Apple provided developers with a Health Records API at WWDC. Based on technology acquired with Gliimpse, the company hopes the new API boosts adoption and innovation in the space. To get an educated sense of its significance, I spoke with the developers behind medication reminder app MyTherapy.

Introducing MyTherapy

Loosely based in Germany, MyTherapy (part of smartpatient) makes apps for iOS and Android devices.

The app reminds people to take their medicine and maintain their treatment program. It does much more than that – it also enables medical professionals to monitor adherence to treatment and provides tools that help family and friends support patients in following the regime.

Given that both MyTherapy and Apple’s Health Records are about shared medical data, I thought I’d take a moment to chat with smartpatient MD Sebastian Gaede and CTO Wolfram Kerl.

I don’t usually run interviews in Q&A format, but I have this time as I felt their answers provided useful insights for developers, patients, and others in this space.

What does the health records API do now?

"Health Records, released as an extension to Apple’s HealthKit framework earlier in the year, was a massive leap forward in connecting the world of healthcare IT with that of consumers. Historically, these two markets don’t communicate well. With Health Records, users can pull their health records from the clinical systems of hospitals and clinics that are registered with the service (a number that is steadily growing), directly to their iPhone. The release of the Health Records API is the next step, allowing developers of third-party apps to access this data. The result will be a new generation of health apps, turning clinical records into actual use cases for end users."

“Apple is one of the few companies on the planet that would attempt to connect consumers to the different Electronic Health Record (EHR) systems that exist, and perhaps the only one capable of pulling it off.”

How can it enable development in the digital health space?

"Today, if you want to connect with healthcare institutions, you must do so one by one, often through proprietary systems. Apple is one of the few companies on the planet that would attempt to connect consumers to the different Electronic Health Record (EHR) systems that exist, and perhaps the only one capable of pulling it off.

"If they do – and the early signs are certainly promising – the mass connectivity that will exist is like nothing we have seen before. From a consumer’s perspective, they can truly centralise and take control of their health records. By sharing this data with health apps, the personalization and user experience will far exceed anything currently available."

What sort of apps may benefit?

"Almost any health app can benefit in one way or another. ... Being able to share clinical-grade healthcare data directly could greatly enhance the service a healthcare professional is able to give."

How might humans benefit?

"It can be life-saving. Next to the above example of remote healthcare, we see the potential to effectively avoid dangerous drug-drug interactions. Both new and existing apps will be able to work with a much more detailed layer of personalisation with no extra (in fact, less) effort on behalf of the user.

MyTherapy MyTherapy co-founder Sebastian Gaede

"It gives people greater access to their healthcare information and encourages people to take a more active role in their care. This has been shown to actually improve patient-doctor communication, while having a positive effect on aspects such as medication adherence."

To what extent might these technologies enable democratization of healthcare, making it more accessible?

"Democratization of healthcare must happen, and it will. It is unacceptable for people to have to fight to gain access to their health records to which they are legally entitled.

"Technology such as the Fast Healthcare Interoperability Resources (FHIR), the standard upon which Apple Health Records is built, is making huge strides in overcoming these obstacles.

"FHIR was developed with the intention of allowing different EHR systems to communicate with each other. However, the ‘last mile’ of healthcare, the connection from clinical systems to end consumers, so far has proven hard to crack. Apple Health Records is probably the biggest push so far for bridging it."

How can the API benefit your app?

"Setting up a medication reminder in MyTherapy can only be done with user input at present. (Patients) must find their medication and dosage, and they must enter the details of their regimen.

"The Health Records API changes all of that and creates the possibility for reminders to be fully automated for prescription medications. This is a massive improvement – particularly for patients on multiple medications and also helps reduce error."

What do developers need to know as they approach the API?

"It was stressed to us at WWDC that the information the API is giving us access to is not processed by Apple at all.

"Health Records, rather, works like a gateway to the information stored on EHR systems.

"This means developers are going to have to be knowledgeable in processing FHIR data. FHIR is still a relatively new standard and by no means perfect, so developers will have to be prepared to meet new demands. For many developers of consumer apps, dealing with FHIR will be a new experience.

"For the time-being, data is also pulled every seven days unless the Apple Health App itself is opened (in which case the data is pulled every four hours).

"This is important to understand if you want to create a user experience around data that may have been entered by a provider just some minutes ago. There is every chance that Apple may improve this, but for the time being we must work within these constraints."

What other use cases do you see?

"In combination with Apple’s ResearchKit API, we believe the opportunities this presents from a research perspective are enormous. Each user’s clinical data is stored on their iPhone. Encryption is paramount and privacy must be water-tight, but the sheer volume of clinical-grade data that could be easily contributed for studies could be a true game-changer for clinical research."

How might the API scale across international markets?

"There is only so much Apple can do to ensure the success of Health Records and the API. By choosing FHIR as a foundation, they already went for a global standard. Technically, this makes releasing Health Records out beyond the U.S. absolutely possible.

"Our impression is that Apple is keen to test the water in the U.S. and closely track consumer response. If this response is positive – and we believe it will be – we can absolutely see Apple rolling it out internationally."

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