Apple's new Health app might be just what the doctor ordered, but experts warn the British healthcare system simply isn't set up to make the most of it -- with one medically minded observer warning that Apple faces a "cultural wall" within the NHS.
Unveiled in last week'sannouncement, Health will be an app built in to iPhones and iPads. It will collate the data collected by the apps that track your exercise and bodily functions, from the distance you run while exercising to your heart rate or blood pressure. But that's just the start.
"HealthKit collects data from apps on your health," explained Craig Federighi, Apple's software chief, "measuring things like your weight, blood pressure or blood glucose. If you stray outside your normal levels, the app can notify your hospital, doctor or healthcare provider directly."
That's potentially massive -- connecting our ad hoc fitness tracking with medical professionals who can actually do something with that data could be the quantum leap that turns fitness apps from lifestyle to lifesaving.
The good news is that the first part of Health -- compiling all your health-related data in one app -- should work anywhere. But the healthcare system in the UK is very different compared to the US, and industry observers are skeptical that the second bit -- directly communicating with your healthcare provider -- will work on these shores.
Analyst Ben Wood of CCS Insight believes that Apple's focus will mainly be on the fun, fitness-tracking side of healthcare. "Apple's initial target will be personal wellness and what we call 'recreational health,'" he says. "This taps right into the growing group of consumers who are part of the "quantified self" movement -- i.e. measuring things like number of steps, distance run, quality of sleep etc."
"This is the low-hanging fruit," says Wood, "as you don't need to undergo rigorous compliance from bodies such as the USA's Federal Drug Administration (FDA), which "professional" healthcare devices require. That sort of measurement is a much tougher nut to crack, as regulation would be required if any monitoring were to be used by your NHS doctor."
"The other issue Apple would face with the NHS," suggests Wood, "is the sheer bureaucracy and time to go through arduous procurement and certification processes.
"It could take years and years."
'Lack of trust'
Professor Eivor Oborn of Warwick Business School points out a number of potential issues for Health. "There is a lack of good working relationships and trust between the NHS and private technology companies," she says. "Current relationships are piecemeal and not strategic. They're also peppered with lack of trust, which is reinforced by public fear of corporate greed."
Apple has made deals with a number of healthcare institutions in the US, including Mount Sinai, Johns Hopkins, Yale, and other hospitals and colleges you might have heard of in movies. But among the institutions revealed in Apple's presentation there is one British name: Cambridge University Hospitals, an NHS Foundation Trust.
A spokesperson for Cambridge University Hospitals told me that the institution had given permission for Apple to use its logo in the presentation, but didn't have any further details on the specifics of the relationship between the two.
So while it seems Health could technically connect to your doctor, getting it to work across the country would involve reaching deals with a huge number of healthcare bodies. In the US it's more straightforward: Professor Oborn highlights the relationship between Apple and US healthcare provider Mayo Clinic, which is a nonprofit organisation that runs more than 70 hospitals. By making a deal with groups such as Mayo Clinic, Apple can reach multiple hospitals, doctors and other healthcare operations without having to make loads of individual deals. In Britain, there's no equivalent.
Even if there were, Oborn believes the British healthcare system doesn't put enough stock in data, which is becoming increasingly importance in other types of business and government. "The UK health system is a laggard," she argues, "in using 'big data' as evidence or as a valued form of knowledge in directing healthcare decisions. Healthcare knowledge is primarily sought from traditional medical research like the National Institute for Health and Care Excellence (NICE), and the mindset is that this is 'true' knowledge."
"Information or data derived from devices thus faces a cultural wall in the NHS," says Oborn. "These devices are currently worn by individuals, by choice, and are essentially fed back to one or more firms; but that operates outside the current health system."
So don't get too excited about your phone contacting your doctors to tell them how you're feeling. The need for regulatory approval, the logistical difficulties of reaching deals with multiple heathcare bodies, and a general lack of interest in data could all get in the way.
That said, there is of course nothing to stop you simply taking your phone to the doctor's and showing your app data to your physician: "There is no doubt," reckons Wood, "that a doctor would take an interest in your quantified self data and then perhaps move to more thorough assessment techniques."
The NHS isn't known for its success with new IT projects: last year, the Public Accounts Committee -- the nation's auditors -- branded the failed NHS computer systems upgrade project as one of the "worst and most expensive contracting fiascos in the history of the public sector." The failure is set to have cost the taxpayer more than £9.8bn.