Milton Keynes University Hospital (MKUH) is working with Apple and a host of other big tech companies to sponsor a data-led change in the way patients interact with clinicians.
MKUH CTO Craig York has big plans to transform the way patients use their healthcare data. By working alongside Apple and exploring relationships with a range of other technology companies, he aims to create a digitally enabled healthcare organization:
“My ambition is that patients will have access to their complete record. It’s their record, not our record. It's not going to be easy.”
York has already made significant progress. In October 2020, MKUH became one of the first hospitals in the UK to enable patients to view their consolidated healthcare records directly within the Apple Health app on their iPhones. The Health Records feature, which is part of the Health app, shows activity, heart rate, nutrition and other health-related data from iPhone, Apple Watch and third-party apps. York says other healthcare tech leaders that want their organizations to benefit from similar relationships must be open to innovation. He adds:
These big tech companies are often looking for opportunities to work with healthcare providers. And being willing to have a conversation is a good start. Having them in your office – and talking about your plans, listening to the new things they’re bringing out, thinking about how that might impact your organization and bringing that innovation sensibly into a strategy over a course of time – is key.
Through the link-up between MKUH and Apple, patients can choose to create a direct connection between the hospital and their iPhones, allowing clinicians to see a central view of their medical records, including lab results, medications, procedures, allergies, conditions, vital signs and immunisations.
The system also notifies patients when their data is updated. York says the progress he’s made in other areas, such as digital care records and the implementation of Cerner’s Millennium electronic patient record and its recent integration with CCube Solutions’ electronic document and records management system, mean it’s possible for the organization to attract companies with innovative ideas, such as Apple. York explains:
There were some very high bars set and our organization also had to ensure that they were comfortable with what we were going live with. But it was an incredibly proud moment. When we signed the NDA with Apple, they talked to Cerner in the US and said, ‘who in the UK has got your system, the right connectors, and would have an appetite to do something along these lines?’ They recommended us and it's nice to be on a list like that.
Health Records on iPhone is designed to protect patients’ privacy. The system uses a direct, encrypted connection between the user’s iPhone and the healthcare organization. With the necessary checks made to ensure data is used safely and securely, York is keen to take the implementation of Apple Health Records to the next level. He says:
There’s definitely a willingness. I'm hoping the full functionality that the United States has will come to the UK soon. And we are looking forward to that happening.
York compares developments in the UK to North America and says improved data access means more patient power:
America is always a little bit ahead. In the UK, and Canada, the functionality exists so that a patient can look at a result in the hospital. Now in America, they've gone to the next stage where a patient has the right – not the other way around – to share some of their health data with the health provider, the hospital.
Sharing health data
That relationship means a patient can go into Apple Health and choose to push data to clinicians. York gives the example of personal step count, which is a standard measure recorded in Apple Health. At an outpatient appointment, a doctor might say they want to see regular improvements in an individual’s daily step count. The patient could then choose to share data with their doctor, which would provide an up-to-date indicator of the individual’s progress. York says that kind of data sharing helps improve the efficiency of the patient/doctor review process, which is why he continues to nudge Apple about progress. York says:
Having the proof there would be useful. So, in America, as a patient you can share that information. We're still waiting for that functionality to be turned on over here. I do ping off an email to Apple every so often just saying, ‘I see there’s a new release in iOS with some updates’.
While York is hopeful that there will be new developments soon, it’s important to recognize that the hook-up with Apple Health isn’t the only area where York is looking to make the most of patient information. MKUH is also in conversations with Microsoft and Google and the hospital continues to investigate and use digital services, such as Zesty’s MyCARE app, which allows patients to book and change appointments. The aim across all these developments is to empower patients with technology and data. York adds:
In our new digital strategy that's going to be released in the next couple of months, I've ensured that our ambition is to provide our patients complete access to their patient record. Apple Health is one part of that, of course, but we also have Zesty as well, where we allow access to a part of the Cerner record.
York recognizes that his hospital is a trailblazer in terms of UK healthcare organizations. If other hospitals are going to make similar advances, he says it needs to be easier for suppliers and healthcare tech leaders to work together and explore new opportunities – and he believes effective governance from the NHS, with the application of international standards, is the key to success:
They need to say, ‘this is the direction of travel and all suppliers who want to supply NHS organisations need to meet the international standards.’ We don't want to go and reinvent UK versions of them too much. These international standards are there – they are being used in other places around the world. We should adopt those at pace to really reap the rewards within our organizations for efficiency and safety gains, but also to have the patient as a fully engaged stakeholder in their care.