From The Editor | September 19, 2014

The Great HealthKit Betrayal

ken congdon

By Ken Congdon

We’re nearly two weeks removed from Apple’s launch of the highly anticipated iPhone 6 and Apple Watch. While much of the free world is feverishly placing its order for a new iPhone, the health IT universe is too busy feeling sorry for itself. Most of the coverage I’ve read to date has lamented about the fact that HealthKit was barely even mentioned during the September 9 unveiling.

Believe me, as a health IT journalist I too was a bit disappointed by HealthKit’s absence from the launch event. However, I wasn’t at all surprised. Apple, after all, is first and foremost a consumer-driven business. It makes sense that the company used the event as a platform to showcase the new design features of the iPhone 6 /6 Plus and the fitness tracking capabilities of the Apple Watch. These attributes are what your Average Joe is interested in. Consumers don’t care so much about how health data from these devices can be aggregated by HealthKit and leveraged by their healthcare providers. It’s not what they consider “sexy” and it’s not what sells new iPhones and Apple Watches — at least not yet.

Apple’s launch events have always been spectacles focused on generating consumer excitement, and the company stayed true to form on September 9. Why then were health IT and mHealth thought leaders so disappointed? When did our expectations of Apple change? To me, Apple’s Worldwide Developers Conference in June is to blame. This is where Apple unveiled HealthKit and trumpeted its partnerships with the likes of Mayo Clinic and Epic. This glimpse into the transformative possibilities of HealthKit whet our appetites for future developments and announcements. When none came last Tuesday, the health IT industry was inevitably let down.          

While this disappointment is certainly understandable, I’m preaching patience. Apple’s strategy with HealthKit and the Apple Watch will likely follow the same pattern as its previous hardware and software initiatives – it will rely on the sleekness of its hardware to attract users and the power of its iOS platform to attract developers. Developer innovation is where the true power of HealthKit will ultimately be realized.

Apple’s CEO Tim Cook indicated as much during the launch event when he the said the company hopes independent developers will enlighten Apple to the “art of the possible” with the Apple Watch and HealthKit, helping to create “things we can’t even imagine yet.” This hands-off strategy has worked pretty well for Apple in healthcare to date. In fact, a recent study by Manhattan Research found that 75 percent of U.S. physicians own some form of Apple device (iPhone, iPad, iPod) and use it on the job. Apple has won over physicians despite the fact that it has never released a purpose-built device or set of applications specifically for the healthcare market. The Apple Watch and HealthKit will easily have the same (and almost assuredly a much greater) impact on providers.

Apple’s “art of the possible” strategy is already taking shape behind the scenes. Beyond the company’s highly publicized partnership with Epic, EHR providers Cerner and Athenahealth have also announced that they are working with Apple to develop applications that leverage HealthKit. The goal of these HealthKit/EHR integrations is to help doctors monitor patients with chronic conditions from home and identify health risks.

Mayo Clinic also isn’t the only healthcare provider engaged in the effort to prove out this concept. Recently, Stanford University Hospital and Duke University Hospital announced that they are preparing to launch trials with diabetics and other chronic disease patients using HealthKit. Stanford University Hospital doctors say they are working with Apple to let physicians track blood sugar levels for children with diabetes remotely using an iPod touch and HealthKit. Similarly, Duke University Hospital is developing a pilot to track blood pressure, weight, and other measurements for patients with cancer and heart disease.

These provider trials (and the ones that subsequently emerge) are the developments the health IT industry should be keeping its eye on. These HealthKit use cases will mature over time, and most won’t warrant a huge “reveal” event. While this may not satisfy our need for instant gratification, it’s the nature of the beast. Apple, after all, is a consumer company.