Silicon Valley and Healthcare (Part 2)

Silicon Valley and Healthcare (Part 2)

In our last blog, we began the conversation on Silicon Valley’s “new” interest in healthcare; let’s continue with Apple Inc.

Recent reports from CNBC continue to refer to Apple’s interest in healthcare. Apple is seeking to be the “central bank for healthcare information,” “looking to host clinical information,” and is “talking to hospitals, researching potential acquisitions, and attending healthcare IT meetings.”


CNBC broke the story back in June 2017, and we have been following closely since. It would appear that Apple is trying to use applications, new processes and its experiences to create a common junction for health information technology by citing their success in the App Store, iCloud, and possibly even iTunes, as experiences they can bring to healthcare.

Apple has already developed interesting tools, such as the HealthKit, that is available to third party developers, to create consumer fronting solutions. While innovative and creative, I have seen few actually succeed. The challenge is they can’t find a payer. Not just who will pay, but also who would use the technology to both improve quality, and reduce the cost of care.

As we have noted repeatedly in the pages of the PWeR News blog, the technology revolution that has transformed every U.S. industry since the mid-1980s, has had only a limited impact in healthcare.


There are many reasons why this is yet to work. First, without the providers buy-in, nothing is going to move quickly in healthcare. Mandated providers use a technology, which does not make their lives easier or provide better care to patients, will not work and will be resisted at every turn. Not only does the technology have to work, but also it has to provide more information than the traditional paper record in the provider’s office.

In the old days, payers owned hospitals and medical groups, and hospitals owned payers, and medical groups; both had financial incentive to control costs and improve quality. Though we have experimented with many modern models, most have not succeeded in the long-term. What quickly comes to mind has been the attempt over the last five or six years to use Accountable Care Organizations (ACOs) as change agents. We will talk about ACOs in a future blog. Overall, the ACO model has not brought net savings to Medicare; some would argue that not enough time has passed to prove effectiveness.

We believe patients should control their data, not just legally as required under HIPAA, but also literally. In the CNBC article, it mentions that Apple is working with organizations that are looking to “give patients a central role in controlling their own medical data.” Those words are music to my ears. I vividly recall the discussions many years ago, on what we were going to call our own electronic healthcare record. We wanted to avoid the use of words like “clinical,” “practice,” “medical,” “health,” and like terms found throughout the market. Even in our view then, the “electronic” part was not the important element. Therefore, we called it        PWeR® or Personal Wellness electronicRecord™. There are few more committed to Apple’s cause than we are.

Talking about Apple’s entrance in this space, we are reminded that other giants have tried. IBM has tried for decades to make a real impact, and you also have Google and Microsoft. I recall Google Health’s app failed when they tried to get patients to upload their health information, and then have their medical providers either access the information, or upload new information. I never met a provider that participated, and I suspect that even tech-heads were reluctant to take part.

Let me suggest to Apple and other technology leaders and innovators two ideas: First, bring together relevant contributors – those in practice management, integrated health systems, insurance companies and large (ERISA-type) employers, and most importantly primary care and specialty providers. Bring them all into a room with a lot of whiteboards and process engineers, brainstorm and design what we all collectively need, and then test it. Most of us have the best of intentions, just not all the tools and leadership we need. From there, then we bring in the lawyers, the lobbyist and eventually the legislators, because I assure you that laws must be changed. For companies like Apple, the technology is the easy part.

Second, experiment technology companies on yourself. If you want to change healthcare, use your own company as the change agent. You have more power as an employer than you do as a technology company. Employers control the health plans, and through them, providers that provide care to their employees. You can use that leverage to push new technology. It will expose you to the challenges that we have highlighted before, but also it will put you in control to use, test, and learn from your ideas. It can be done!

– Noel J. Guillama, President