Could today be the most important announcement for digital health ever?

Written on Monday 2nd June 2014

Today is the start of Apple’s much-anticipated World Wide Developers Conference (WWDC) in San Francisco. I believe this conference could herald the start of the most transformational and exciting period in healthcare: the arrival of digital health into the mainstream. Today could therefore be the most important announcement in digital health that’s ever been made.

To me, WWDC is always much more interesting than the company's much-vaunted iPhone or iPad events. While the iPhone and iPad events focus on the new hardware and are widely covered by the mainstream media, WWDC is mostly about the software that drives our everyday use of Apple products. This outlines the direction the company and the millions of us who use their products are heading.

If rumours are correct, Apple are expected to introduce its long anticipated health and fitness platform “Healthbook.” Healthbook will likely be an application that enables the integration of health and fitness data across Apple’s devices. This functionality will allow people to easily capture a wide range of biometric information such as weight, heart rate, sleep, and nutrition. It may also track more clinical information such as blood work, blood pressure, hydration, blood sugar, respiratory rate, and oxygen saturation. This could mean millions of everyday people using a smartphone to track and chart their healthcare. If you look at the history of Apple inspiring behavioural change with technology, this is a very exciting time for anyone with an interest in digital healthcare. I believe there are three reasons why today could be a seminal moment for the digital health movement: 

1. Making Digital health Innovation Mainstream

Apple has been under pressure in some quarters recently, with accusations they are complacent in the wake of such a sustained period of success and are simply not innovating anymore. The iPhone is seen by many as a historical one-off with regards to both the revenue growth it delivered for Apple and disruption it delivered to the mobile phone landscape. The iPhone totally transformed the way we not only consume media but fundamentally how we communicate with the world around us. It is a well know fact that Apple were by no means the first to develop a touchscreen mobile phone with IBM’s ‘Simon’ released as far back as 1994 and HTC, Motorola and LG all releasing touchscreen smartphones before the iPhone in 2007.

What Apple have been able to do is to take technology and make it easy and desirable for people to use, developing business models that support usage and uptake.  Most of the innovations Apple are synonymous with from the Mouse to the iPod and even the iPad existed before Apple turned the idea into a mainstream one. Apple’s vision has been one step ahead of the competition.

The pace of progress in the technology industry is relentless, but I expect Apple to pull the same trick once again. Health is now a booming business. In 2013, a study by Kantar Media found that 25 percent of smartphone owners and 22 percent of tablet owners use their devices to track their health, diet, or exercise. The ‘quantified self’ movement started in 2007 (the same year the iPhone launched) and can be described as self-knowledge through self-tracking with technology. This has gained more and more momentum with companies such as Jawbone, Withings, Pebble and Fitbit producing wearable technology that integrates with mobile applications, enabling you to track a wide range of health and fitness related personal data.

Technology powerhouses such as Google and Samsung have recently launched health initiatives. Google announced Android Wear in March 2014; the software will allow developers to outfit wearable technology that can interact with Android devices and has healthcare applications. Samsung recently announced the outlines of a new health platform (called ‘SAMI’) into which a variety of consumer health monitoring devices could report. Samsung also announced a new health focused wearable device called Simband, which can track and display body metrics in real time. Both initiatives lack the detail and practical application needed to truly become mainstream technology at this stage.

The market for wearable technology will continue to be considerably smaller than the ubiquitous smartphone market. If Apple has truly built the capacity for health tracking into the operating system of the new iOS 8, we will have a platform for millions of people to start tracking their health regularly without any investment needed. The resulting visibility of this technology could revolutionise digital health. My Mum will not be purchasing a Jawbone any time soon but she does have an iPhone.

2. The Power of Integration

Reports indicate that Shazam, the massively popular music identification application, will be integrated into the new iOS operating system, possibly through Siri. Why would they want to do this? Because becoming a first-party application means the service is very likely to become an integrated part of someone’s use of the device. The capacity for seamless integration that the Apple eco-system allows (in a manner Android could never really accomplish) has the capacity to put innovation in digital health applications into overdrive.

Nike recently announced that it would be discontinuing its wearable fitness tracker the Nike+ Fuelband. Many were shocked and indeed it inspired some commentators to pour cold water on the wearable technology and health tracking movement. However, I believe that this completely misses the bigger picture. Nike CEO Mark Parker stated that:

“Today, we have about 30 million FuelBand users. We're hoping to push that to over 100 million. We have partners that we work with...obviously the most visible partner we have is Apple. We've been working with them for a long time. And we're excited about where that relationship will go forward.”

It seems obvious that Nike will integrate it’s software into the HealthBook ecosystem, allowing all Apple users to seamlessly use Nike+ software with devices ranging from the iPhone to any future iWatch.

This is where the opportunity is in healthcare. It is likely that if Apple announces Healthbook as part of the iOS launch at WWDC today they will want developers to create apps that feed into that system. This will mean that the most talented and innovative developers will be encouraged to work on healthcare applications that will be supported by and integrated directly into the Apple operating system. What could this healthcare platform ubiquity herald for mobile health? 

3. The Contextual Health Computer Arrives

The smartphone is by far the most ubiquitous piece of technology with the high level of computing power on offer from the latest iPhone still seen by many technology commentators as the best smartphone available. A contextual computer in its current mobile form was still in the realms of science fiction a decade ago. Healthbook has the opportunity to kick start a new era in medicine, enabling people to think completely differently about their relationship with their health, their healthcare provider, healthcare professional and even pharmaceutical companies.

A contextual computer in its simplest form understands who you are, where you are, your behaviours, your interests and your likes and dislikes. Based on this information, it is able to offer support to the user in real time. It crunches data in the context of someone’s life. What this means for health is exponentially exciting. If we overlay the personal information we have outlined, with disease information (everyday symptoms of chronic conditions such as multiple sclerosis, triggers for conditions such as migraine, mood measures with mental health conditions, etc.) and the usage of medicines (such as adherence, times the medication is taken, etc.) we can build applications that would not only record data, but help predict and manage conditions. This information could clinically impact patients and redefine the relationship that the patient may have with their condition and treatment.

The possibilities for partnerships with other technologies such as IBM’s Watson (artificial intelligence engine) could supply advice and support to at least the level of a medical professional, in real time. We can also see very quickly the whole concept of patient support and post-marketing clinical trials for pharma being re-engineered with applications built to understand the whole patient. 

In Conclusion

Academics argue about the nature of innovation. Most agree that innovation is actually a system that enables thousands of people to come together to bring new ideas, values and technology to life. Often the focus of digital thought leaders is on the future possibilities beyond our current grasp, such as Oculus Rift for medical education or Google Glass for Parkinson’s. In my opinion innovation is about application. There is little point having developed a life saving medical intervention if the vast majority of people who could be helped cannot get access to it.

The possibilities for Healthbook exist in the reach and reputation of Apple. There is a chance that amazing things can now be developed that my Mum could use everyday to manage her health. This could be a seminal moment and a massive opportunity for all of us working at the intersection of technology and healthcare.