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Technical Doctor's insights and information collated from various sources on EHR selection, EHR implementation, EMR relevance for providers and decision makers
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As Health Apps Hop On The Apple Watch, Privacy Will Be Key

As Health Apps Hop On The Apple Watch, Privacy Will Be Key | EHR and Health IT Consulting | Scoop.it

One day soon, you may be waiting in line for a coffee, eyeing a pastry, when your smart watch buzzes with a warning.


Flashing on the tiny screen of your Apple Watch is a message from an app called Lark, suggesting that you lay off the carbs for today. Speak into the Apple Watch's built-in mic about your food,sleep and exercise, and the app will send helpful tips back to you.


The notion of receiving nutrition advice from artificial intelligence on your wrist may seem like science fiction. But health developers like Lark are making a bet that Apple's first wearable device, the Apple Watch, will fly off the shelves and this kind of behavior will become the norm.

Lark is just one of over a dozen health developers with new apps for the Apple Watch, which ships to consumers this week. These apps range from medication management to a button that provides instant, virtual access to a doctor.


Apple has made no secret of its health and fitness plans for the Apple Watch. And in recent months, it has recruited medical experts to work on services like ResearchKit and HealthKit, which aim to open up the flow of health data between consumers, mobile developers and medical researchers.


But is Apple doing enough to protect the privacy of your sensitive health data?


In advance of the Apple Watch's release, the company has taken some steps to put you in control of how your data is shared. You can choose to share health information with third-party apps like Lark via Apple's Health app, which comes with the device. Your health data, collected via the Apple Watch or the iPhone, is stored on Apple's HealthKit.

"Apple is leaving your HealthKit data on the device and not collecting it," said Morgan Reed, executive director at The App Association, a Washington, D.C., nonprofit that works with patient advocates and app developers.


According to Reed, this prevents third-party app developers from selling your health data without your consent.

"It also means that if an employer wants access to your health care information, they would have to demand that you give it to them," he said.


But it's still early days for the Apple Watch, and it remains to be seen whether health developers will follow Apple's privacy guidelines.

"We haven't had a developer ecosystem for a product like a smart watch," said Ben Bajarin, who specializes in consumer technology for Creative Strategies, a consulting firm. "This is [uncharted] territory."

A Message On The Wrist


Health app developers hope the Apple Watch will improve how doctors and patients communicate.


Imagine a doctor receiving a buzz on the wrist for an e-prescription request, which could be approved with a few taps. A patient could receive a similar alert when test results are available.


Developers are exploring these possibilities and more.

"We are predisposed to small changes on the skin. It was not that long ago — and is still the case in parts of the world — that mosquitoes used to kill us with a light touch," said Ron Gutman, chief executive of HealthTap, a website and mobile app for secure video calls with a doctor.


"It is so easy to turn off a notification from a website, but you can't ignore what's on your wrist," he said.


Gutman was so intrigued by Apple's smart watch that he developed three apps: one to help you manage your meds; another that connects you to a doctor with the touch of a button; and a third, which helps physicians reach new patients.


"Be prepared to take charge of your health information, and feel free to say no to sharing data with apps."

- Morgan Reed, executive director at The App Association

Managing Medications


For patients who are juggling a variety of meds — all with different dose requirements — an Apple Watch app that sends alerts to the wrist could prove useful.


WebMD, used by millions of people to check their medical symptoms, tossed around a bunch of ideas before settling on medication adherence.


"All we wanted is for the user to be reminded that it's time to take their medication, and then quickly tell us whether they plan to take it or skip it or snooze," said Ben Greenberg, who heads up WebMD's mobile products. "That interaction demands so little." The app also instructs people whether to take their medication with food, or at a certain time of day.


Other companies that are developing medication adherence apps for the Apple Watch include MangoHealth, which can also tell you how well you've managed your prescriptions over time, and pharmacy giant Walgreens.


Appealing To Doctors


Some app developers hope that doctors will flock to buy the Apple Watch to help them manage an overload of patient information.

