Duke Medicine talks HealthKit-Epic integration

We've had physicians basically knocking down my door to say, 'when can we use this?'"
By Erin McCann
10:17 AM
Let's set it up. Hospital readmissions cost healthcare organizations a pretty penny – a $41.3 billion penny annually, in fact. And with hospitals watching their balance sheets more than ever, it's something to pay close attention to. 
Naturally, in recent years readmissions has been a choice target for medical researchers and healthcare organizations looking to rein in spending and keep patients from returning shortly following hospital discharge. And the key to this comes down to knowing how the patient is doing when they return home. 
Ricky Bloomfield, MD, is one of those people charged with the task by utilizing mHealth technologies. And with Apple's HealthKit, that's becoming a reality. As director of mobile technology strategy at Duke Medicine, Bloomfield helped the university health system be among the first to integrate Apple’s HealthKit with Duke’s Epic MyChart electronic medical record.
Bloomfield, who will presenting Duke's HealthKit integration project experience Wednesday, April 15, at HIMSS15 this week, says that looking back on from when they first implemented the platform last year, "it has worked as seamlessly as we hoped."
Right now, Duke Medicine is utilizing HealthKit for a small number of patients for its initial pilot, aimed at demonstrating feasibility and safety. So far, so good, said Bloomfield. And now that some clinicians are using it, word has gone around, and now even more are asking for it. 
How it works is when a patient chooses to share their data, the physician enables the HealthKit in the system, and the patient receives an alert that they can begin sharing their data. The patient gives consent for the Epic MyChart app to read their healthcare data and subsequently send it to the healthcare institution. 
"What I really like about the system is that it puts all of the controls into the hands of the patient," said Bloomfield, "so that the patient can choose what data points to share." Each data point can be enabled or disabled individually by the patients. 
For next steps, Bloomfield is already in conversations with other Duke Medicine clinics that want to offer the platform to their patients – obstetrics and gynecology, endocrinologists, and even oncologists from the various Duke clinics have expressed interest, he said. "We've had physicians basically knocking down my door to say, 'when can we use this?'"
Bloomfield anticipates the platform will eventually have enormous implications for a disease such as congestive heart failure, which stands as the biggest, most significant contributor to Medicare hospital readmissions in the nation. In numbers, the disease is responsible for more than 134,000 re-hospitalizations and $1.7 billion in costs each year. About 20 percent of CHF patients who are discharged are readmitted to the hospital within 30 days. The HealthKit-Epic integration, he says, can help with that. 
"All you have to do is step on the scale each morning and then that data is automatically saved to HealthKit and then transmitted to MyChart," said Bloomfield. "They don’t have to worry about the connection between (their) device."
One of the biggest things that set this platform apart from similar ones? Apple made the patient's privacy and security a priority, Bloomfield says. A patient's data is stored on the device itself, he explained, so it's not synced between devices on iCloud or something like it. Apple also doesn't have access to the data. "I really like how patient privacy was designed into this system first and foremost," he said. "It accounts for the privacy issues that I think in prior attempts to do something like this didn't quite work the way this one does."
Bloomfield's session kicks off at HIMSS15 Wednesday, April 15, at noon in the North Hall, B Lobby. 
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