Posted on: June 12, 2019

I wrote a few months ago about the exponential rise in the amount of personal health data generated by wearables like the Apple Watch. At the time, I mentioned that health information exchanges (HIEs) play a critical role in ensuring that data is available to providers when they need it—and doesn’t overwhelm them. So, why is that?

First, let’s acknowledge that all info is valuable. To someone. At some point. That said, the usability of all that information relies as much on the capability of healthcare information technology systems as it does the capability of the wearable generating it.

Right now, Apple Health connects to personal health portals within a few electronic health records (EHR) systems using FHIR technology, which means that, in theory, information can flow in both directions, both into a patient portal and out of one. Technically, consumers could connect their Apple Health accounts to multiple patient portals and then Apple could become the main source of bidirectional health information exchange.

The questions quickly add up. What if the consumer doesn’t have a provider portal account? What about all the one-off EHRs? What does Apple share back into all of these various systems?

Most EHR portals are unidirectional, meaning they don’t have the ability to take in information, only to send it out. So connecting to Apple Health may not help a consumer contribute their own information—it would only help them see what the doctor already has.

And even when wearable data can be contributed directly into the patient’s record, validating the data to make sure it’s correct is a significant concern. What if I put my Apple Watch on someone else, take their EKG and then send it through my patient portal to my doctor. What does that do?

At the moment, HIEs have advantages in communicating with wearables because they already have bidirectional capabilities. The federal government is setting the stage for one national HIE system, or a network of networks, which may also accommodate on-and off-ramps in one location and may serve the same purpose.

Still, we all need to work on the challenge of determining who needs what data, at what point, and which information is valuable. I compare it to my oil change light coming on 3,000 miles before I need an oil change. The car is essentially self-monitoring, so my mechanic doesn’t know if there is a problem. And the reminder warning is just one more piece of data to me, which isn’t valuable 3,000 miles out. The same information would be very valuable 50 miles out. More isn’t always helpful. And I never get my oil changed on time because I’m used to ignoring the light.

Thinking about the exchange of individual data that way, an HIE can ensure that providers receive notifications about exceptions or abnormalities in a patient’s health readings instead of being inundated by normal numbers. For example, if a person uses a home monitor connected to the HIE to track their blood sugar, their provider will only be alerted to readings that are out of the normal range. In other words, at the 50-mile mark instead of the 3,000-mile mark.

At the same time, the connection between the device and the HIE lets a consumer see the effects of their exercise patterns, for example, on readings recorded by their providers—such as body mass index or blood pressure. That can provide validation of a consumer’s efforts to improve their health and encouragement to keep going. In turn, they may contribute to reduced healthcare costs by avoiding complications.

And isn’t that a major goal of the healthcare industry?

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