Alongside the much anticipated final details on the Apple Watch, the company announced on Monday partnerships with several hospitals and related software to allow end users to participate in medical research through their iPhones. I’ve tracked a wide range of technology companies over the years as they’ve tried – and largely failed – to break into the healthcare industry and use technology to transform key processes. Many things have held these companies back, not the least of which is the heavy regulation which applies to healthcare. But one thing Apple has done differently has enabled it to breakthrough where others have failed.
From enterprise-out to consumer-in
Essentially, all of the healthcare technologies I’ve seen from various companies over the years start with some key process from the perspective of the hospital, the provider, the doctor or administrators, with patients often a secondary concern, if they’re involved at all. It’s usually about digitizing records, giving doctors apps to write prescriptions, installing new equipment in hospitals, and so on. It’s what you might call an “enterprise-out” approach to healthcare – in other words, it starts with the business end and works its way out to the patient. What Apple has done is turn this on its head by empowering the patients themselves to take their health and related information into their own hands, generate data that can be used in studies, and feed it directly to the institutions that need it. By contrast to the historical approach, this could be described as “consumer-in” – the solution starts with consumers and goes from there. By turning the traditional model around, Apple has broken through in a way few other companies have been able to and will make a meaningful difference as a result.
The base that sells Watches can also do good
Of course, ResearchKit wasn’t the only thing announced on Monday. The main event was arguably the Apple Watch. But it’s the very same base of iPhones (700 million sold, we were told in the keynote) that allows Apple to have high confidence of selling lots of Watches that enables them to produce a solution like ResearchKit. The only reason hospitals are willing to work with Apple is it has this massive installed base of devices which are capable of feeding them the kind of data they need. And Apple has the distribution mechanism in the form of the App Store to publicize and make available the applications which are at the core of the solution. I was asked by at least one reporter today whether ResearchKit would help Apple sell more iPhones and the honest answer is I doubt it. Yes, there might be some people with chronic health conditions who currently use an Android and who switch to be able to participate in a study. But this isn’t about Apple selling more of anything.
I’ve mentioned before I have a smart friend who’s also something of an Apple fan, who suggested last summer that perhaps the genesis of Apple’s HealthKit and related activities was Steve Jobs’ own health challenges in his later years. He must have found working with the healthcare system enormously frustrating and felt, as many of us do, unempowered throughout the experience. Think of how ResearchKit transforms the experience of someone who feels powerless because of a chronic illness, forced to visit hospitals or doctors’ offices frequently for tests and measurements, often themselves dehumanizing. I don’t think ResearchKit is about selling more Apple gear at all – I think it’s about helping to solve some of the more real and meaningful challenges people deal with in their everyday lives. The fact Apple is open-sourcing some of the software is another sign this isn’t about just reinforcing the Apple ecosystem. I suspect that, even if the spark behind all this was rooted in Steve Jobs, it’s Tim Cook’s more philanthropic Apple that’s making it happen in this way.
Apple’s partnership approach at work again
The other key feature of all this is Apple is far from doing all this work by itself. ResearchKit grew out of close partnerships with hospitals, doctors and universities. Just as Apple Pay was hugely reliant on partnerships with card issuers, banks, and merchants, and the success of iTunes was based on partnerships with content owners, so ResearchKit wouldn’t be possible without these other institutions. For all the criticism of Apple’s closed approach to doing things, it’s often its very willingness to work closely with partners that makes breakthroughs like this possible.
Just the beginning
Of course, I’m not naive enough to believe Apple has suddenly solved the world’s healthcare problems in one fell swoop. ResearchKit is a very targeted solution to a very specific problem, that of medical research. Much of healthcare remains hidebound and undisrupted by technology. But Apple’s consumer-in approach and the power of its installed base of devices could be helpful in a whole range of other settings within healthcare, with its current Health app and HealthKit tools as the foundation but with much more innovation taking place around them and around iPhones and their potential to track things. The Apple Watch, of course, also has great potential for being part of this picture, with the additional health data it captures. I suspect what we’re seeing is just the beginning of the transformation in healthcare that’ll be possible through the combined power of Apple’s installed base and the experts it works with to create solutions that start with consumers and the devices they already have.
I was very pleased to see that ResearchKit will become open source.
