Correction: A previous version of this article said that Gliimpse founder Anil Sethi was still at Apple. In fact, he left the company last year.
After many months of rumors, Apple announced today that it is launching a personal health record (PHR) feature with iOS 11.3, the beta of which launched today to users in Apple's iOS Developer Program. The feature, called Health Records, will aggregate existing patient-generated data in the Health app with data from a user's electronic medical record — if the user is a patient at a participating hospital. At launch, Apple is working with 12 hospitals across the country, including Penn Medicine, Cedars-Sinai in Los Angeles, Johns Hopkins, and Geisinger Health System.
“Our goal is to help consumers live a better day," Apple COO Jeff Williams said in a statement. "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. By empowering customers to see their overall health, we hope to help consumers better understand their health and help them lead healthier lives.”
The feature will use HL7's FHIR (Fast Healthcare Interoperability Resources) specification. Users will be able to see things like allergies, medications, conditions, and immunizations, as well as the sort of things they might check an EHR patient portal for, such as lab results. They can be notified when the hospital updates their data. The data will be encrypted, and users will need to enter a password to view it.
Many of the hospitals participating at launch have a history of digital health innovation. Cedars-Sinai in Los Angeles, for instance, has been a major user of Apple products for some time — the hospital distributes iPads to patients for entertainment and communications purposes, and has a comprehensive patient app for the phone and the Apple Watch.
"Putting the patient at the center of their care by enabling them to direct and control their own health records has been a focus for us at Cedars-Sinai for some time," Cedars-Sinai Chief Information Officer Darren Dworkin said in a statement. "We are thrilled to see Apple taking the lead in this space by enabling access for consumers to their medical information on their iPhones. Apple is uniquely positioned to help scale adoption because they have both a secure and trusted platform and have adopted the latest industry open standards at a time when the industry is well positioned to respond.”
The complete list of participating hospitals is: Johns Hopkins Medicine; Cedars-Sinai; Penn Medicine; Geisinger Health System in Danville, Pennsylvania; UC San Diego Health; UNC Health Care in Chapel Hill, North Carolina; Rush University Medical Center in Chicago; Dignity Health, a multistate health system covering parts of Arizona, California, and Nevada; Louisiana's Ochsner Health System; MedStar Health in the Washington, DC metro area; OhioHealth in Columbus; and the Cerner Healthe Clinic in Kansas City, Missouri.
Notably absent from the list are Duke University and Stanford University, which have been hospital partners for a number of launches in the past and from which Apple has made high profile hires — Dr. Ricky Bloomfield from Duke and Dr. Sumbul Desai from Stanford. However, Apple says additional health systems are set to sign on in the coming months.
News of Apple somehow entering into the EHR or PHR business did not come as a total surprise to the industry. Apple acquired Gliimpse, a small health data startup, in August 2016. Gliimpse was working on a PHR that skirted HIPAA difficulties by having the patient control their own health data. The main innovation of the product was an AI engine that reads medical records (with patients' permission, accessing them via the patient portal) and breaks down and codes them into a standardized and readable language. In retrospect, it seems very likely Apple acquired that technology and talent in order to develop this feature.
Gliimpse CEO and founder Anil Sethi left Apple to start a new health records startup, Ciitizen,
Additionally, in June of last year that Apple was working with startup Health Gorilla, which specializes in aggregating diagnostic information such as bloodwork.
PHRs have a long and storied history in digital health — in addition to countless startups, both Google and Microsoft have attempted to create viable PHRs. Google Health's failure in 2011 was much-discussed and Microsoft's HealthVault, while still around, has never managed to obtain widespread adoption or move the needle on interoperability. Nonetheless, many thought leaders, including former National Coordinator for Health IT Dr. David Brailer, see a move toward patient-centered health records as either inevitable or necessary.
Apple has advantages no other company has ever had in this space. The company's longterm approach, introducing HealthKit, ResearchKit, and CareKit gradually, as well as its ubiquity in the United States, give it a real shot at making a patient-centered health record work.