The big Apple Watch event was finally held earlier today in San Francisco. It took awhile to get to the main event because there were some other trailers of coming attractions.
Most notable for the Apple faithful was the latest MacBook laptop (available in April ‒ and in gold) and a new partnership with HBO for AppleTV.
The other big pre‒Watch announcement was ResearchKit ‒ which is designed to help clinical researchers with (yet another) "framework" primarily designed to tap Apple patients more directly for clinical trials and research.
It's a delicate balance because like HealthKit, it's leveraging the Apple platform as more of a launchpad into the big healthcare tent ‒ soon to include Apple patients and clinical research. The big healthcare tent is one that Apple has eyed longingly ‒ largely because they've historically played a relatively minor technical role.
They are treading carefully here ‒ and rightly so ‒ because the iPhone (and potentially Apple Watch) could easily be subject to FDA clearance for broader (more specific) health claims. The personal genomic testing company 23andMe got out ahead of their skis on this exact point (here) so everyone is watching this healthcare/tech trajectory closely.
Also, the FDA is only one federal watchdog agency with big teeth. The other ‒ and one that's begun to watch health, wellness and tech with a keen legal eye ‒ is the FTC. Here's an example from just one headline last month.
The FTC cracks down on health apps that promise to detect diseases without proof
A key distinction is the line that's getting fuzzier by the week. It's the one that separates health (as in fitness and wellness) and real healthcare (as in monitoring blood glucose for a specific medical condition like Type 1 Diabetes). Beyond just healthcare, it also ties into consumer sensibilities around trust ‒ and trusted sources.
This emerging debate ‒ and Apple's announcement today ‒ are all very interesting, of course, and it will capture tons of coverage from many different angles, but it's not the reason for the headline or the reason why Apple won't lead in the healthcare space.
Like millions of people around the world ‒ I wanted to watch Apple's live event as it was broadcast over the internet. Like millions of people, I was greeted with what Apple considers an apology.
That's entirely their prerogative, of course, it's their event, but the message it sends to millions of people around the world is no longer one of tech‒chic or tech "leadership," but one that's increasingly tone deaf. It's effectively a big middle‒finger to everyone that doesn't own specific Apple products.
Arguably the richest tech company on planet earth won't allow millions of people around the planet to watch their own product announcement (which they broadcast live over the internet) simply because we don't use their product.
In the words of comedian Lewis Black ‒ "How f*****g stupid is that?"
Relative to healthcare, it's also a troubling and arrogant message. Proprietary formats (both hardware and software) is really antiquated thinking ‒ and nowhere are open‒source formats more needed and critical than healthcare. Not fitness or wellness ‒ but real clinical healthcare.
The technical term for open data formats is interoperability ‒ and here's how that plays out in the case of one patient with one chronic health condition ‒ Type 1 Diabetes.
So for me, medical device interoperability is something that I deal with on a daily, hourly – sometimes minute-by-minute basis. I have Type 1 diabetes [which is] very complex, very difficult to control. So what does that mean? So I have four prescription medical devices with me 24/7 – two of which are attached to my body. That’s an insulin pump and a continuous glucose monitor which is constantly feeding data into a little receiver every three minutes with my current glucose reading.
These are amazing machines – it’s incredible technology – and the care of diabetes has improved dramatically because of them and because of some of the newer insulin’s that we have on the market. However, one of the most important things for me and for others like me with Type 1 in terms of managing our disease is understanding [the] patterns and right now all of my medical devices use different data formats, different data standards [and] they don’t communicate.
So I have all of this incredible information literally 24/7 – not just from my prescription medical devices – but also from my Fitbit, from a Bluetooth blood pressure monitor, from my digital scale and from a variety of different iPhone apps that are used for nutrition tracking etc.
None of it connects. They’re all in completely different data streams, and even though each of them provides something that would be an incredibly vital element for me to truly understand how to manage my disease, how to predict when I need to change insulin in response to exercise, or stress, or schedule changes, or whatever the case may be – I can’t get that information all in one place. Even though it’s electronic – even though it’s all downloadable in one form or another – it’s all on different platforms, different computing systems and it doesn’t work together. Anna McCollister-Slipp ‒ The View of Digital Health From an 'Engaged Patient'
Frankly I don't care that much what happens in other industries like media, entertainment or transportation relative to proprietary formats (either hardware or software) because we all have some choice in those areas of our life ‒ even if those choices are dictated entirely by price or prestige.
The statement we absolutely have to avoid in healthcare is the one that Apple appears to not only embrace – but openly fosters.
Nurse: We're sorry Mrs. Jones, but your lab results and data from your hospital visit are only available on an Apple device using an Apple 'app'.
Of all the companies with the power to change this ‒ Apple has the perfect tech profile. The screen capture above (from their live event earlier today) is exactly why they won't change healthcare. They're still stuck in the thinking of proprietary formats and they still want to dictate those formats. That's not a company I want to trust with my healthcare ‒- or my healthcare data.
It's certainly very lucrative and wildly profitable, but it's not remotely revolutionary. For a brand that prides itself on "thinking differently," it really doesn't ‒ at all. In the end ‒ that's the legacy of Steve Jobs that's lost and forgotten. How to really think differently. Start by offering the world free and open access to your own broadcast. That's the first step off the old world thinking of owning the printing press. They've proven they can mint money ‒ but can they really mint new ideas in healthcare? Millions will never know that they're even trying because they couldn't see the broadcast.
