This editorial article is a part of Tech + Health Month of Technical.ly's editorial calendar. This month’s theme is underwritten by the Chesapeake Digital Health Exchange. This story was independently reported and not reviewed by CDHX before publication.
If you have the Apple Health app on your iPhone, your fitness is being monitored the the background while you do everything from grocery shopping to taking an evening stroll, as steps are counted and movement is measured. On an Apple Watch or Fitbit, the app can monitor your heart rhythm — a feature that can catch certain health problems before they become serious.
Now imagine if, after spotting an irregularity on your Apple Watch, you could call your doctor’s office and have them check it right then and there so they can advise you on whether you should set up an appointment for further investigation, go to the emergency room, or simply keep an eye on it.
That kind of tech is pretty much the future of healthcare, and if you have a device running iOS 15, it’s already available with ChristianaCare providers, thanks to a partnership between Delaware’s largest healthcare organization and the Apple Health App.
Dr. Tim Shiuh, chief health information officer and VP of clinical transformation at Newark-headquartered ChristianaCare, sees it as a step toward whole health and wellness care that keeps track of health and fitness every day, as opposed to the kind of healthcare that centers on practitioners diagnosing you when you’re sick.
“We really want to pivot to being continuously involved in your care and engaging and building the relationship” between providers and patients, Shiuh told Technical.ly. “This technology is really going to change the paradigm. I think really it changes patients and how they think about how they manage disease and wellness. It’s an exciting time, when people are engaged with their smartphones and embracing the technology from a fitness and wellness perspective.”
While an app sharing such personal information will raise privacy concerns, ChristianaCare stresses that nothing is shared automatically without permission, and the sharing is encrypted.
The new feature builds on Health Records on the iPhone, which creates a direct, encrypted connection between participating health institutions and a patient’s smartphone so patients can see a central view of their allergies, conditions, immunizations, lab results, medications, procedures and vitals directly within the Health app.
Apple worked with the health care community to augment the SMART on FHIR standard to support end-to-end encryption for this health data sharing feature, meaning all data is secure and encrypted in transit and at rest, according to ChristianaCare. Apple does not have access to the encryption keys and cannot view what patients have shared with their health care team. This feature is designed to meet the privacy and security requirements of the Health Insurance Portability and Accountability Act of 1996, aka HIPAA.
It’s also not set up so that your doctor is monitoring you continuously; the data is available to them, but it’s up to the patient to tell their practitioner if there is an irregularity. More commonly, it allows the practitioner to get a more accurate picture of the amount of exercise a patient takes in an average week, which can be discussed during routine appointments.
“When do you have engagement with your practitioner, the data makes the conversation more meaningful,” Shiuh said. “In the past, patients had to keep track of all of that information in logbooks that they’d bring to their doctor’s office — or maybe that data just wasn’t available. By enabling data that originates from digital devices such as Apple Watch and iPhone to be viewable directly within the provider’s electronic health record software, it creates a much better picture, and it enables health care providers to analyze it and find actionable insights that can help change the trajectory of a patient’s care.”
Randall Gaboriault, ChristianaCare’s chief digital and information officer, says it’s about patient agency.
“It gives each individual the ability to collect and own their self-generated health data and then choose to make some or all of that data available to their health care provider,” he said. “This in turn opens up an entirely new potential for the patient and care team to engage in conversation and learning that can ultimately improve health.”
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