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Why app developers are embracing the Apple Health records API

A new crop of APIs based on the FHIR standard promises to change the expectations of mobile health apps. Six-year-old app maker Medisafe illustrates the promise and problems.

Mobile health application makers may now be able to take the crucial next steps to integrate with pharmacies, drug companies and ultimately even EHRs thanks to the Apple Health records API and others.

A case in point is Medisafe, developer of a mobile personalized medication management application with 4.5 million registered users, which has been waiting six years to tie its offering into something larger, said Omri Shor, CEO and co-founder of Medisafe. "Healthcare has been aching for a connecting tissue that will start to connect different places across the ecosystem," Shor said. Thanks to the Apple Health records API, "I think the interoperability age is coming now. It's going to be able to happen from the provider space to the patient side."

An opportunity to do more

Since its inception, Medisafe has been a tool consumers used to keep track of medication timing and dosages, check on prescription interaction and even alert a friend or family member if doses were missed. But what Shor wanted was so much more -- the opportunity to tie into providers, pharmacies or even drug manufacturers so that a patient no longer had to enter the information manually and had a truly interactive support system. "I think in any other space other than healthcare I would expect that to happen upfront," he said. "If I download the American Express app, I do not imagine even for a second I have to enter each transaction. It should happen in the back end. I think that it is important for patients to have the same. It almost comes as a given because that ability should have already been here."

I think the interoperability age is coming now. It's going to be able to happen from the provider space to the patient side.
Omri ShorCEO and co-founder, Medisafe

Medisafe user Lucy Trieshmann, who takes a fistful of prescriptions twice a day, would agree. She sees physicians in eight different specialties from rheumatology to orthopedics and nephrology, and there's no single doctor who coordinates her care, she explained. When she fell ill two years ago, she'd never really taken a lot of prescription medication and needed something to help her keep track and warn her of interactions. "I take a bunch of weird medications nobody's super familiar with," she said. A patient portal isn't helpful because she can't edit it, and it doesn't warn her about potential drug interactions. The ability to have this information on her phone, and eventually have it linked to a pharmacy and her providers, will be invaluable to her, she said.

The Apple Health records API, which is based on the FHIR standard, "will remove the friction that's been in the process," Shor said. "Patients are going to be able to easily and accurately download their medication records into Medisafe."

Despite promise, the path is difficult

"There is increased adoption of FHIR," said Arielle Trzcinski, senior analyst serving application development and delivery at Forrester Research. "I like the standardized approach. There is consistency in the terminology and the data sent over and it is in a consistent format that can be ingested in a scalable way."

But despite the promise of the Apple Health records API, the road ahead for Medisafe and other companies like it is unlikely to be either straightforward or easy, simply because of the nature of the healthcare industry. "Everything is long in healthcare," Shor said. He's met with large hospitals and provider groups, most of which don't have the technology in place for integration right now, and they also lack the financial incentives.

"One pharmacy can integrate and they do have an API; however, for us to integrate there [has] to be a certain level of incentives," he said. "Another pharmacy also has opened an API but hasn't made the business case to do anything with it." Most promising right now are pharmaceutical companies and payers, both of which have a vested interest in patients taking their medication correctly. So even after a six-year wait, Shor continues to take the long view. "There's a lot of value in knowing how the system operates."

This was last published in July 2018

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