit Data in Real Time.”)

Larry Dignan, Editor-in-Chief at ZDNet, builds a compelling case for why this could be the attempt that succeeds in providing a consolidated platform for clinical laboratories, physicians, and other care providers to push data directly to patients and—with the patient’s permission—to each other, regardless of the platforms healthcare facilities use to store and transmit data.

He notes that much of Apple’s newest features build on foundations laid by the healthcare industry to create scalable, functional EHR systems. By working with existing protocols, Apple’s Health Records platform is already positioned for compatibility with many healthcare providers.

Furthermore, Apple is already known for partnering at the enterprise level with major businesses and industries, while also holding the trust of millions of Americans who store their personal information on Apple devices.

Is Apple the Future of EHRs?

Despite this, until the platform—and adoption by the public—is proven a success, it will be yet another walled garden of medical information. Even then, Apple is only one segment of the global mobile market.

Unless Apple provides access to other platforms (such as Android), those patients—and the medical communities serving them—are left consolidating information on their own through a sprawl of various portals. This also means that medical laboratories, pathology groups, and other service providers must continue to invest time and funding into communicating data in ways compatible with a plethora of internal and external systems and software.

Still, the platform offers an intriguing glimpse at the future of medical records and heralds a shift toward empowering patients with easy, comprehensive access to their own data, which would be a boon to the medical laboratory industry.

—Jon Stone

Related Information:

Apple Previews iOS 11.3

Apple Announces Effortless Solution Bringing Health Records to iPhone

With Medical Records Tools, Apple Wades Deeper into Digital Health

Apple Confirms “Health Records” Solution with Aim to Bring Medical Records to iPhone

Apple Will Let You Keep Your Medical Records on Your iPhone

Apple Unveils mHealth Integration with EMR Data through Health App

Apple, Inc. Wants to Solve the Problem of Electronic Health Records

Viewpoint: How Realistic Is Apple’s Attempt at the EHR Industry? Very—6 Reasons Why

Apple Can Win Electronic Medical Record Game with Health Records in iOS 11.3: Here’s 7 Reasons Why

Apple Is Officially in the EHR Business. Now What?

Apple to Launch Health Records App with HL7’s FHIR Specifications at 12 Hospitals

Could Amazon or Apple Actually Make a Dent in the EHR Market?

Apple May Be Developing Mobile Device Technology to Monitor User’s Health and Transmit Data in Real Time

Apple May Be Developing Mobile Device Technology to Monitor User’s Health and Transmit Data in Real Time

Industry analysts speculate that Apple might be planning to enter the EHR and healthcare related markets by transforming mobile technologies into gateway devices connected to providers’ EHR systems and patient data

Imagine a mobile device that monitors vitals while connected in real-time to healthcare providers, electronic health records (EHR), and clinical laboratories. One that measures the physical condition and emotional state of the user by casting light onto skin, and then records and transmits it with a swipe of the touch screen. Would such an innovation change how patients expect to interact with their providers? And how physicians, anatomic pathologists, and medical laboratories receive data from their patients? Certainly.

This is why US patents recently granted to Apple have caught the attention of industry analysts. Some speculate that the tech giant is planning to enter the mobile healthcare monitoring device, EHR, and healthcare data storage markets, as reported at Becker’s Health IT and CIO Review and Patently Apple.

How this would affect medical laboratories and anatomic pathology groups remains to be seen. But where Apple goes, industries follow. Thus, it’s worth following the company’s activities in the healthcare market.

Bringing Clinical Data, Medical Laboratory Test Results, to iPhone

Mobile devices launched the era of consumer-grade fitness wearables. It’s not uncommon for a smart phone or watch to capture and store a range of health data generated by users. This can include everything from heart rate and sleeping patterns to dietary logs and fertility tracking. But, to date, much of that healthcare data is user generated and does not integrate in any meaningful way with the majority of EHR systems. Nor does it enable communications with primary care providers or diagnostic services—such as medical laboratories or pathology groups.

This may soon change.

According to a CNBC report, a unit at Apple is “in talks with developers, hospitals, and other industry groups about bringing clinical data—such as detailed lab results and allergy lists—to the iPhone, according to a half-dozen people familiar with the team.”

The report states that Apple:

·       “Wants the iPhone to become the central bank for health information;

·       “Is looking to host clinical information, such as labs and allergy lists, and not just wellness data; and,

·       “Is talking with hospitals, researching potential acquisitions, and attending health IT industry meetings.”

Christina Farr, the report’s author, predicts that Apple could be preparing to apply its music industry model to the healthcare industry by, “Replacing CDs and scattered MP3s with a centralized management system in iTunes and the iPod—in the similarly fragmented and complicated landscape for health data.”

Former National Coordinator of Health IT for the Department of Health and Human Services, Farzad Mostashari, MD, ScM, rather enthusiastically noted the significance of the move, stating, “If Apple is serious about this, it would be a big f—ing deal.”

At a special event in September, Apple COO Jeff Williams (above) announced Stanford Medicine’s Apple Heart Study, which uses “data from Apple Watch to identify irregular heart rhythms, including those from potentially serious heart conditions like atrial fibrillation,” and, according to Williams, “notify users.” This is just one of several healthcare-related study collaborations Apple is exploring. It is not known if Apple is looking to collaborate with medical laboratories. (Photo copyright: Apple.)

