The Connected Age: Digital Tools for Health

Abstract

my September/October column in Nursing Education Perspectives, I wrote about Connected Age and Wearable Technologies (Skiba, 2014). this column, I will continue the conversation and discuss a real game changer - patient-generated health data (PGF1D) - that is certain to affect how we deliver care while also placing the patient/consumer front and center.The story begins with Apple. This past September, Apple intro- duced its new iPhone 6 and iPhone 6 Plus, with the new operating system OS 8, which contains a health dashboard. These smartphones had 3 million pre-orders. Earlier in the year, Apple created a FlealthKit for third-party developers. And soon to be available, in 2015, is Apple's long-awaited entry into the wearable market, the Apple Watch.Is the convergence of these three Apple components a game changer in terms of consumers and health care? Let's look at their individual contributions to the health care marketplace.THE TROIKAOS 8 Operating System Health AppThe OS 8 operating system Flealth App, signified with a white back- ground and a red heart, allows you to create a medical ID and enter health data such as physical activity, nutrition, and vital signs. The app can monitor your physical activity using iPhone motion sensors; data are displayed on an easy-to-read dashboard that allows you to select a particular measure and graph it by day, week, month, or year.Duffy (2014), writing in PC Magazine, outlines how you can set up your medical ID and emergency contact information. Next, she explains how you can use numerous third-party apps for automatically importing data. Once you have your data entered, you can create cards or health charts that can be placed on your dashboard, using these to monitor your health, show your health care provider, and, in some cases, connect to a hospital or clinic electronic health record (EFTR).You can see how easily one can become an engaged patient using a smartphone. Flail (2014) provides a running list of health apps avail- able for the OS 8 operating system, including blood pressure monitors, activity trackers, weight scales, and sleep trackers.HealthKitApple created the FlealthKit platform so that third-party developers could design apps that provide data to various providers and organi- zations. Many electronic health record companies are also planning to interconnect their systems and allow the addition of patient-generated health data. The FlealthKit platform allows PGF1D as well as sensored data from various devices. Gregg (2014b) describes five apps that inte- grate with the FlealthKit, including the following:* American Well allows patients in a telemedicine video visit to share patient-generated data. Its CEO states: For the first time, we can make a connection between consumer health data on your iPhone and a doctor that visits your home over video. This opens a world of opportunity, with increased access to care for people everywhere and better care of patients with chronic conditions.* Humana allows consumers to share their health data, steps in particular, with their product Vitality and earn points to reward their progress. Vitality then translates those points into rewards such as movie tickets and music downloads.* Patient IO uses PGHD from the HealthKit platform to update the personalized treatment plans it creates.Health care organizations and EHR corporations, such as Cerner and Epic, will be integrating with HealthKit. Cerner (Gregg, 2014c) will be integrating key health metrics into its mobile platform. Cerner Wellness, to share with health coaches to provide incentives and other new opportunities. Stanford University Hospital (Selleck, 2014) will start a trial using HealthKit with children with Type I diabetes. The plan is to give patients an iPod Touch to track blood sugar levels using DexCom, which will integrate its glucose sensors with HealthKit for storing the data. …