Decoding Apple Health following 2022 WWDC – Conversations with Dr. Tommy Korn, MD

Apple’s attempt to delight its customers was on full display during this year’s WWDC. While the tech giant showcased many new user-friendly features coming to your iPhone, Mac, and Apple Watch, we were excited by all things health and fitness announced.

The 2022 WWDC event is just another story of how Apple is consistently and smartly building its position in healthcare in an evolutionary way. 

Related reading:

• Your iPhone, iPad, and Apple Watch is a powerful healthcare companion. Interview with Dr. Tommy Korn (post WWDC insight series)
• Apple’s new iPad Mini is becoming a powerful healthcare tool, says Dr. Tommy Korn
• The one iPad and iPhone feature every senior should use now, according to Dr. Tommy Korn, MD
• You’re in control of your health data with Apple devices! Interview with Dr. Tommy Korn (post-WWDC Insight Series)

New health features in iOS 16 and watchOS 9

Some new features coming to your Apple Watch in the fall include the updated Workout app, advanced metrics, views, and training experiences inspired by high-performing athletes. The new watchOS 9 software will also introduce sleep stages to the Sleep app, and a new FDA-cleared AA-Fib History feature provides deeper insights into a user’s condition. 

The new Medications app makes it easy for users to conveniently and discreetly manage, understand, and track medications.

At MyhealthyApple, we take time to understand some of these changes and their potential benefits for society.

With that in mind, we sat down with our favorite practicing physician, Dr. Tommy Korn, to understand his perspectives on Apple’s health and fitness announcements. 

Dr. Tommy Korn, MD, is an ophthalmologist at Sharp HealthCare in San Diego, California. He has spearheaded Sharp’s many digital healthcare initiatives into various technologies, including Apple CareKit, telehealth, Apple Watch, iPhone, and iPads, to improve patient care and healthcare processes. Dr. Korn has also served as a consultant to various health technology companies in the telehealth, remote monitoring, and patient care experience spaces. 

Question:  How is Apple approaching the healthcare space?

Dr. Korn: 

Follow the breadcrumbs, and you will see that Apple is taking a slow and deliberate path in health. They are steadily empowering their customers’ lives through wearables (Apple Watch) and software (Apple Health App).  

Apple Watch

Look at the history of the watch. It first started as a timepiece. Later it became a fashion accessory. Soon, it became a fitness tracker and a heart rate monitor. Then Apple entered the watch market and started to redefine what a watch could truly do. They have transformed the watch into a personal health guardian with continued refinements. This is now the Watch’s main “job” and why people hire it to keep them safe and healthy.

The Apple Watch is the only computer physically attached to your body for most of the day. It’s not the iPhone, iPad, or Mac. The watch collects your body’s health information both actively and passively. It’s silently monitoring your well-being. 

Now that Apple is figured out the “true” job of the Apple Watch, they will approach health from two categories. 

The first is wellness or “health preservation” –  the business of keeping people healthy and out of hospitals.   The second is healthcare or “health repair” – the space between doctors and hospitals where patients recover from medical diseases or conditions. 

Apple is addressing both categories, but they are more laser-focused on wellness. From a societal perspective, preventing health problems is better than fixing them.  

Apple’s 3 key ingredients for success include: 

• • Privacy of their customers’ health data
  • Frictionless user interface experiences for their customers
  • Empowerment of their customers’ health data

When Tim Cook (Apple CEO) says that health will be Apple’s greatest contribution to society when you look back, he’s spot on. Health affects every person on Earth.  

Apple Health App 

Without question, the most important app on any iPhone is your Apple Health app. It is a personal health records app that stores all data about your health, wellness, and medical information. This is your most sacred data on your iPhone. Surprisingly, many patients I encounter are not aware of it.

It already stores COVID vaccine cards, health medical records uploaded from hospitals, cycle tracking, how much you exercise, and all the biometric data from the Apple Watch. It has more information about you than your doctor or hospital. You control this data, and no one, not your employer, not your doctor, not an insurance company, not even Apple itself, has access to it.

That’s user empowerment and privacy, and this is where Apple excels.

The Apple Health app is also the asymmetrical innovation that our society needs. Healthcare incumbents like hospitals and insurers cannot compete against the Apple Health app because they use siloed health data and store it in cumbersome hospital EMRs (electronic medical record apps) that are not easily shared or discoverable. This causes extreme burnout for physicians and healthcare workers.  

For example, if a person travels to another state and becomes ill, their iPhone has all of the user’s health information that can easily be shared with the hospital or doctor in the visiting state. 

That would certainly make my job easier as a healthcare worker. I could easily view the patient’s health information on their iPhone (with their consent) in seconds rather than review hundreds of pages of medical data faxed from another hospital which would take hours!

