Proving the Business Case for the Internet of Things

Apple to incorporate HL7 into iOS 10 in autumn

William Payne
July 12, 2016

Apple will add support for the international healthcare data exchange language HL7 in the next version of its operating system iOS 10, scheduled for release this autumn, according to the chief executive of Duke Health, Dr Ricky Bloomfield. The move will be a major step to positioning Apple mobile phones and tablets as not only consumer health devices but also professional clinical devices able to interact and share data with hospital healthcare IT systems and local family doctor IT systems.

HL7 is a set of data standards for the interchange of healthcare data between hospital IT systems as well as other healthcare data systems, including family doctor systems, healthcare data exchanges, and health data registries.

The protocols are a standard way of exchanging data between different patient IT systems within a hospital, such as electronic patient records, pathology and results systems, picture archive systems, radiology and clinical information systems. It is also the standard way that hospital systems communicate with health funding and insurance systems.

Although originating in the United States, HL7 has been adopted in a number of countries across the world, in particular by Canada, Mexico, UK, Japan, Finland, Sweden, Germany, India, China and Australia.

Bloomfield, who is an Apple HealthKit champion, made the comments at the MobiHealthNews 2016 event in San Francisco. Bloomfield had earlier been briefed personally by Apple personnel at the Apple Worldwide Developer Conference on the latest developments in HealthKit and iOS 10 scheduled for this autumn.

With the addition of HL7 support, any iOS 10 app will be able to create and share an HL7 continuity of care document (CCD). A CCD is a standard interchange format within HL7 providing a number of rich data formats for exchanging different sorts of clinical data in summary record format. CCD formats include for vital signs, family history, and plan of care. The rich data document provides a standardised format based on XML for exchanging clinical data without loss of meaning or content.

There are several ways Apple HL7 CCDs could be used.

One is that mobile devices monitor and record patient data which is then exchanged with hospital or family doctors via the HL7 CCD format. The advantage is that hospital and family medical practice IT systems can readily understand and consume patient data in HL7 CCD format.

Another way Apple devices could use HL7 is to accept CCDs from family practices or hospitals, such as care plans or other healthcare schedules. The Apple device could then use the CCD to monitor a patient's adherence to the plan, reporting back to the medical practice with an updated CCD.

A third way that an Apple smart phone or tablet could use an HL7 CCD is simply as an interchange format between family practice doctors and hospitals. In some parts of the world, patients are entrusted with their own patient records, and act as gatekeepers and exchangers of data between different healthcare providers. An Apple HL7 CCD could provide the same service, but in electronic format.

Lastly, in an emergency, an Apple device could provide useful information on vital signs leading up to a crisis. Being in CCD format, the data would be immediately consumable by professional clinical information systems, which could then carry out vital signs analysis to provide diagnostic support for emergency physicians.

Dr Bloomfield believes that incorporating HL7 into mobile devices is liberating for patients.

"This is really an exciting time for patient empowerment in the patient generated health data movement," Dr Bloomfield said. "It will be exciting to see where this goes."