Apple sees FHIR as way to liberate patient data

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As healthcare seeks to solve its interoperability challenges, tech giant Apple is positioned to empower data-sharing on a massive scale with consumer mobile apps that use emerging industry standards.

In particular, 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 consumers to securely access their health data on their iPhones.

“Standards are only real if they’re used—and, if they’re used at scale,” said Apple’s clinical informatics lead Ricky Bloomfield, MD, on Wednesday at the Office of the National Coordinator for Health IT’s Interoperability Forum in Washington. “If any of you have an iPhone in your pocket running the latest version of iOS, you likely already have a FHIR app on it. That’s a real FHIR app, not some pretend or watered-down FHIR app.”

According to Bloomfield, the Apple Health app has been available since 2014 and “makes it very easy” for users to manage their healthcare information such as activity levels, blood pressure, glucose and nutrition. “Third-party apps can read and write to your database—which is secure on your phone—and you as a user have complete control over who has access to the data,” Bloomfield told the conference.

He also noted that in January, Apple announced a FHIR-enabled Health Records feature that now enables patients of hundreds of hospitals and clinics to access medical information from various healthcare institutions and to organize it into a single aggregated view on their iOS devices.

Patients “securely download” their EHRs “directly” from those health systems, observed Bloomfield, adding that the data “does not traverse” any Apple servers. “It’s a secure, private connection to you,” he said, emphasizing that the information “rests securely on your device” and “represents a single, longitudinal record which is easy to understand” and can be updated automatically when new records are available.

“We do feel that it’s very important to be completely transparent to the user regarding the data that’s on their device,” added Bloomfield, who reiterated that the data is “usable in its raw form to the user so that nothing is hidden whatsoever.”

While the Apple Health Records feature is currently available in a “view-only” data state and is a “small but useful step” to enable patient access to the information, he remarked that “we’d rather do something more with it.”

Towards that end, Apple in June announced the availability of a Health Records API in an effort to enable developers to create an ecosystem of apps that empower patients by communicating with Apple’s HealthKit—provided they have users’ permissions—to access and share this data.

Also See: Apple Health Records API owes much to FHIR standard

“I am tremendously optimistic about the state of the health IT ecosystem today,” concluded Bloomfield. “I think we’re at a unique period of time where we have this convergence of the technology required. I think FHIR has a lot of promise—and OAuth—and the regulatory piece where we see requirements in the 21st Century Cures Act promoting interoperability.”

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