The government agency and the Silicon Valley tech giant jointly announced that the Health app included with every iPhone will soon be able to sync with certain types of medical records that, up to this point, have only been available through My HealtheVet, the VA’s online Web portal.
Starting this summer, veterans will be able to direct their iPhones to automatically populate with information on allergies, health conditions, immunizations, lab results, medications, procedures and vital signs. Those are the same seven data types already available to a growing number of patients who get their care from certain health institutions that have already signed up with the program. In San Diego County, the two main participants are UC San Diego Health and Scripps Health.
Kevin Lynch, Apple’s vice president of technology, said in a telephone interview Monday that the VA has adopted Fast Healthcare Interoperability Resources, the same communications protocol that Apple has used to enable encrypted health records synchronization with other private and public health systems and individual doctors' offices.
Putting health records onto a patient’s iPhone, Lynch added, will allow aggregation of medical information across participating institutions. So, for example, if a veteran was referred outside the VA system for certain specialty care, they could see a more holistic view of care provided, prescriptions written and results received.
“For veterans, we think that it’s going to be very empowering,” Lynch said.
Data collected directly from a patient, say from a heart monitor on their Apple Watch, can also be integrated with health record information. In June, Apple released a special interface called an application program interface or “API” for health records, providing a way for iPhone owners to grant access to specific types of health care information without handing over every scrap of personal health data that resides on their smartphone.
Already, Lynch noted, developers outside Apple have begun building useful apps. A new entry called “One Drop,” for example, helps patients manage diabetes, tailoring its approach to the specific information it finds in a patient’s health records.
One Drop, Lynch said, is proof that much is possible when patients have their own health-care data directly in their possession and are able to decide what gets shared and with whom.
“By combining data from things like your condition in your lab results with data we can see about you like your activity level and your heart rate, you get a more-complete picture of how your health’s doing, and we think that’s going to be super helpful for people to really understand the state of their health and take action on it,” Lynch said.
The VA is the largest health-care organization in the nation with more than 1,200 facilities in total providing health care to more than 9 million Americans. It was unclear Monday exactly how the new iPhone health records system will be rolled out. Neither the San Diego VA nor the main headquarters in Washington, D.C., were able to provide additional information Monday afternoon.
Given the steady drumbeat of health-care privacy breaches that have occurred in recent years, many veterans may wonder whether or not they can trust Apple’s latest offering?
Georgia Weidman, a well-known security consultant and founder of Bulb Security, and author of the book Penetration Testing, said by email Monday that she has been quite impressed with Apple’s ability to encrypt and secure data on the phones it manufactures.
“Given Apple’s public and ongoing commitment to privacy and security and the holistic manner in which they go about providing a trusted platform in iOS, I would think Apple’s health records on iPhone is likely the most secure way in which veterans can access their VA health records,” Weidman said.
Bulb, she noted, is often hired to try and hack into mobile information systems. So far, she said, Apple’s encrypted system running on iPhones has not been an easy target.
“Apple is consistently difficult to compromise,” she said.
Doctors’ progress notes, documentation of health-care encounters that serve as the backbone of treatment, are not yet on Apple’s syncing list. Lynch said that these notes, which have become increasingly accessible to San Diego patients, are not yet transferred automatically because their format is not yet standardized.
“We don’t have mature standards yet for getting that data from health-care institutions. There is work in the industry happening on that but, right now, we are not bringing those notes in,” Lynch said.
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