Aaron Berdofe, MHI – Health Informatics

via apple.com

The internet was abuzz yesterday as Apple unveiled it’s new iPhones as well as the highly anticipated Apple Watch.  Prominently cited during the Apple Watch presentation was the new Apple HealthKit that made its public debut a few months ago.  I’ve found the healthcare community divided as to the “Cool Factor” of Apple’s Healthkit and what it potentially can be.  There are those who are eternally optimistic that this will usher in a new era of innovation…and there are those who aren’t exactly impressed with how beneficial tracking your activity and heartrate is for the average person, let alone how much their doctor would care about the data.

Regardless of which side you stand on, I think anyone would be stretching the argument to say that Apple is now entering into the healthcare market.  Yes, they have made partnerships with Mayo and Epic, and yes, every doctor under the sun wants to bring their i-whatever into work, but Apple has not made a move to play a central part in dealing with healthcare information.  Instead, they have opted to take part in what people are calling the wellness industry which is different from healthcare most notably by the fact that medical staff and payers are not involved.

The anciallary reasons Apple is not entering the healthcare market are pretty fresh in recent memory. Both Google and Microsoft failed at creating healthcare software.  And the FDA has been…well, let’s say “in a bad mood” lately. First, they went on the offense attack at the company 23andMe for being a clinical laboratory that diagnoses disorders even though it isn’t and never claimed to be.  Asking them to tighten up their disclaimers might have been appropriate, but nobody reads EULAs either.  For a follow-up act, the FDA is now going after those evil and villanous (not to mention typically European) cheese producers…what? The people at the FDA understand that not all bacteria will kill you, right?  Just for fun, let’s utilize the Foodborne Outbreak Online Database (FOOD!, they’re so clever) from the CDC to see how many cheese-related outbreaks there have been over the past 16 years.  Yes, before you ask, I literally spent minutes sorting that database for cheese.

This cheese ratio would make horrible nachos.

Hmmm, and only 1 has resulted in a death which was from some Queso Fresco in a private home in Texas.

I feel more safe already…

But back to Apple.  The main reasoning they are not entering the healthcare industry is the simple fact that the industry of healthcare is about as demented and perverse as they come.  Excuse me, let me rephrase in business terms: Healthcare is not an ideal market for a consumer-oriented tech company to get involved in.  In terms of market size, any industry (not just healthcare) is limited to the number of working professionals in it.  Apple goes after general consumers which is an ever-growing number only dependent on the number of people who have money to buy things.  Also, Apple’s strength is simplifying processes for end-users.  While designing a clinical application that worked smoothly and was lauded by doctors across America would not be difficult for them, restructuring the billing and insurance side of the industry would require burning health insurers to the ground and restructing the industry.  Additionally, they would also have to hope the FDA wasn’t having a bad day and mistake them for some extra moldy cheese even though I agree this hypothetical situation should be watched very carefully.

No, Apple will stick to the low-risk, no responsibility approach on the consumer side where companies can utilize the limited wellness data that is being collected on personal devices through the Apple HealthKit environment. While I certainly do see some value in wearable health technology in terms of potentially changing behavior, monitoring of basic vital signs and activity levels has not proven to be interesting to a patient’s physician.  Apple even recognizes the divide between consumer health information and medical information in their App Store: “Health & Fitness” is a separate category from “Medical”.  I don’t think we’ll be seeing CCDs being exchanged through HealthKit anytime, but who knows, people might start getting the idea in their heads that maybe, just maybe all of this information about their own personal health should be in their possession instead of being locked up in an EHR (or paper chart).