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  • Jonny Evans

Apple says it’s healthy to be skeptical about Digital Health

Is technology really good for your health? Can Apple really make a difference in future healthcare? Questions like this are all perfectly appropriate, argues Apple’s vice president for health, Dr. Sumbul Desai.

You have to test what tech firms claim

Desai leads Apple’s teams in developing health-focused software and sensors, such as Activity, Health, ECG reading on Apple Watch and the company’s selection of health-focused research apps. She joined the company in 2017.

While she clearly believes in the potential of digital health technologies, (as does her boss, CEO Tim Cook), she’s also a health professional in her own right, and understands how important it is that patients and healthcare providers be sceptical as big tech attempts to get into the market.

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Speaking at a roundtable discussion in London, she said: “The scepticism from providers and patients is healthy because you should ask questions, and make sure you’re using information in the way you should be using it,” according to i-newspaper.

She stressed that she believes the best approach to resistance is to work closely with healthcare providers and scientists and across the medical communities to make sure the digital health solutions tech firms provide are actually effective.

Proof is essential

In essence, that’s the big difference between true healthcare product and service provision and snake oil salespeople. In the absence of regulation or effective testing, any tech firm could claim its product delivers health benefits.

Stringent testing and the limitations of tight regulatory environments mean tech companies must move at a much slower pace than the “move fast and break things” workflow the sector is used to. You really don’t want to break things if those “things” are actually people seeking healthcare outcomes.

And that’s the challenge for all the digital health firms engaged in the application of connected technologies and health. It’s why you see so much of the focus in the space on prevention and lifestyle outcomes – as it’s perfectly permissible to say something “might” be good for your health, but not acceptable at all to say it “will be” good unless a product or service has been tested.

The need to evidence health-related claims is why Apple is investing in research to explore things like women’s medical conditions, hearing and heart health. It is also why the company works closely with key medical organizations such as the World Health Organization (WHO).

The data-grabbing thing

Many of the potential big picture outcomes around health relate to artificial intelligence, remote patient monitoring and data analytics – all of which rely on patient data in order to function.

The idea that your devices will be able to monitor your habits in order to pre-emptively warn you of an oncoming problem demands sensors to gather your data and machine intelligence to analyze that information.

For quite natural reasons, people are more protective of their health info than most other forms of personal data. That’s why Apple’s approach – it only gathers the information it needs to make its products work and lets users decide whether they want to share it with, for example, research projects – gives it an edge.

“It’s the user’s data and we only ever have access to it if the user is participating in a study they consented too,” said Desai. It helps even more that the information is never gathered in one place in the first place.

Of course, one place medical information is gathered is in your patient records, and this is certainly a space in which there is room for improvement. Many existing EHR systems simply don’t work well together; this is where Apple’s Health Records app is making a difference. (Desai spoke in a great deal of depth about this just last year). Once a patient’s data is held on devices equipped with up-to-the-moment personal health data as well as historical data, that’s an opportunity for data analytics to come into its own.

This is the kind of thinking that’s evidenced by the atrial fibrillation detection feature inside the Apple Watch, the efficacy of which is confirmed by the sheer number of reports of people whose lives have been saved by these devices.

The only question around these solutions will be if data is handled privately on the device, or in public using cloud-based systems. The former is secure, if limited by the size of machine-learning models used and device processor efficiency; the latter is far less private and therefore more open to abuse. There is some work to do until our primary care provider really sits on our wrist, but Apple seems to be committed to engaging in that task.

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