Pilot program to use HealthKit app to flag heart failure problems

Taking heart health data into a brave new world, Duke University is one of a select few piloting Apple’s HealthKit app. Researchers from Duke will be working with heart failure and cancer patients to pilot a program for uploading patient data to the electronic record using HealthKit.

The application has many in the healthcare community seeing possibilities.

“Once we have this proof of concept, this does open up the doors for other companies to be able to get their data in front of clinicians so there’s actual information from their devices,” Zubin J. Eapen, MD, medical director of Duke University’s Same-Day Access Heart Failure Clinic in Durham, N.C., said in an interview with Cardiovascular Business. “This is a great way to integrate these data into the electronic health record so that the best decisions can be made for the patients.”

Eapen and colleagues are piloting the program with hopes that the technology will help to better connect physicians to data about patient conditions that may provide early warning to worsening conditions. “If we can detect some trends early enough, we may be able to ward those off and preemptively treat patients before they need more intensive care like in the emergency department or the hospital,” Eapen said.

In conditions such as heart failure, basic biometric data like regularly checked blood pressure and weight data can have significant implications to the patient’s health outlook.

As Eapen stated, patients collect this data themselves, in addition to physicians using devices to monitor patients remotely. The trick has been to get data into the EHR where it can be read easily.

“This is one of the first consumer-facing applications that can allow us to collect that data. And importantly -- this is what’s exciting about the study -- we’ll not only be able to collect that data, but integrate it into the electronic health records so that for every patient there is one record, whether we collect it in the hospital, clinic or at home.”

Eapen and colleague Richard A. Bloomfield, Jr, MD, of Duke’s director of Mobile Technology Strategy, see HealthKit as an opportunity to do just that.

“Our providers are interested in technologies that will allow them to take better care of patients, and being able to remotely monitor patients has long been one of our goals, both for clinical use as well as research,” wrote Bloomfield in an email exchange. “HealthKit, combined with the Epic MyChart app, is the first widely available technology that allows us to do this.”

HealthKit, in concert with the Epic MyChart application, will bring data recorded by patients and through provided devices to the EHR.

Bloomfield, when asked to speak to why Duke focused on cardiology and oncology for this pilot, responded that cardiologists and oncologists have been ready for some time. “These teams had already expressed interest in conducting studies with patient monitoring devices, so it was a logical fit. These patient populations also have conditions that can be benefited through home monitoring of activity, weight and BP [blood pressure].”

At present, the team at Duke is still waiting for HealthKit’s release to take their final steps toward starting their pilot. In order to bring this technology to their review board, they want to be assured that patient data will be secure through the apps it will pass through before reaching the Epic system.

However, if this pilot works, they propose that more devices with more complex data could be integrated through HealthKit. “There’s definitely tons of different applications that could be possible if we’re able to make this pilot work,” Eapen said. “What we hope is that if we can pilot this successfully. This opens up the pathway for other companies to develop applications, whether it’s a defibrillator company or some other technology that might be in the home or in the patient.”

The HealthKit release has been pushed back while Apple resolves bugs in the system. In the meantime, teams at Duke, Stanford and in other medical institutions remain poised to start piloting this emerging technology to help monitor patients.