Apple's ResearchKit Is a Brave New Step in Digital Health and Research

MARCH 15, 2015

Apple recently made a big splash in the news with the Apple Watch and the new MacBook, but perhaps the other big piece of news is Apple’s push into medical research with its ResearchKit. The premise behind this initiative is to create an open-source software package that medical researchers may use to collect data in order to push the medical research paradigm.


Apple is banking on the fact that users of iOS devices (ie, smartphones) have reached a point where collection of data can be meaningful. This is based on the fact that many of Apple's recent smartphones feature multiple sensors that can be leveraged to collect certain data. This includes accelerometers, microphones, touch sensors, and cloud-based technology to record data. For those who have been following the increased use of mobile medical apps, this is, in a sense, taking all the data patients use to evaluate their own health daily and sharing it in the name of research.


ResearchKit will go live next month, but in the meantime, Apple announced 5 currently available apps with backers from multiple major medical institutions. For instance, Stanford University has put together MyHeart Counts, an app that uses ResearchKit to help assess the cardiovascular health of users. The app will collect input data like labs, collect data from wearables (eg, fitness trackers), and use built-in sensors to collect background data. These data will be fed back to patients, making them aware of their cardiovascular disease risk and steps to improve their health.


Other apps include those focused on asthma (Mt. Sinai Weill Cornell Medical College), Parkinson’s (University of Rochester), diabetes (Massachusetts General Hospital), and breast cancer (Dana-Farber Cancer Institute). Many of these apps use built-in sensors, such as the Parkinson’s app's use of a microphone to detect speak fluctuations or gait disturbances. Other apps, like those focused on asthma and breast cancer, allow users to input data, track their health, and give feedback. The asthma app, for instance, tells users about the air quality in their area and teaches proper inhaler technique.


So why is Apple doing this, and why now? The main reasons are that the technology is ripe and stable enough to utilize, with much research and many partnerships being established to create such apps using mobile smart technology. The other factor is the large uptake of mobile smartphones and associated wearables. In addition, society as a whole is getting more accustomed to sharing data and personal information, with the biggest example being the high use of social media.

But what about sharing medical data? Well, that has seen a large uptake, with many users of medical apps already sharing data. The establishment of online social health communities (eg, PatientsLikeMe) has demonstrated the embracement of the e-patient movement and quantified self-mentality and how patients are willing to track and share data with others.

Further, we have seen the success of genetic testing, with 23andMe available to the public, but the key to success of 23andMe has been the willingness of its customers to allow their data to be used for research. This, in turn, has prompted 23andMe to pursue the possibility of creating drugs and getting into the pharmaceutical industry. The key point here is that data have a lot to offer, and the ability to mine it from a willing public is largely due to the rise of technology and the Internet.


These data will have lasting impact, in one form or another, on the medical field. On one hand, it will increase the expanse of epidemiologic studies and may open the doors for further clinical trials. This may be an avenue for public health initiatives to assess patients and data or a new way for researchers or pharmaceutical industries to collect data from clinical trials. The attractiveness will most likely be the scalability and the low cost to run such projects, especially in light of possible remote data collection and the decreasing overhead and logistical barriers of many studies. This has undoubtedly been proven true, as Stanford’s app has had more than 11,000 new participants sign up after the Apple event, which conventionally would have required a year and 50 centers around the United States to recruit.


On the other hand, while Apple is being lauded for the breadth and scope of ResearchKit, and much hype is in the news, the limitations and concerns associated with ResearchKit have yet to be addressed. One large concern is privacy. Recently, Anthem, the second-largest health insurance company in the United States, was hacked, with up to several million patient accounts exposed. Will Apple and its partners that use ResearchKit be able to protect its users from such an event? Other concerns include the viability of data collected. Will data collected be an accurate representation of the public? For example, those with socioeconomic difficulties may not have access to these devices and may not be represented.

The other issue is that while ResearchKit is open sourced, it will only be supported on iOS devices, missing individuals that use other devices. This raises concern about what other big players in mobile (eg, Windows, Samsung, Google) may do in an attempt to emulate Apple. The results could fragment the system, making the premise of medical research even more convoluted, especially given concerns about the accuracy of data measurements from multiple different devices.


While these concerns will be surely addressed with time, the key point is that the nature of data collection and health research is moving in a dynamically different direction with the advent of technology. The humble smartphone is quickly proving to be capable of more than texting, gaming, and social media; it is also a tool that can be used to expand our medical knowledge.

For pharmacists, the widespread use of technology to gather data on patients may be useful in terms of clinical studies. Pharmaceutical companies may use these apps and associated devices to find new uses for old medications or to conduct larger studies. While most pharmacy companies are slowly embracing the use of digital health, it will be interesting to see if they show interest in ResearchKit or similar technology for customer feedback and/or analysis.


Timothy Aungst, PharmD
Timothy Aungst, PharmD
Timothy Dy Aungst, PharmD, is an associate professor of pharmacy practice at MCPHS University. He graduated from Wilkes University Nesbitt School of Pharmacy and completed a PGY-1 Pharmacy Practice Residency at St. Luke's University Hospital, and then a Clinical Geriatric Fellowship at MCPHS University. He is passionate about the rise of technology in health care and its application to pharmacy. He has published primarily on the role of mobile technology and mHealth, and made multiple national and international presentations on those topics. He blogs at TheDigitalApothecary.com, and you can find him on Twitter @TDAungst.
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