People with smartphones and wearable devices regularly show up to the doctor’s office with readouts from apps detailing everything from their heart rate to sleep patterns. Now, with the new iOS 15 update this fall, some iPhone users will be able to send data directly from their Health app to their doctors’ electronic medical records systems.
That type of integration could make it easier for patients to share information with their doctors, said Libo Wang, a cardiology fellow at the University of Utah School of Medicine who studies wearables. “The current workflow is mildly laborious, and requires the patient to email the pdf, and a clinician manually uploading that file to create a permanent record in the official electronic medical record,” he said in an email.
Users could already pull in data from the other direction: since 2018, Apple has allowed people to add records from dozens of clinics and hospitals to their Health app.
The new integration will work with six electronic medical records companies in the United States. That includes Cerner, which controls around a quarter of the market, and five smaller groups. Apple says it could continue to add more. Doctors who use the records from those companies would be able to open any shared data within a patient’s health record. The dashboard opens as a web view directly inside the record; it doesn’t take providers to another outside app. The design is similar within the records for each of the six companies, Apple says.
The Health app data isn’t directly transferred into the electronic health record. Doctors can see a window with the data, but the information isn’t permanently added to the record. If an iPhone user decides to stop sharing their health data, none remains within the health record. The system is built using a framework called SMART on FHIR, an open interface for third-party applications that can work within electronic health records. Any group can create an app using the platform.
For physicians — and particularly cardiologists — direct access to iPhone data within health records could help them make more meaningful use of the information, Wang said. One 2020 study found that when physicians directly reviewed the strip generated by the Apple Watch that visually shows a user’s heart rate, they were able to flag more cases of abnormal heart rhythms than the Watch’s algorithm flagged. If the rhythm strips are shared directly to someone’s doctor, the doctor might be able to identify any concerning patterns.
The downside, though, is the potential for information overload, Wang said. More data isn’t necessarily better, particularly if doctors don’t trust its accuracy. While the data collected by wearables and smartphones may seem helpful to patients, it’s still not entirely clear if it actually helps people feel better or gives them better care, he said.
Cerner, one of the electronic health record companies participating in the initial rollout, was able to test the new Apple feature at its onsite clinic for employees. “Having secure ways to view and share this information in a clinical context has been helpful,” said Sam Lambson, vice president of interoperability at the company.
It’s more and more common for patients to bring health data from their personal devices to health visits, and Lambson said Cerner is focused on efforts to incorporate that into its systems even outside of the new Apple program. One advantage of the Apple system is that it’s easy for doctors to use, said Jessica Oveys, director of product management at Cerner.
“I think the key to it is certainly empowering and making the patient feel at the center and secure, and making it easy for them to share. But also, it’s really presenting the data in a way that’s actionable and relevant to the clinician,” she said.