Apple expands effort to give patients iPhone access to medical records

Tech giant partners with 39 health systems and leverages HL7’s FHIR interoperability standard and OAuth 2.0 security profiles for authentication.

Apple has launched an enhancement to its Health app that enables patients at participating U.S. hospitals and clinics to get access to their medical records from multiple providers on their iPhones.

Previously, 12 major providers—including Cedars-Sinai, Johns Hopkins Medicine and Penn Medicine—were able to make the Health Records feature available to their patients as participants in Apple’s beta software program. However, patients from 39 healthcare organizations now can view their medical records, in read-only mode, on their iPhones by updating to the new iOS 11.3 mobile operating system.

Also See: Apple update to enable users to see health records on their iPhones

The enhanced Health Records section within the Health app enables patients to see medical data— encrypted and protected with the user’s iPhone passcode—gathered from various healthcare institutions and presented in a single, aggregated view. Patients also receive electronic notifications when their records have been updated by providers.

Apple is leveraging HL7’s Fast Healthcare Interoperability Resources (FHIR) standard for transferring electronic medical records and OAuth 2.0 security profiles for authentication to enable patients to securely access their health data on their iPhones.

“I have long believed that the best solution to healthcare information exchange privacy and policy challenges is to make patients stewards of their own data,” says John Halamka, MD, chief information officer at Boston’s Beth Israel Deaconess Medical Center. “Apple has enabled that to scale using national standards.”

The 39 U.S. healthcare organizations currently offering the service to their patients include (by region):

Northeast and Mid-Atlantic
  • AtlantiCare
  • Geisinger Health System
  • Johns Hopkins Medicine
  • LifeBridge Health
  • NYU Langone Health
  • Partners HealthCare
  • Penn Medicine
  • Thomas Jefferson University Hospitals
  • Valley Medical Group
  • Yale New Haven Health and Yale Medicine
  • Cerner Healthe Clinic
  • CoxHealth
  • Mosaic Life Care
  • Nebraska Methodist Health System
  • OhioHealth
  • Rush University Medical Center
  • Southwest General Health Center
  • Truman Medical Centers
  • The University of Chicago Medicine
  • Adventist Health System
  • BayCare Health System
  • The Duke University Health System
  • MedStar Health
  • Methodist Le Bonheur Healthcare
  • Mission Health
  • Ochsner Health System
  • Ortho Virginia
  • TSAOG Orthopaedics
  • UNC Health Care
  • Vanderbilt University Medical Center
  • WVU Medicine
  • Cedars-Sinai
  • Dignity Health
  • Eisenhower Health
  • Providence St. Joseph Health
  • Scripps Health
  • Stanford Medicine
  • UC Irvine Health
  • UC San Diego Health
“We’ve been at this for about a year with Apple,” says Shez Partovi, MD, Dignity Health’s chief digital officer and senior vice president of digital transformation. “Patients change insurance (and) change doctors, and because of that they don’t have a single place with all of their records together. So now, as these participating organizations increase, you will have a place for all of your records—wherever you’ve been seen—that are actually with you on your iPhone.”

Alistair Erskine, MD, chief informatics officer at Geisinger, says the Danville, Penn.-based provider was one of the original 12 healthcare organizations that participated in Apple’s beta program and is now among the 39 providers offering the service to their patients to empower them to make better informed decisions about their health.

“In order for our patients to participate in this program, they must have a patient portal account,” says Erskine, who adds that authentication through the Health app is set to use the same login credentials as Geisinger’s patient portal. “The OAuth 2.0 mechanism is what’s being utilized with Apple. The bottom line is that patients don’t have to come up with yet another user password and—more importantly—they don’t have to re-enter the password every time they try to access the record.”

Likewise, Mike Restuccia, senior vice president and chief information officer at Penn Medicine, says his institution’s offering of the Apple Health Record on the iPhone requires patients to have an account on Penn’s patient portal—myPennMedicine.

“I was one of the beta participants, and the data just flows into your iPhone, including lab results, medications, and conditions—it’s very powerful when it’s right there at your fingertips,” adds Restuccia. “We didn’t have to do anything unique—we just had to abide by the FHIR standards in exchanging patient data, in addition to establishing a secure connection, which goes without saying.”

However, Dignity Health’s Partovi emphasizes that Apple does not create, receive, maintain or transmit protected health information and that when health record data is transferred from a healthcare organization to the Health app, it is encrypted and does not cross Apple’s network.

“We are hosting the data for the patient,” observes Partovi. “Apple doesn’t have a copy of the patient data.”

Yauheni Solad, MD, medical director for digital health at Yale New Haven Health, calls the Apple initiative one of the first examples of a widespread implementation of the FHIR application programming interface and a critical component of the success of Apple’s Health Records.

“The other enabler is many healthcare institutions finally have an electronic medical record that they can share data with,” believes Penn’s Restuccia. “That is why it was so hard for Google and Microsoft to succeed years ago.”

Nonetheless, Geisinger’s Erskine points out that if an organization does not have an EHR system from one of the larger health IT vendors such as Cerner and Epic “it may be harder to establish a path to connect to Apple Health Records.”

“I can’t speak for the other EHR vendors, but Epic did a really nice job making it pretty seamless and easy for us,” comments Andy Crowder, chief information officer at San Diego-based Scripps Health. “From the time that we said ‘go’—meaning we were going to do this—it took us about two weeks. The ability to turn this on was so easy for our organization.”

For healthcare organizations wishing to register with Apple to participate, additional information is available here. The company says registration is only available to U.S. medical facilities, and that it “does not charge institutions any fees for registration or to maintain a connection.”

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