Healthcare is a $3 trillion industry, and after a stretch of circling and speculation, the past couple of weeks saw a number of technology and financial giants making public announcements around their intentions to dive into this ripe-for-innovation industry.


Healthcare is a $3 trillion industry

Beyond DeepMind and Verily, Google announced that it has been diligently working toward leveraging its AI to better predict mortality outcomes, save lives, and lower healthcare costs. Last week also kicked off with the announcement of a partnership between Amazon, Berkshire Hathaway, and JPMorgan to form an independent healthcare company for their employees, a vague yet economy-shaking piece of news that signaled a shift in how serious these corporations are about disrupting the industry.       

This news alone would be significant enough, but in an effort to truly bring healthcare to the front pages, Apple also announced that they’ve partnered with 12 health systems to beta test a Health Records feature that gives people the ability to access their medical records. Apple’s move touches us closely, as it helps us more clearly see a world where patients truly have control over their own healthcare information—a world that we at Redox believe should exist. The work we do every day helping great technologies integrate with providers across the country is focused on building infrastructure that powers this world. That Apple regards this infrastructure as critical, too, is promising.  

Overall, we think this move is great news. It signals that Apple, the most valuable company in the world, is making investments into consumer-driven healthcare. As long-time and sincere advocates for people having access to their complete medical histories, we see Apple’s move into healthcare as a great signal to everyone (health systems, patients, and providers) that they’re investing time and resources into building infrastructure for patients to get transparency into their healthcare information. Though this isn’t a direct move to solve interoperability, it’s a stepping stone toward making patient-owned data a reality.

While this development is encouraging, there have been many attempts and failed experiments with patient portals. The underlying issue is that patients typically don’t care about their healthcare information outside an episode of treatment or an acute setting. The encouraging thing about Apple’s approach is that users can be passively engaged — they’ve partnered with EHR vendors, health systems, and service providers to tackle the interoperability problem and get data, albeit a limited number of locations, into the portal without the need for manual labor. Sustained user engagement — and a clear value to users — has often been a brick wall that stops products from gaining traction, but with the ability to bypass this wall entirely, Apple’s approach could have real legs.

We’re excited about the potential impact this could have on galvanizing and growing the community of consumer health developers. Apple already has an active developer community who builds tools on top of their platform; this pre-established and enterprising developer base will likely attempt to build apps that engage users and affect behavior.

Tremendously useful (and widely used) tools have been built on iOS. Could one of the next ubiquitous applications be healthcare focused? We believe it can, and this move from a massively-influential company lays the groundwork for direct-to-consumer clinical innovation to build upon.

Challenges facing Apple, Amazon

The path to the widespread adoption of a patient-facing clinical application isn’t completely free of obstacles. As noted by Jeff Bezos, healthcare is a uniquely and persistently challenging industry, and even giants like Google and Microsoft have had trouble breaking into the market. 

In our eyes, there are three main issues Apple (and any outside player) could run into the following:

Adoption is always slower than expected in healthcare: It’s estimated that new treatments take around 17 years to be adopted. Maybe it’s the risk-averse nature of an industry whose primary objective is to do no harm; maybe it’s because doctors are too busy with burgeoning patient panels to keep up with new technologies. In either case, innovative techniques and tools are not being quickly adopted. Apple is making the bet that their massive consumer base accelerates or skips these otherwise lengthy adoption cycles. Will Apple’s offering find a different route that produces the desired (and necessary) traction quickly enough?

The issue of network density: This is perhaps the biggest issue facing Apple: can they get network density such that a user can reasonably believe that his or her complete medical history is accounted for, regardless of where care occurred? If not, partial coverage may hinder adoption of the platform and prevent applications built on top of it to get traction. The reason that this is such a big issue is due to the fragmented nature of our healthcare system—patients, especially those who could benefit from Apple’s tool the most, likely require care at a handful of institutions. If a patient who sees a primary care doctor at one organization but visits a specialist in another wants to compile data from both practices, they’re potentially out of luck. Without the functionality to sync data from multiple locations, the ability to obtain a truly cohesive and useful view medical data is limited.

Current integration is very basic: The current scope of this new tool only provides a read-only snapshot of patient data from one institution —that is, patients cannot input their own data.

While provider-reported information is useful and does provide value, it only represents one half of the patient-physician equation. Beyond that, provider-reported information like Apple seeks to provide is already available to patients via existing patient portals.
Why does this make sense for Apple?

Despite the looming challenges, it’s clear that Apple is committed to this initiative and has stressed that their goal is to give consumers more insight into and control of their health data. In addition, another likely goal is to build a complete experience for people living within the Apple ecosystem.

Our bet is that they’ll look to incorporate all this data within the Apple ecosystem to sync all aspects of one’s life—healthcare included—into a holistic platform that iOS apps can tap into making it difficult to live without.

Photo: PHILIPPE HUGUEN,AFP, Getty Images

3 challenges Apple faces in path to widespread adoption of health record feature