Apple is set to release a new iPhone (or maybe multiple phones) next week, along with a new version of its iOS that includes a “Health” app for storing medical and fitness data. It also comes with tools called HealthKit that software developers can use to hook into various apps and fitness tracking devices, like the Fitbit or Nike’s FuelBand, that people have been using to collect their heart rate, calories burned, cholesterol and blood sugar readings, and consolidate it into one dashboard.
Apple has also been in talks with various health systems and electronic medical record providers (including Epic Systems, which we use at the University of Chicago Medicine) so this data could integrate directly with a patient’s personal health records.
The idea behind all this is that doctors can monitor the data for any trouble spots, and use it to make better decisions about a patient’s treatment. But are months worth of data about how many steps a patient took or how many carbs they ate each day useful to a physician? And are they able to do anything with it?
Ari Levy, MD, is the Associate Medical Director for the University of Chicago Medicine’s Program for Personalized Health & Intervention, which focuses on helping patients make lifestyle changes—diet, physical activity, etc.—to prevent and treat disease, the exact kind of changes that doctors might be able to induce after reviewing the data generated by these apps and devices.
He said the value of this data is that is gives a doctor a window into the patterns of a patient’s daily life. Instead of relying on self-reporting, which can be unreliable, they can look to the data to find out the real story. So when a patient shrugs and says, “I work out a few times a week,” the doctor can look at his heart rate numbers and calories burned week-by-week to see if that’s really true.
The trick for the doctor then, Levy says, is to turn that revelation into what he calls a “coachable moment.”
“When the pattern of activity is either too constant for too long, or shows something that’s out of the norm, then it begs the question of what’s going on,” he said.
But he says many of today’s physicians aren’t trained to work this way.
“This is where what I like to call the skill of medicine, or the art of being a doctor, comes into play. But in fact, this is where I think the physicians have lots of limitations,” he said. “We just haven’t been trained to look at data this way, so it’s where many of us can go awry.
Levy is also CEO of Engaged Health Solutions, a health care company he started with William Harper, MD, the Medical Director for the Program for Personalized Health & Intervention and President and COO of the company. Engaged Health offers coaching and education to help business support the health and well-being of their employees. He said those coachable moments are actually best used by dietitians, athletic trainers or behavioral specialists who know how to help people change their routines for the better, not necessarily doctors.
Whether doctors are ready to make use of it or not, pretty soon millions of people with iPhones are going to start experimenting with tracking their own health data. And paying enough attention to your body to count calories and steps can’t be a bad thing—as long as you stick with it long enough to make the data meaningful. Levy said that data on fitness tracking apps shows that usage drops precipitously after the first 30 days, and to almost zero by the end of six months.
“That’s the marketing ploy for these devices: Everybody wants to have something that’s cool,” he said. “But am I going to use it consistently? And am I going to learn and adapt and modify with it?”