Apple is said to be working with a US collective of leaders in the healthcare IT field in its secretive efforts to integrate more electronic health data with the iPhone, a move experts say could advance medical record interoperability.

Participants in the Argonaut Project – an initiative focused on expanding the use of open standards for health data exchange – are some of the industry’s most notable vendors and providers: Accenture, athenahealth, Cerner, Epic, McKesson, Meditech, Surescripts, The Advisory Board Company, Beth Israel Deaconess Medical Center, Boston Children's Hospital, Intermountain Healthcare, Mayo Clinic, Partners HealthCare.

It's not a bad place, then, for Apple to get some ideas about better integrating its products into a complex and fragmented healthcare ecosystem.

Argonaut Project leader Micky Tripathi, president and CEO of Massachusetts eHealth Collaborative, would not comment on anything specific about Apple’s discussions with the group but offered some thoughts on what iPhone-based health records could potentially mean for healthcare more generally.

In particular, Tripathi seemed excited that Apple could play a significant role in improving interoperability – especially with regard to consumer-mediated exchange.

“There has been more and more effort and attention being paid to empowering patients with the ability to aggregate their own data, and then do more with it than they otherwise would have,” he said.

“That’s the idea and the hope people have. There are many challenges to that but we’re making incremental progress on the way.”

Tripathi said he could envision a world in which a patient is able to aggregate all of their records on their device, and “use that as the vehicle for sharing.”

For instance, a diabetic could use an iPhone-based diabetes app and populate it with his or her own health data.

“They could say, ‘All right, app, go to the API at Beth Israel Deaconess Medical Center and get my diabetes-relevant information.’ Maybe that’s lab results related to diabetes but it’s not everything. Those records could be voluminous but the app is able to go out and get just that information that’s important to me.”

The big challenge at the moment is that healthcare is still largely lacking when it comes to a “trust ecosystem,” said Tripathi. But that’s another area where Apple, with is nearly unparalleled familiarity, could offer an answer.

“One could imagine Apple playing a role that very few other organisations can play,” said Tripathi.

“Hospital A, Hospital B, Hospital C, rather than issue their own credentials, would be willing to say, ‘Oh, if Apple trusts them, that’s fine. We’ll let the app in to do what it’s going to do,’” he said.

Apple could also ease clinician concerns when it comes to patient-mediated data.

“Providers have a degree of mistrust of information that has been handled by the patient. Not because they don’t trust them, but you just don’t know what happened in that circumstance. Did it get garbled, is some stuff being left out because they don't want me to know something?

“Apple certainly has the technical smarts to be able to establish data provenance with those records, so if I got the record through some Apple service, through various existing security and non-repudiation kinds of mechanisms that exist today, I would be able to know that this record hasn’t been screwed around with since it came from Beth Israel. It just happened to be in the patient’s control, they haven't changed anything.”

For his part, Tripathi feels there’s been something of a sea change with public perception: how they see their data and how they see their smartphones.

“If you had asked five years ago, there would have been a different sense to this. It just feels to me, intuitively and anecdotally, like we’ve had some sort of a change in the way we think about privacy and protection of privacy,” he said.

Earned or not, Tripathi thinks people have a much higher degree of comfort in trusting their data with companies such as Apple.

“People have much more of a sense of their phone being an extension of themselves,” he said.

“Your phone is much more a part of you and a reflection of you, and something you trust to have personal information – sometimes deeply personal information.”



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