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Major LA hospital integrating HealthKit data into patient records, but unclear if they can opt out

LA’s Cedars-Sinai Medical Center is now integrating HealthKit data into patient records to provide doctors with a more comprehensive picture of the health of the patients they are treating, reports Bloomberg.

The hospital updated its online medical records system this weekend, turning on access to HealthKit for more than 80,000 patients, Darren Dworkin, chief information officer at Cedars-Sinai, said in an interview.

“This is just another set of data that we’re confident our physicians will take into account as they make clinical and medical judgments,” Dworkin said.

Tim Cook said back in February that he thought this type of use of HealthKit would be “profound” … 

The Apple CEO said then that users would see real benefits.

“HealthKit, I think, is going to be profound because it enables you to take all of the information from different apps and if you desire to you can share that information with a physician, you can share it or you can place it in a way that you can begin to correlate the data and find out some pretty interesting things about your health and be able to monitor it.”

One potentially controversial aspect of the Los Angeles hospital’s decision is that use of HealthKit data is opt-out, rather than opt-in. From a quote by Dworkin, it even appears there may be no way to opt-out while still using HealthKit.

Rather than turn it on as sort of an opt-in, we’ve basically enabled it for all of our patients. The opt-out is just don’t use it.

Tim Cook specifically referenced HealthKit users being able to make the choice, saying “if you desire to, you can share that information with a physician” (our emphasis). We’ve reached out to Mr. Dworkin for a comment on this, and will update when we receive one.

Apple this month announced a partnership with IBM to use HealthKit and ResearchKit data for medical research on an opt-in basis. Apple made its ResearchKit platform open-source, allowing researchers and developers to distribute data through compatible apps.

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Comments

  1. Colby Landwehr - 9 years ago

    It is good to see the healthcare industry taking an interest in new technologies that could give a more in-depth look in to a patients daily life. Hopefully Tim is right and this will bring a profound change.

    • markbharr - 9 years ago

      Hopefully, the healthcare providers will put a little more thought into this than these buffoons. Patients need to provide opt-in permission, not this “We will take your data because we know better than you do”. It looks like the only opt-out is to not use Cedars-Sinai, which may be the most appropriate action.

      • Misreported. Of course it’s opt-in. How on earth could the Hospital even get access to one’s Healthkit data and associate it with a patient record unless that patient provided them with the ability to do so?

        FFS.

  2. Gregory Wright - 9 years ago

    I must say hospital higher ups make it seem a patient records are very important. The reality is doctors today rely more on a patient lab work than anything else. This is because in order for a medical practice to make any money the office must have a few thousands patients and few doctors to attend them. A PCP and specialists don’t have the time to research a patient’s history. Lab work and the initial examination is what counts. Sure, a patient history is important but the important part of a patient history is obtained during the interview. If the patient is seeing the same doctor all the time the doctor already knows the patient history. I think to much emphasis is put on medical records.

    • Benjamin Rapoport - 9 years ago

      Gregory,

      Actually, as part of the Electronics Health Records requirements of the ACA (Obama-care), all Hospitals are required to implement systems that allow for a patient records to be accessed by other healthcare institutions. For instance, many hospitals when admitting a patient will automatically be notified that a patient has records at another healthcare provider. It even allows for importing those records with a mouse click. But many private practices don’t participate in systems that share at this time, and that can still be an issue. If your PCP has a relationship with an area hospital, then it is possible your records are bing shared, and this could be important in an emergency.

  3. bfredit - 9 years ago

    WAT.

    From what I read, HealthKit’s data stays on the phone and it’s never synced to iCloud. This means that the patients have to

    • install the hospital’s app,
    • log into their hospital accounts, and
    • allow access to the HealthKit data,

    right? Am I missing something?

  4. nana (@purplemaize) - 9 years ago

    Not all Healthkit apps are availible to 4s iPhone there is a limit, I only can get 2 apps on my phone.

  5. Benjamin Rapoport - 9 years ago

    This is confusing article by Bloomberg and is missing some important facts.

    HealthKit data (seen in the iOS Health App), cannot be accessed by a hospital’s Electronic Healthcare Record (EHR) software unless the iPhone user authorizes it by giving permission. Here are the steps required to share information if your doctor actually wishes to receive it and review it. Something that not many in the profession are actively considering.

    Epic (www.epic.com) is one of the nations largest EHR software developers to the healthcare industry. They are in large hospitals, and manage every department along with out-patient clinics, urgent care facilities and practices that are affiliated with the hospital.

    I happen to use UCLA Healthcare and Cedars Sinai for my family. I recently signed up for UCLA Healthcare’s patient portal at: https://my.uclahealth.org/MyChart/

    In order to gain access to my medical chart I was given a form at recent visit. The form explained how to sign up and contained a special access code. I was given the form and code in person, after providing my ID. Once in the portal I could see my past visits, meds, prescriptions, lab results, etc.

    Epic makes the software for UCLA and Cedars Sinai, as well as many other large healthcare providers. They also make an iOS app called MyChart. The app allows you to connect to the same data you get at the UCLA site, but it is shown within the App. I see the exact same information in both.

    What Cedars Sinai has supposedly done is activate the ability within their system to request data from a patient’s iPhone. To do this several things need to happen. First the doctor would want to be notified directly about something HealthKit monitors and have it uploaded directly to your medical chart, rather then you making an appointment or calling the doctor. If the doctor decided it would be beneficial for your iPhone to notify them automatically when something is abnormal, they could create an order within the hospitals system, similar to a lab order.

    In discussing this with EHR professionals, I understand the process to be as follows: The doctor would go into your medical chart, and if they see you have already linked your MyChart iOS app with the hospital’s EHR system, would have an option to request a specific dataset, such as your Blood Glucose level from the MyChart App. The request would be downloaded to the MyChart App the next time you login, and I assume some interaction is required within MyChart to confirm what data is being requested. But regardless, Apple’s HealthKit will prompt you for permission for MyChart to access HealthKit.

    If you accept, then MyChart would upload that data only when a specific condition is met as defined by your doctor in the order. When that result is uploaded and added to your EHR chart, the doctor who ordered it is notified, and the result is reviewed. It is the same process they use for an x-ray, lab test etc. Only its being requested from your iPhone via the MyChart App. Since patient medical records are involved here, the app should be HIPAA compliant in terms of transmitting and receiving data securely.

    The MyChart App HealthKit integration is reported to be very insightful, in that it offers healthcare professionals the ability to request precise and individually definable data points that they believe will help in providing care, and avoids sending large databases of personal information that would be time consuming and not helpful.

    If Cedars is actually allowing this, then the future is truly here, since most hospitals have not implemented that feature. I will have to visit one of their location so I can signup for their EHR patient portal and see how this works first hand.

    I found very useful information here:
    https://catalyze.io/blog/how-the-epic-healthkit-integration-actually-works/
    As well as discussing this with individuals who are familiar with Epic’s EHR system.

    Benjamin

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Avatar for Ben Lovejoy Ben Lovejoy

Ben Lovejoy is a British technology writer and EU Editor for 9to5Mac. He’s known for his op-eds and diary pieces, exploring his experience of Apple products over time, for a more rounded review. He also writes fiction, with two technothriller novels, a couple of SF shorts and a rom-com!


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