Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Friday, November 30, 2018

I Think This Is Pretty Big News And Is A Pointer To Things To Come.

This appeared last week:

Apple in Talks to Give Veterans Access to Electronic Medical Records

Under plans being discussed, Apple would create software allowing veterans to transfer health records to iPhones

By Ben Kesling and Tripp Mickle
Apple Inc. AAPL -0.05% is in discussions with the Department of Veterans Affairs to provide portable electronic health records to military veterans, a partnership that would simplify patients’ hospital visits and allow the technology giant to tap millions of new customers, according to people familiar with the effort and emails reviewed by The Wall Street Journal.
Under the plans being discussed, Apple would create special software tools allowing the VA’s estimated nine million veterans currently enrolled in the system to transfer their health records to iPhones and provide engineering support to the agency. Apple in January announced its foray into the electronic-records field with a feature that allows patients to import and store medical information.
Top VA officials, as well as associates from President Trump’s Mar-a-Lago Club, discussed the project last year in a series of emails reviewed by the Journal. The emails show how the Trump administration wrestled early on with the project’s goals.
An Apple spokeswoman said the company has nothing to announce.
The partnership would be a major boost for Apple at a time when technology companies are looking to elbow into the $3.2 trillion health-care market. Alphabet Inc. recently hired prominent hospital-system executive David Feinberg to oversee its health initiatives, and Amazon.com Inc. has joined with JPMorgan Chase & Co. and Berkshire Hathaway Inc. to form a company that reduces its workers’ health costs.
Tech companies for years have sought, without much success, to bring together disparate troves of medical information and remove technological barriers to giving patients, providers and researchers access to health records. That access, health specialists have said, could improve care and speed the development of cost-effective treatments, but the effort faces technological hurdles and privacy concerns.
The VA partnership has the potential to accelerate Apple’s efforts to overcome past challenges by allowing it to tap into one of the nation’s largest, concentrated patient populations, health-care experts said. To date, the company has had to take a more patchwork approach, signing agreements with hospital networks and relying on them to encourage patients to import their medical records to iPhones using the new “Health Records” feature.
The company’s ultimate goal is to enable patients to import their records and share them with health-related apps, which would use the data to provide services like automated prescription refills, according to people familiar with Apple’s plans. Apple would take a 15% to 30% cut of those subscriptions as it does with most apps offered through its App Store.
“With nine million users, they will have the largest mobile platform for storing records on personal phones,” said Iltifat Husain, assistant professor at Wake Forest School of Medicine and co-founder of Impathiq, a health-data analytics company.
More here:
This seems to me to be a way for the person to be empowered with their health data on their phone and for them to decide who they share it with and who they accept new information from.
Sound good as an option to me.


Anonymous said...

Thanks for sharing David. This will test the ADHA and Government. Will they openly embrace this and support adoption or will they put blockers in place to ensure their myhr remains the only gateway to personal health information. I know I would sooner use this than the myhr

Dr Ian Colclough said...

Mmm. Back to basics.

What is the likelihood this will lead to a secure, inter-operable, highly-functional, Shared Electronic Health Record [SEHR] which doctors and other health professionals can trust and rely upon to provide comprehensive, coordinated, clinical care to their patients?

Anonymous said...

I don't think it is trying to be all things to all problems. It does seem
to be tackling the patient side of the dodecahedron. It would I hope
refocus attention back the the coordinating GP as the point of
synchronisation. The patient needs to have a social connection to the data,
if it just goes in a black hole they will drop the app like a stone much
the same as the myhr has never been picked up, I do agree that it must
connect into the care team, perhaps the patient through a trust model
becomes the bridge that information flows.

If nothing else it shows Government departments and their Agencies are not
equipped to operate at this end of the value chain. Open standards based in
ovation is to fluid for them.

Bernard Robertson-Dunn said...

IMHO, most people are not interested in their own health, never mind their health data. The existing myhr numbers support this - fewer than 30% of them have ever had a Shared Health Summary uploaded. And many of those records have probably been populated by GPs and nurses keen to take money from the government.

If people were interested in their health, they don't need medical data, there's plenty of advice available even if some of it is dubious (see the Wisdom of the Crowds as featured on this blog earlier).

At best, patient oriented health apps will be a niche market. Health service providers will always need better record keeping systems but they will be a small part of their clinical activities. The time and effort required to manage them needs to be minimised because the overheads can have a detrimental impact on the client/provider interactions.

Anonymous said...

I'm sure Apple won't be doing it out of the goodness of their heart! Where is it stored, where does it go, it is not just "on your phone", it'll be in the cloud so they can mine it somehow. In other words - no such thing as a free lunch. And I agree with Bernard, those few people interested in their health will probably find other ways of going about compiling their health information data. I know I do.

Grahame Grieve said...

> Where is it stored, where does it go, it is not just "on your phone", it'll be in the cloud so they can mine it somehow.

This is factually incorrect; the information is only on the iPhone and never travels through apple servers, encrypted or not, and is otherwise found in backups, which are encrypted and not available to Apple. Apple cannot mine the data, nor be forced to yield it to any government. You might have noticed some rather public battles with the FBI about this recently.

> In other words - no such thing as a free lunch

no. you have to buy the device. It's working out as a good business for Apple - selling private devices (say, https://www.intego.com/mac-security-blog/why-ios-12-is-huge-for-security-and-privacy/). It's possible that Apple will change tack in the future, though that'd be a rather big change, or more likely that they'll be forced to make the data insecure (by the our very own 5 eyes governments - no wonder people are sceptical about government grabs for data - see also current news about forthcoming Australian regulations requiring government backdoors in encyption products, which one assumes will include the MyHR infrastructure)

Anonymous said...

That is also my understanding, Apple has no interest in the data, in fact it builds privacy into its products and Privacy is a hardwired constraint as I understand it. Not something you get from others. I use the health app that currently comes with the iPhone, it is great and cannot wait for the US version to arrive equiped with Grahame community built FHIR. My only concern is adoption by organisations. I tried with MediTracker by the GP practice was confused as they thought only the MyHR was allowed.

As for the metadata laws, Labour for now seems to be making all the right noises. I am sure Dutton and his flock mean well but all they are doing in reality is letting the terrorist win by dismantling or freedoms and rights. If he is so paranoid perhaps Hunt can talk to a pharmacy and bulk buy some cotton wool to wrap themselves in.