In the video segment that played at the end of the ResearchKit presentation, the point was made about how difficult it is to get even a couple hundred people to participate in long term medical studies –and how the people who do are generally not a representative cross-section of the population.
This open source initiative should go a long way in helping medical research.
What I strongly felt from the announcement is that Apple is going head first into health. They are not afraid to go very, very close to what would be regulated, and I’m sure their current trajectory will take them to the point that they will have to face it. And I sensed that Apple is preparing themselves for that.
To really work in health, to really disrupt health, you have to face regulations. You can’t try to work around it like Uber has done, face bans and become the public enemy of governments around the globe. That will not work. And I think Apple is prepared to go into this.
Yes, this is just the beginning. But given the monstrosity and inefficiency of health care systems around the world, the difficulties involved in setting up research trials and getting reliable data, and the huge costs and barriers involved in drug development, this is definitely a market worthy of disruption.
I hope that Apple continues along this path.
While I do agree and hope that mobile IT can and should disrupt health care, I really don’t want that to be used as a lock-in tool. The generated data needs to be secured, and standardized. If only because most won’t be able to afford a $600 phone to link up to a $400 watch, when a $200 phone + $200 watch can provide the same services.
Well at least Apple open sourced HealthKit, for what it’s worth.
I think the hurdle here is not really the technology nor the APIs, but the willingness to work with regulative authorities. Regulation is that big in healthcare, and it’s big for a reason. If Google is willing to work really hard on that, they I see no reason why they will be locked out.
My concern is whether Google will find the incentive to do this.
Yet another “2+2” post that fails to make the leap to “4.”
Healthcare is an enormous market http://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_(PPP)_per_capita
but it has been relatively impervious to technological progress. Yes, we have clever drugs and expensive scanners. However, there are a huge number of other things where much work has not really started in earnest: diagnosis, promoting healthy behaviour, monitoring chronic conditions, delivery of care, research, paperwork, etc. Apple is not a match for all of these things, but they can make very meaningful contributions to some of them. They are smart enough to know that they cannot be involved in the detail of all of it, hence the partnerships and their work on creating supporting platforms.
It will be exciting to see the application of modern technology to delivery of healthcare. As for lock-in; that is really a problem of success, i.e. you worry about that if it ever happens. As for Google, they may poses technical prowess, but their one-trick-pony of monetizing everything by way of ad revenue based on data-grab is not a good match for healthcare.
I’m not sure I get your point: Research kit is not about a patient’s health care, but about research. I’m not aware of any impact to an individual’s treatment participation will have, am I missing something ? If it’s only about research, lots of projects have a similar outpatient protocol, but with dedicated hardware, so it woudln’t really be a sea change as much as a convenience, if Apple’s sensors cover what researchers need ?
Just using existing hardware rather than dedicated new hardware is a huge game-changer. And this way patients can opt in rather than having to be explicitly found and invited.
not “patients” though, but “panel members”.
They’re all patients in that they’re all suffering from a specific disease. Eg Parkinson’s patients.
to me:
1- “patients” = receiving treatment
2- “test subjects” = being experimented on
3- “panel members” = being observed, possibly after being selected via filters (demographics..).
Since research kit participants are neither receiving treatment in the context of their participation to the project, nor testing anything (drug, food, activity…), so they’re panel members selected for a specific condition. The relationship is purely one-way.
patient can also mean “suffering from a condition” but is less negative than “X sufferer”. Doesn’t have to mean you’re receiving treatment. E.g. a cancer patient
Some people have started to pick this apart.
https://statsdoc.wordpress.com/2015/03/10/apples-researchkit-is-not-yet-ready-for-primetime-a-medical-researchers-perspective/
Well I have the opposite opinion of the article you linked to, and I think it correctly addresses significant and sensible issues around medical research. In the absence of details from Apple, I think it is totally appropriate to raise these concerns.
Medical research is complicated and it is very naive to suggest that a single open-sourced framework, even if it comes from Apple, is suddenly ready for every researcher to use. In fact, I’m absolutely sure that it isn’t ready for prime time. As with any research method, it has to be checked, scrutinised and compared with previous studies until the research society will even accept the results.
However, ResearchKit is a new approach with a lot of promise. That in itself is, I think, worthy of attention.