The first CareKit apps are out. What’s next?

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Although HealthKit and ResearchKit were ambitious in their own right, CareKit has enormous potential (and also great potential for failure).

The first apps that make use of Apple’s CareKit framework are now available for iPhone users, in the App Store. These apps focus on diabetes, depression, pregnancy and early parenthood, and post-op care management.

CareKit takes its place along HealthKit and ResearchKit, which Apple introduced to developers in 2014 and 2015. HealthKit was focused on fitness and nutrition, and provided a repository were users can visualize, enter and share their health data between apps. ResearchKit gave investigators a common platform to remotely “e-consent” study participants for app-based trials, and securely collect their data.

Although HealthKit and ResearchKit were ambitious in their own right, CareKit has enormous potential (and also great potential for failure).

Apps that use CareKit help patients with five aspects of disease management:

•Patients can track symptoms and monitor treatment effectiveness (an app called Start, for instance, lets users track their depression score over time, after starting new meds)

•The app will prompt users for key tasks, such as medication dosing, wound care, or in the case of One Drop, logging food intake and checking blood sugar (some glucometers will beam the glucose levels directly into the phone).

•The “Insight Dashboard” helps patients learn from their reported symptoms and logs of medication adherence and other activities. An Insight may reveal a diabetic patient’s glycemic control suffers on weekend afternoons, or that poor medication adherence one week leads to worsening survey scores down the road, in a patient with depression.

•Patients can upload and store a Care Plan in their app (one presumably developed in conjunction with a doctor – like an asthma action plan or prenatal care guide).

•CareKit apps invite their users to securely share data with family members or healthcare providers, through the “Connect” module.

While standardizing care plan integration and symptom tracking is probably a useful contribution, it seems to me CareKit will really shine – or fade into obscurity – based on physician adoption of the “Connect” module.

Healthcare institutions and providers have already started partnering with app developers to collect patient-generated health data [like Ochsner health – see O Bar article on page 13]. Thanks to CCM from CMS, providers can now be reimbursed for reviewing remote data from chronically ill patients. Several studies have shown improved care and lower costs through remote monitoring, for CHF, COPD, and other disease states associated with frequent readmissions. Maybe CareKit and its “Connect” module will lead the way to more apps – and physicians – making use of this service.

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Editor At Large
A specialist in emergency medicine informatics at Mount Sinai in Manhattan, Dr. Genes is EPM's resident tech guru. He practices emergency medicine at Mount Sinai Hospital but can be found sharing his wit and wisdom all over the web.

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