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Duke looks toward next steps with Apple HealthKit

'We’ve had physicians basically knocking down my door to say, "When can we use this?"'
By Erin McCann
08:04 AM
Duke Hospital

Duke Medicine is among the elite first-movers working with the still-new Apple HealthKit software, having implemented it shortly after its release last September. And now Duke is trying to figure out how to forge a wider path forward with the platform. 

Ricky Bloomfield, MD, is one of those people charged with the task. 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 implementation of Epic MyChart electronic medical record.

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, Bloomfield said. Indeed, now that some clinicians are using it, word has gotten around enough to pique interest in other departments.

"We've had physicians basically knocking down my door to say, 'when can we use this?'" Bloomfield told Healthcare IT News.

For next steps, in fact, 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.

Bloomfield will present Duke's HealthKit integration project experience Wednesday, April 15, at HIMSS15. He said that looking back on when they first implemented the platform last year, "it has worked as seamlessly as we hoped."

[Innovation Pulse: How platforms like Apple's HealthKit can foster an ecoystem of IT innovation.]

Here's how Duke uses HealthKit: When a patient chooses to share their data, the physician enables HealthKit in the system, and the patient receives an alert that they can begin sharing their data. The patient then gives consent for the Epic MyChart app to read that healthcare data and subsequently send it to a 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.

As Duke expands its use of HealthKit, 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 at noon in the North Hall, B Lobby.

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