"Doctors are finally getting amazing hardware that just works, and they're willing to pay a premium for it," said Daniel Kivatinos, cofounder of Drchrono, an electronic medical record company.


Using Drchrono's app for the watch, a doctor can receive alerts, such as when a patient has arrived at their office.

The watch could prove useful in helping doctors communicate with each other about tricky medical cases. Doximity, the Facebook for doctors, has developed a secure app that care providers can use to dictate notes, send messages and receive notifications that a fax has arrived.


But the Apple Watch's appeal may be limited to certain specialties, such as family physicians and dermatologists. Surgeons routinely remove their rings and watches before procedures, to ensure their hands stay sterile.


Moreover, doctors will need to do the work to ensure that apps they use are taking adequate steps to protect patient data. Apps may say that they are meeting privacy requirements, but most aren't properly vetted. The government has long been concerned about the proliferation of mobile health apps that make false or misleading medical claims.


Opportunities And Challenges


Privacy experts and policymakers have been worried about developers that collect and sell personal health information.


The U.S. Federal Trade Commission concluded in a recent study that developers of 12 mobile health and fitness apps were sharing user information with 76 different parties, such as advertisers.

Apple has responded to some of these fears by barring developers from selling health data that it collects via Apple devices to advertisers. After some high-profile hacks to celebrities' accounts, Apple also forbade developers to store sensitive health information in iCloud.

"Apple has clear privacy rules, but consumers should still be on guard," said Reed from the App Association. "Be prepared to take charge of your health information, and feel free to say no to sharing data with apps."


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Drchrono Announces EHR for Apple Watch to Improve Doctor Visits

Drchrono Announces EHR for Apple Watch to Improve Doctor Visits | EHR and Health IT Consulting | Scoop.it

drchrono, an award­-winning Electronic Health Record (EHR) which includes all of the benefits of billing, practice management and an records in one place, will be the first to offer an integrated EHR on Apple Watch on April 24. The company is a leader in health technology: they were the first to build a native electronic health records (EHR) application for the iPad, offer developers an open healthcare API, a first-and-only EHR integration with Square and data sync with Box.


The drchrono Apple Watch app will revolutionize the physician office experience by providing automated, real-time communication between healthcare providers and patients. Physicians will be able to quickly view a patient’s information on their wrist, respond to patient messages via quick text and view a patient’s prescription refill request, all without having to access the EHR on their phone, iPad or web. As such, the app will be a seamless extension of the drchrono ipad, ipad, web and cloud experience.


“The drchrono Apple Watch app was designed with doctors’ busy lives in mind and is intended to make medical professionals more productive, efficient and organized,”  says Michael Nusimow, co-founder and CEO of drchrono. “Doctors are incredibly busy;  drchrono on Apple Watch gives them insights about their practice and patients just by checking their wrist. Its simply amazing to have a hands free way to gather quick insights about a patient.”


Each Apple Watch “mode” will be utilized to optimize for a physician seeing patients or on-rounds. For instance, “Glance”, which is the watch’s quick view mode will offer doctors a snapshot of their schedule. “Short Look Notifications” or short reminders, will be used to display chats or messages generated from the EHR app; a common use case could be chat messages from colleagues reminding doctors to wrap things up in advance of their next appointment. Finally, the “Long Look Notifications” mode, will offer a doctor a view of the app itself.

The drchrono Apple Watch app will be available from the Apple Watch App Store on April 24.


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drchrono preps EHR, PHR for Apple Watch

drchrono preps EHR, PHR for Apple Watch | EHR and Health IT Consulting | Scoop.it

The first developer to make an EHR exclusively for the iPad is now aiming to be the first choice for physicians and patients looking to make the most of their new Apple Watches.


When the Apple Watch first becomes available from select retailers April 24,  Mountain View, Calif.-based ambulatory EHR developer drchrono will be ready – just as is it was five years ago, when a newfangled contraption called the iPad first hit stores.


At HIMSS15 in Chicago this past week, Daniel Kivatinos, drchrono's co-founder and chief operating officer, demonstrated new software for the Apple Watch that had been in the works for months – since Apple first put out the software development kit for the device.


