How Apple’s medical platform is going to change healthcare
By Wisdomofthecrowd
And what the Minister of Health can learn from this
At the Apple event on March 15, 2016, Apple launched enhanced versions of the health platform development tools it had developed in the iOS platform. Apple’s goal is to make it easier for consumers and medical professionals to develop applications that allow users to monitor their personal health. Apps developed with Apple’s development tools can collaborate with each other and exchange data, but only if the user agrees to this. With these assets, Apple is taking steps towards the future of healthcare in which healthcare platforms will play a leading role.
Battle between platforms
Apple is certainly not the only one. There is now a real platform-battle going on in the medical field. Companies such as IBM (Watson), Philips (together with Salesforce), General Electric and Medtronic (manufacturer of pacemakers and insulin pumps), Johnson & Johnson (pharmacy) have launched platforms focused on medical applications. On the side of the consumer we see, next to Apple, Google, Amazon, Intel, Qualcomm and Samsung (with or without wearables developers) coming up with platforms focusing on the storage of health data from smartphones and sensors in a secure cloud.
It is a matter of time before both sides, hospital and patients at home, are brought together. Microsoft developed the Health Vault, a platform where users can keep track of their health data from various sources and decide for themselves with whom they share this data. HealthVault has already been rolled out on a larger scale and has become more established in America, England and Sweden. The platform fulfils a bridging-function between the user (the patient) and the hospital (the medical specialists). In the Netherlands, a pilot project was done with HealthVault and ChipSoft, the largest supplier of patient files to hospitals.
Another category of care platforms, such as the Dutch VieDome, the Belgian Cubigo and the Finnish Active Life Village, focus on care at a distance and the combination of care (initially of chronic patients) with domotics services, which are part of patient living at home and care. Here we see cooperation between insurers, healthcare providers, patient associations and telecom companies.
Philips is a forerunner in the field of health platforms. To this end, it collaborates with Amazon (cloud services) and Salesforce (customer relations).
Medical platforms replace the doctor
The character of care is on its way to drastically change. With smartphones, smart sensors and wearables, the health of citizens can be continuously monitored. In addition to the information provided by medical specialists from the hospital, this provides a much more complete picture of an individual’s health. Particularly in combining user data with data from the hospital, major gains can be made in improving care compared to what is currently done exclusively in hospitals. All at a relatively low marginal cost.
Care is changing towards a system consisting of two elements:
- an intelligent system that can learn from all the available health and lifestyle-related data from large groups of users, and
- A coach who translates medical insights into personal advice and guides people in planning a healthy lifestyle and, if necessary, motivates, seduces, or almost unconsciously directs them to achieve health-goals by means of medical treatments, care and complementary lifestyle services.
Read a more detailed picture of the future of care in ‘Together smarter’, chapter 3 ‘Healthier through collective intelligence’.
Schematic representation of the system for collective intelligence that aggregates and interprets data from different sources (above) in order to subsequently develop new knowledge and provide tailor-made coaching. (Out: Smarter together. M. Kreijveld, 2012)
Intelligent computer systems, such as IBM Watson, are already capable of analyzing and interpreting medical data and can thus make a reliable assessment of a person’s health or potential illnesses. Furthermore, in doing so, they even beat medical specialists.
Some health platforms, such as PatientsLikeMe.com, have already led to a new and faster way of clinical research, where clinical studies are increasingly being complemented or replaced by ‘field studies’ using apps and portable sensors that can track people in real life. Moreover, the number of participants is often ten to one hundred times that of a regular clinical study.
These developments can have a major impact on healthcare. Now the doctors and medical specialists have a decisive role as gatekeepers: they make a diagnosis and determine who gets a referral and how it is treated. In the future however, this position could increasingly be taken over by the intelligent systems of care platforms.
A new look at the EPD
The healthcare platforms currently under development focus on subareas of what will one day be an integrated healthcare market in which medical data and knowledge are combined with the information, knowledge and insights, both soft and hard, of users, and in which all kinds of services can connect to the same platform.
For healthy citizens and satisfied patients, the seamless collaboration between many players is essential, as is the integration of different products and services into a user-friendly offer. Platforms are indispensable to enable such seamless collaboration.
A number of care platforms have been established in the Netherlands, but they have not yet been very successful. Moreover, there is a risk of fragmentation between providers and regions where experiments are carried out on a small scale. Additionally, there is the global platform battle we discussed above.
The integration of the various subplatforms into a well-functioning healthcare system does not happen by itself. It can take years before the sector achieves further integration through consolidation and new cooperation. Even then, it is likely that there will be some large islands where the data or the hardware used is not interchangeable.
Citizens do not need more separate innovations, but instead desire integrated solutions and a pooling of knowledge in which patients can also have an input. Additionally, they need sufficient control over their data and a minal fragmentation over more providers.
A national health platform instead of a patient record
It is in the national interest that there is more central control, so that eventually there will be an underlying care platform on which various providers can plug in their supply and where security and interchangeability is guaranteed.
The government could take an important step in the creation of such a platform. The Dutch Minister of Health wants a network of start-ups to develop new care innovations. In order to achieve this, he is currently working with insurers on an electronic patient file, now known as the National Switch Point. However, these initiatives do not address the core of what qualitatively better healthcare needs: cooperation between many different providers in order to achieve personalized, patient-centred health management.
This requires an integrated health-platform to which everyone can connect and to which commercial healthcare providers can plug in, as well as sports associations and dieticians, sports equipment manufacturers, insurance companies, food manufacturers, psychologists, etcetera. Such a shared basis could accelerate innovations in healthcare significantly.
Advice for the Minister of Health, Welfare and Sport
The platform could even play a role in increasing the overall (average) health and happiness of society as a whole, and therefore have a link to basic health insurance. These are all matters that concern a public interest and can justify a intervening governmental role.
Apple and its people can learn how to build such an ecosystem and how to continuously develop a good platform: by providing simple yet powerful development tools that facilitate the development of new applications while integrating medical standards and legal, ethical aspects. In this way, the Minister can be sure that the innovations developed actually connect to the platform and are therefore compatible with all other applications in the healthcare ecosystem. This can give a powerful impulse to innovation in the healthcase sector.