Apple's iOS 'Health Records' Feature Now Works With 75+ Providers

If they add NHS, that’s the whole of the United Kingdom covered

Apple will need to do is make the code for this free and create a kit that is cross platform and universal.

Apple is basically implementing an existing standard from an international health organization. This is largely a function of standardized, structured data, not some special sauce. Other companies and medical institutions are free to do the same.

From the information mentioned in the article, FHIR (Fast Healthcare Interoperability Resources) is a spec by HL7 (Health Level Seven), a not-for-profit, ANSI-accredited standards developing organization. Argonaut focuses on subset of the FHIR spec through core API and data services.

Health Level Seven | http://www.hl7.org/
FHIR Specification | https://www.hl7.org/fhir/overview.html
Argonaut Project | http://argonautwiki.hl7.org/index.php?title=Main_Page

This is all fine and good... until your healthcare provider shares all of the detailed information about your previously unknown chronic illness to your insurance company. You might have control over who you share it with, but once it's "out there"... you have no control over it. Crooked insurance companies (and they ALL are crooked) will see this information as a potential gold mine and seek to obtain it any way they can once they know it's available.

HIPAA laws expressly forbids the sharing of patient records with insurance companies without a ROI from the patient. I have been in the pharmaceutical/healthcare industry for over 10 years. And from my experience... no healthcare provider would risk their practice/medical license doing that.

You do realize your “insurance provider” already has this information from your physician. They pay the bill, and they call the shots.

No, they do not. They can see which drugs you're buying (since they pay a share), they can see you've been visiting a doctor, and they may request a doctor's report (such as to confirm that a costly treatment is advisable), but they don't have a full picture. They can only guess and extrapolate what kind of treatment you're getting. They don't get lab results, and they don't listen in on conversations you have with your doctor (nor do they get regular reports on them).

They know exactly what is going on with your health,

That's a stretch.

This is all fine and good... until your healthcare provider shares all of the detailed information about your previously unknown chronic illness to your insurance company. You might have control over who you share it with, but once it's "out there"... you have no control over it. Crooked insurance companies (and they ALL are crooked) will see this information as a potential gold mine and seek to obtain it any way they can once they know it's available.

This is all fine and good... until your healthcare provider shares all of the detailed information about your previously unknown chronic illness to your insurance company. You might have control over who you share it with, but once it's "out there"... you have no control over it. Crooked insurance companies (and they ALL are crooked) will see this information as a potential gold mine and seek to obtain it any way they can once they know it's available.

As someone who works for one of these "crooked" companies, if you have a chronic illness, that's going to be hard to hide, if it's hidden at all. We might not have all the details, but we know which drugs you're taking, how often you visit the doctor, which services we're being billed for, what surgeries you're having, etc. That's like saying "You can't guess which coin is in my hand, but I can tell you it's not a penny, dime, quarter, half-dollar or whole-dollar". We don't just get a bill that says "you owe us $80,000 for 'none of your damn business'" and pay it. That's absurd. We also have staff that help those with Chronic Diseases. If you have diabetes for example, we will discover that (it will be shared with us legally) and you're likely to have someone contact you in an attempt to help you better manage your disease (all free of charge). Sure, that helps bring our costs down. But it's also a fantastic benefit for those who accept it.

Your theory that ALL insurance companies are crooked and out to screw you however we can is a complete joke with absolutely no evidence to back that up.

There are a couple inaccuracies here in the comments, so I felt compelled to post. Sorry.

1. HL7 FHIR is the newest standard for healthcare interoperability (i.e. sharing data between systems). The previous standards are 20-30 years old. These standards are really a template but don't speak much to the content of the messages. There are additional standards for certain types of data exchange that HL7 also formulates, mostly leaning back on the HL7 FHIR or HL7 v2 standards, for instance there's a specific guide for immunization data which is typically used for public health reporting. There's more layers than this too, but let's just say healthcare data is extremely complicated and diverse, and so it is very complex to share electronically in a meaningful way.

2. While there would normally not be much motivation to adopt a standard, the U.S. federal government has had a huge part in causing EHR adoption though the HITECH Act and Meaningful Use incentives for providers, and they set standards for Certified Electronic Health Record Technology (CEHRT). The next version of the standards will likely require FHIR adoption, which will make it a lot easier to share data in a more open source way (plug and play apps), unlike now which his heavily controlled by private companies who set very high prices for basic activities.

3. When you sign up for insurance you attest that you have disclosed all illnesses. If you're trying to hide something, it could come back and bite you when you have a complication of that condition. Additionally, you also typically agree to have your insurance company have full access to your records at any provider office you visit. This includes cash payments. This is standard because the insurance company is on the hook for a series of quality measures which are tied to their accreditation, among other reasons. Most states have laws that protect individuals from bad practices on the insurer side. If you were inappropriately denied a claim, etc., you should be able to report it to someone and they will investigate. But if you lie to the insurer no law will protect you much. That's partially because your lie can impact the rates of everyone else covered by the plan and you might not be paying your fair share based upon your cost risk to the plan.

4. HIPAA explains requirements to keep your health information confidential, and circumstances where it is okay for a covered entity (like your doctor's office) to disclose it and whether they need a special consent. There are a lot of scenarios where it is okay without a special consent (called payment, treatment, and operations), such as claims to your health insurer, referrals or records sent to other doctors, data sent to IT companies that host the EHR or apps (like Apple), etc. In some cases the covered entity needs to enter into a data sharing agreement to set the requirements for how the data is protected, in transit and at rest, what happens if there is a breach, etc. I think my point here is that your healthcare data is all over the place and that's absolutely legal, and it also should benefit you because your doctors can have more information or better tools to make sure they know how to treat your illnesses. We often address the sensitive to health data sharing in this way: You don't want your health data shared, but when you get to the hospital you want them to have your whole medical history instantly. These two concepts don't work well together, and at some point there has to be a balance of the desire for absolute privacy and the desire for your trusted healthcare professionals to have the right information at the right time to help you.

I'm so glad you responded. I've been wanting to tell one of you vultures "how it is" for SO long, it's not even funny. Yes, ALL insurance companies are crooked - including the one with which you are employed.

You've just lost all your credibility.

They (insurance companies) do anything and everything they can within their power, moral or immoral, to save a damn dollar for the company.

I work for a non-profit company.

Annnnd I'm done reading.

It sounds like you've had a rough go at it. But I'm not about to get drawn into an argument with someone who holds such strong feelings. Clearly a reasonable conversation isn't happening here, so it's best to just drop it now and move on. Best of luck to you.

If they add NHS, that’s the whole of the United Kingdom covered

Although given the NHS history with computer systems.......................

Apple is basically implementing an existing standard from an international health organization. This is largely a function of standardized, structured data, not some special sauce. Other companies and medical institutions are free to do the same.

From the information mentioned in the article, FHIR (Fast Healthcare Interoperability Resources) is a spec by HL7 (Health Level Seven), a not-for-profit, ANSI-accredited standards developing organization. Argonaut focuses on subset of the FHIR spec through core API and data services.

Health Level Seven | http://www.hl7.org/
FHIR Specification | https://www.hl7.org/fhir/overview.html
Argonaut Project | http://argonautwiki.hl7.org/index.php?title=Main_Page

Yes, it’s a world I have to partially live in. HL7 is the earlier standard and FHIR is trying to replace it. It’s more of a suggestion than a strong standard and Cerner is very strongly pushing it, though. It’s something my company spends a lot of time and resources dealing with on a daily basis.

The issue isn’t the data standards but establishing trusted endpoints. And when you factor in hipaa, hitech, and hitrust laws and certifications this will be a slow rollout for anyone.