- Plenty of mobile health (mHealth) technologies claim to bridge the gap between providers and patients through an innovative mobile application, but none is as widely touted as Apple’s HealthKit that rolled out as part of iOS 8. So far, several major EHR developers have revealed their future plans or ongoing work to their platforms with the app as a means of leverage mHealth tool as an effective means of improving patient outcomes.
One such EHR company was Cerner, whose foray into mHealth began more than ten years ago with Cerner Wellness. As Brian Carter, Senior Director and General Manager of Cerner Personal Health, tells EHRIntelligence.com in this one-on-one interview, HealthKit has the potential to promote an ecosystem where EHR technology and mHealth can meet and enable providers to manage patient populations effectively by having access to previously inaccessible data sources.
How does Cerner’s health IT platform (i.e., EHR, mobile) integrated with HealthKit?
The integration itself is pretty simple. There is a developer documentation kit that is available in the iOS developer resource library and it works like integrating with most types of data platforms using certain technical contracts — obeying certain processes and parameters with their platform.
The first time you open the integrated version Cerner Wellness app it launches you into HealthKit to give our app permission to share data and you turn on which elements you want to give access to. From then on, anytime data hits HealthKit it wakes our app up and drops a copy of that data into our app and then our app is able to share it with our platform.
How does data flow between the provider’s Cerner EHR and the patient’s mHealth technology?
We’ve started by working to flow data from HealthKit into our platform rather than pushing data from our platform into HealthKit. Whether using Nike+ or Withings or any of the other HealthKit-integrated apps, the act of using that app causing that data to flow all the way through HealthKit to our app to our platform. You get credit on our health platform and your health coaches can keep track of what’s happening with your weight without you having to use our app specifically. That’s important because there is a really big economy of different apps out there — we want to tap into that broader ecosystem.
What impact can EHR integration with HealthKit have on patient-centered care? Are there real use cases?
If you’re talking about population health management and accountable care and you’re only looking at the data you’re collecting during an office visit, you’re losing perspective on 99 percent of that person’s life. That’s everything from “Are you actually eating the way that we talked about?” to “Are you testing your blood sugars as frequently as you ought to be?”
The use cases where we see HealthKit having a sweet spot are in helping prevent chronic conditions in the first place. One is actually providing visibility to the individual and his care team on how the individual is living his life on a day-to-day basis as it relates to his health. The second is also about managing a chronic condition if one develops.
What obstacles could get in the way of healthcare organizations and providers leveraging this EHR-mHealth integration?
There are a few challenges. Healthcare organizations and providers as an extension of that are being asked to do more and more every day. The first thing is to help eliminate with real case studies and use cases that this can make their jobs easier. The organizations that are taking on accountability for the overall health of individuals will help drive that.
As a provider being compensated for outcomes and value, I am going to want new ways to make sure that my patients wind up at an overall better health status at the end of the year than being able to say that I provided top-notch, A-plus-quality care while that patient was inside my venue. That shift to accountability will open up providers to looking at new ways of doing things. It also takes off the table questions about how I get compensated for doing these types of things.
What work will need to be done to ensure that patient-generated data is useful to providers and addressing any concerns they may have?
This is not specific HealthKit, but if you look at Stage 3 Meaningful Use and some of the patient-generated health data, there needs to be some accountability frameworks put in place so that providers also don’t feel like they are being exposed by creating these new routes of data to flow into their systems. I’m encouraged because I have seen a number of providers, including many of our own clients, leaning forward on this kind of stuff.