Question: Why are companies like Apple trying to develop solutions like Sleep monitoring?

Dr. Korn:

The new job for the Apple Watch here is to become your sleep coach and advisor.

Currently, to stage someone’s sleep, patients have to go to a hospital sleep center. They connect them with electrodes and devices that measure sleep, oxygen, heart, and brain data. 

As they do this, they have to sleep in a bed and a markedly different room than their home. 

That data may not reflect the patient’s true sleeping behavior. Patients can also use remote sleep monitoring devices, but they are cumbersome and must be returned to their doctors for analysis. 

Now here comes the Apple Watch with its new sleep staging software. You can now conduct a sleep study on yourself anytime in the comfort of your home.

If many patients consent to participating in sleep research studies using their Apple Watch, we will probably discover what I’ve suspected for the past 15 years, given the increasing use of mobile screens.   The whole planet suffers from burnout and deteriorating mental health because of poor sleeping habits. 

If your Apple Watch gives you the insight to sleep better, imagine the benefits for your mental and physical health. Now amplify that benefit to billions of people as Apple has many customers. 

Imagine a more harmonious and happier society if every single person on the planet had a good night’s rest. Wow.

Question: What is the benefit of having Atrial fibrillation (A-Fib) history?

Cardiologists normally prescribe to patients to wear a cardiac Holter monitor that records heart electrical health over a long period of time. This device allows the doctor to discover heart abnormalities, such as A-Fib, that may not be detected from a single, isolated measurement. 

Left untreated, A-Fib is one of the leading conditions that can result in a stroke. Currently, to get the A-Fib reading, you have to put your finger on the digital crown of the Apple Watch. This completes the ECG circuit so a heart signal with A-Fib can be detected. However, this requires the user to actively acquire the heart information.  

The A-Fib history feature just announced by Apple implies to me that their engineers have figured out how to get an ECG reading without completing a circuit.

 In other words, I don’t have to be actively pressing the digital crown in the ECG app to get this information. It can passively gather the heart reading in the background as I go about my day.

The Apple Watch is less bulky than a Holter monitor and is conveniently worn on the wrist at all times. And here is where Apple redefines another new “job” for the watch.

The Apple Watch is now “hired” as my heart coach.  A-Fib history allows patients to share heart data with doctors that are convenient and easy to interpret. That saves time for doctors who can help curate their patients’ Apple Watch heart data. 

With the new heart and sleep updates, I will be very curious to see if there are any Watch hardware updates this fall to take advantage of these latest software enhancements.

Question:  Is the Medication Adherence feature in watchOS 9 truly a game-changer?

Dr. Korn:

As a doctor, when a patient being treated for a condition is not getting better, two possibilities come to mind.

Number one, is the medication that I prescribed truly effective? 

Or number two, is the patient taking the medication? Is there hesitancy, or are they simply forgetting to take it? 

In ophthalmology, eye drop adherence can be as low as 30%. People forget to take their medications, and that’s not surprising in our busy society today.

Our team built an Apple Carekit app to use iPhone & Apple Watch to remind patients to take their eye drops, and that increased adherence by close to 80%. However, building a health app takes a lot of effort. 

If you look at all the available health apps, there are thousands of them. Many have tried to solve the job of medication adherence, but few have succeeded on a grand scale.

That’s where Apple comes in. WatchOS 9 medical adherence feature now gives the Apple Watch a new “job” as your nurse. This will allow patients to recover faster and have better outcomes.  

Question:  What about the drug-drug interactions feature?

Dr. Korn:

Medication side effects and drug interactions are a big problem in healthcare and affect patient safety. With these new Apple health features, there are now two layers of safety for patients.

The first layer is your doctor, who ensures all the medications you take are OK. The second layer is now from their iPhone, informing patients of potential side effects and dangerous drug-drug interactions. 

Anytime you can reduce error and promote patient safety, it’s a win for everyone. As a busy healthcare provider, I welcome anything to help my patients achieve better health outcomes and keep them safe.

Question:  How can Apple help with health care equity and access?

Dr. Korn:

Health care access is the number one problem right now. As health care providers, having healthier patients in society allows us to focus on those patients who are truly ill and need help. This helps everyone and reduces burnout for healthcare workers.

Apple also thinks about issues related to health care equity. Not everyone can afford an Apple Watch with all its advanced health features. Even if they can afford an Apple Watch, some health features are not activated because certain countries have slow regulatory approval processes. 

Bringing some health monitoring features to iPhones (such as mobility and gait analysis) will make technology more equitable for the broader population. 

At the end of the day, I believe Apple wants to empower everyone equally through the lens of health and wellness. If this happens, it will truly be their greatest contribution to society.