Apple’s History with Healthcare Related Technology

Taken as a single event, these speculations might not convince industry leaders. However, Apple’s long-term investments and acquisitions show a clear trend toward integrating healthcare data into the Apple ecosystem.

Healthcare IT News noted that from 2014 to 2017 Apple:

·       Unveiled three different APIs—HealthKit, ResearchKit, and CareKit—designed to help capture, analyze, communicate, and integrate healthcare data with the Apple iOS and watchOS ecosystems;

·       Hired several MDs, including: Stephen Friend, MD; Rajiv Kumar, MD; Mike Evans, MD; Ricky Bloomfield, MD; and Sumbul Ahmad Desai, MD; and,

·       Engaged with the Argonaut Project and Health Gorilla (a centralized hub of healthcare data and information) suggesting a shift from wearables and basic device-based biometrics toward in-depth reporting, interoperability, and access to third-party healthcare data repositories—such as those in a person’s EHR or medical laboratory portal.

The Future of EHRs or Another Failed Attempt at Innovation?

Apple isn’t the only company to attempt such a system. Other efforts include Microsoft’s Health Vault and Google’s now shuttered Google Health. Another CNBC article notes that Amazon is also researching healthcare related options. “The new team is currently looking at opportunities that involve pushing and pulling data from legacy electronic medical record systems,” stated Farr. “The group is also exploring health applications for existing Amazon hardware, including Echo and Dash Wand.”

However, where most services fail to gain traction is user engagement. After all, if a system isn’t widely used or fails to offer benefits over existing systems, patients and service providers are not likely to go through the process of switching systems. Speaking with CNBC, Micky Tripathi, President and CEO of the Massachusetts eHealth Collaborative notes, “At any given time, only about 10% to 15% of patients care about this stuff. If any company can figure out engagement, it’s Apple.”

According to comScore, 85.8-million people over the age of 13 already own an iPhone in the US. The upcoming facial recognition features on Apple’s iPhone X might also provide the added security needed for those questioning the safety of their data. Should Apple succeed, communicating data between clinical laboratories, physicians, and patients might be both convenient and fast. More importantly, it might be the universal platform that finally provides health data access across the entire care continuum, while simultaneously improving access to providers and empowering healthcare consumers.

Of course, this is a few years from reality. But, we can speculate … would innovative medical laboratories have their patients’ lab test data hosted in the Cloud in such a way that patients and providers could access it securely, along with other protected clinical records?

Imagine how this would enable patients to have their complete medical record traveling with them at all times.

—Jon Stone

Related Information:

Could Apple Be Taking a Bite Out of EHRs?

Could Amazon or Apple Actually Make a Dent In the EHR Market?

Apple Extends Its Reach into Healthcare

Electronic device that computes health data

Apple Is Quietly Working on Turning Your iPhone Into the One-Stop Shop for All Your Medical Info

Wait! What? Amazon and Apple Eye Building EHRs

Apple Is Working with This Small Start-Up to Change How We Track Our Health

Timeline: How Apple Is Piecing Together Its Secret Healthcare Plan

Amazon Has a Secret Health Tech Team Called 1492 Working on Medical Records, Virtual Doc Visits

With Apple Consulting Argonaut Project on Health Records, Interoperability Could Get the Push It Needs

Apple Enlists Help of Startup Health Gorilla to Add Diagnostic Data to iPhones

Mobile Apps for Corporate Health Programs Create Great Patient Engagement and Participation

Clinical laboratories have an opportunity to provide medical laboratory test services to employer-sponsored wellness programs

Venture capitalists are beginning to pour dollars into mobile apps designed to support corporate health and wellness. For savvy pathologists and clinical laboratory managers, this represents an opportunity to serve a cash-paying market for medical laboratory testing.

Another aspect of this trend which may be worth studying by pathologists and clinical laboratory administrators is the use of “gamification” by these mobile app developers. Gamification uses technologies and programming to more deeply engage the user, just as a video game does.

Corporate wellness platform Keas of San Francisco, California, recently announced an $8-million investment round, according to a story at mobihealthnews.com. Ignition Partners and Atlas Ventures provided the capital. With this latest round of funding, investors have $25.5 million invested in Keas. (more…)

Google Health’s Pending Demise Highlights PHR Challenges for Clinical Pathology Laboratories

Google Health is an electronic health record system that terminates on January 1, 2012.

It is notable that Google, Inc. (NASDAQ:GOOG), on January 1, 2012, will shut down Google Health, its patient health record (PHR) platform. That announcement was made in June, so many pathologists and clinical laboratory managers may not realize that Google is exiting the PHR market.

On Google’s official blog, company officials stated their intention was “to retire two products that didn’t catch on the way we would have hoped, but did serve as influential models.”. Along with Google Health, the other product about to be discontinued is Google PowerMeter, a free energy monitoring platform, designed to help consumers cut energy usage and costs. Users can continue to download data stored on Google Health through January 1, 2013.

Growth in Users of Google Health Did Not Meet Company’s Expectations

The decision to discontinue its Google Health comes barely three years after the company launched the service. It hoped that Google Health would help healthcare consumers to make smarter choices. In May of last year Dark Daily reported that the number of Americans using PHRs doubled between 2008 and the end of 2009. News coverage of the Google Health story confirms that PHR use has increased within a narrow market segment of tech-savvy patients and providers, as well as with the growing numbers of consumers interested in fitness and wellness. But the number of Google Health users fell far short of the millions of PHR users that Google projected would sign up and use the service.

(more…)

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