"The moment they release the SDK, we can build a simulator app, even though we don't actually have the physical hardware," said Kivatinos. "We did the same thing with the iPad: When we heard about the iPad in 2010, we downloaded the SDK prior to the actual hardware being released.


"The moment the physical hardware came out for the iPad, we released the app in the app store," he added. "Same situation here: The moment the physical hardware comes out, our app will be available."

Kivatinos says drchono plans to be among the first to offer an integrated EHR as soon as Apple Watch becomes available. He's excited about the device's potential to transform the office experience for doc early adopters, offering a new twist on real-time communication between physicians and their patients.


"We've thought about this a lot: What is our company, what do we do?" said Kivatinos. "Over the past several years we've realized we're creating wearable health records for doctors and patients."

With close to 70,000 physicians and more than 4 million patients registered on the drchrono platform, he said, both groups are poised to enjoy the benefits of this unique way of interaction.


"This is a completely new experience," he said. "For the first time, doctors are going to have information given to them with their hands free: A doctor could be administering a shot, picking up a child, moving an elderly person – looking at the information while doing whatever it is they need to do."


Likewise, said Kivatinos, patients should be drawn to experiencing their personal health records through a device on their wrists, using drchrono's app to schedule appointments, get medication reminders and manage their chronic diseases: "Apple creates a very nice experience for patients. It's not just about usability, it's about enjoyment."


The app will enable docs to view a patient information at a glance, respond to messages via quick text and see eRx refill requests – offering a wearable extension of the drchrono iPhone and iPad apps, according to drchrono.


"Doctors are incredibly busy; drchrono on Apple Watch gives them insights about their practice and patients just by checking their wrist," said CEO Michael Nusimow in a press statement. "Its simply amazing to have a hands-free way to gather quick insights about a patient."

Plenty of other vendors have already readied software for the Apple Watch's release, of course, and many of them were showcasing it at HIMSS15. Epic, Cerner, athenahealth, Vocera, Mayo Clinic and more all announced apps – or plans for apps – at the show.


Kivatinos said he's confident drchrono's early leadership among curious early adopters of Apple technology will keep them well-positioned among physician practices.


"If you look at the early days in 2010, we put our (iPad) app out the first week and had thousands and thousands of docs download it," he said. "It took some of our competitors years to get to that point."


Physicians "want innovation, but they want it to work," said Kivatinos. "We had one doctor who bought a $100,000 EHR, and came to us a week later and said, 'This doesn't work. What do you guys have?' He literally just junked it. If it doesn't work, they're just going to walk away."

The critical questions? "Is it usable, is it designed well, can I just put information into it and walk away quickly? Can I just do my rounds? I don't want this thing in my way."


The company touts different "modes" for the Apple Watch app, depending who's using it and how. "Glance" offers a quick view, giving docs a snapshot of their patient schedule for the day. "Short Look Notifications" can display brief messages generated from the EHR app. "Long Look Notifications" offer a doctor a view of the app itself.


Kivatinos says he's "100 percent" certain the Apple Watch is going to catch on in a big way among consumers – and his customers.

I wonder aloud whether the embrace might be more tepid – something akin to a new form factor such as Google Glass, which found limited acceptance among the general public, but is still enjoying innovative clinical use cases.


Kivatinos says he's convinced it's an Apple to oranges comparison. Glass, with its temple tapping and head nodding, necessitated a new and sometimes questionable type of social etiquette, he said. The "experience was a little different: harder to set things up and install," he said – to say nothing of the cost.


"I bought a Google Glass. It cost $2,000 with prescription lenses," he said. "$2,000 and $350 is a drastic difference. Price point is so critical."

Whether it's docs looking for easy access to vital signs, staff messaging, e-prescriptions and labs; or patients looking for an attractive and convenient interaction to manage their meds or schedule appointments, he's convinced the Apple Watch will find favor among folks and physicians alike.



"The interest is amazingly high," he said.


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