"My watch is saying I'm going into Afib, but it also says I've got that call in 5 minutes...what to do?!?!"

-the dilemma of an Apple Watch user-

I don't own an Apple Watch, but Apple is convincing many that wearable health monitors are the next cool must-have gadget. They have had massive success with their other products, but now there is a watch that can track and report personal data, upload it to Apple's mobile EHR app, and give the option to allow academic studies to use the de-identified data. They are part of the wave of big tech companies that are looking to tie into the growing healthcare tech market that could be worth $509.2 billion by 2025.

We recently wrote a post about Google and their ventures into patient health information (PHI) storage. Apple has a different approach and track record. Where Google leads the industry in online search, Apple has been a leading innovator in hardware design and user experience. How do they intend to leverage their position in healthcare?

The Apple Watch is a piece of hardware made to take part in the emerging personal health wearables market complete with an EKG monitor. On a call in late 2019, Apple CEO Tim Cook noted that "Wearables revenue was up 54 percent, a significant contributor to the company's overall growth." They have created a health monitor that is being widely adopted by the general public, giving them an inroad into healthcare through hardware. The Apple watch has FDA approval as a medical device. They are also prohibitively expensive, and some people who could benefit from its features may miss out. But Apple has been making some partnerships with insurance companies to get the watch on some plans for the elderly.

With the ability to collect data on a large scale, Apple has entered into partnerships for research. Currently, they are participating in three studies:

• Women’s Health Study: In partnership with Harvard T.H. Chan School of Public Health and the NIH’s National Institute of Environmental Health Sciences (NIEHS), Apple has created the first long-term study of this scale focused on menstrual cycles and gynecological conditions. This study will inform screening and risk assessment of conditions like polycystic ovary syndrome (PCOS), infertility, osteoporosis, pregnancy, and menopausal transition.
• Heart and Movement Study: Apple is partnering with Brigham and Women’s Hospital and the American Heart Association on a comprehensive study of how heart rate and mobility signals — like walking pace and flights of stairs climbed — relate to hospitalizations, falls, heart health and quality of life in order to promote healthy movement and improved cardiovascular health.
• Hearing Study: Alongside the University of Michigan, Apple is examining factors that impact hearing health. The Apple Hearing Health Study is the first of its kind to collect data over time in order to understand how everyday sound exposure can impact hearing. The study data will also be shared with the World Health Organization (WHO) as a contribution toward its Make Listening Safe initiative. (Apple)

These partnerships give Apple credibility in healthcare, and the research gives Apple increased influence and hardware sales. Maybe not entirely altruistic, but it does make a positive contribution to healthcare and humanity.

The healthcare industry has been plagued by data breaches even before PHI became electronic. Some, (most notably Epic's CEO, Judy Faulkner), have cited security concerns about allowing third parties to handle PHI data. Apple's reputation for security and privacy is an asset as they make their case for trusted handling of this data. While no device is completely secure, they have been able to maintain a perception of being virus and hacker free. They reinforced their position on security and privacy with the controversial resistance to unlock the San Bernardino shooter's phone for government investigations. This reputation helps their effort to become a trusted source for health data services.

Apple has always been secretive as far as future ambitions. They signal that they are committed to offering more contributions to healthcare. They have recently hired New York City-based Columbia University Medical Center cardiologist David Tsay, MD. He will join other physicians who Apple has attracted. Will they expand on mobile EHR for patients and make a move into clinical EHRs? Their success with simple, functional, feature-rich software would be a welcome improvement to the current EHR options.

Tim Cook gave us a hint in a recent interview, "I do think, looking back, in the future, you will answer [the] question, Apple’s most-important contribution to mankind has been in health." They have made some interesting contributions already. What will be next?

(For the record...This was written on a MacBook Pro...but the writer does not own an Apple watch.)