Assessing The Future Intersection Of Medicine And The Internet Of Things

The 21st Century Cures Act (Cures Act), signed into law toward the end of 2016, encouraged EHR vendors to provide “open access interfaces.” In 2018, Apple announced its entry into the arena of electronic health records by allowing patients to gather their records using the Health app on their iPhones. This may just be the beginning.

Facebook has many group offerings for the public looking to share on any topic. One area that is growing on Facebook are groups on health care issues as the public looks to find others with similar concerns and conditions. In light of recent criticisms on how Facebook handles sensitive data, Facebook announced earlier this month the launch of a new “health support group” as a way for patients to post their questions anonymously via administrators who will share it on their behalf.

Amazon has been in the health care game by offering a variety of medical equipment as well as some non-prescription medications and wound dressings. Now Amazon’s Alexa can provide first-aid information that is offered by the Mayo Clinic and one can also check blood pressure through a collaboration with Omron Healthcare. Amazon claims that Alexa is HIPAA-compliant.

In April 2019, Amazon announced that the Alexa Skills Kit now enables select covered entities and their business associates, subject to HIPAA, to build Alexa skills that transmit and receive protected health information. Currently, this service is available by invite only.

Covered entities reportedly include Express Scripts and Cigna Health Today. Health care systems and facilities are getting into the act as well. They include: My Children’s Enhanced Recovery After Surgery (ERAS) with Boston Children’s Hospital; Swedish Health Connect (by Providence St. Joseph Health, a health care system with 51 hospitals and over 800 clinics); and Atrium Health (with over 40 hospitals and 900 health care facilities). Another covered entity is Livongo, a consumer digital health company.

Livongo members can access their last blood sugar reading and get personalized prompts called “Health Nudges.” Eligible employees with Cigna can earn personalized wellness incentives. With the aforementioned health care systems partnering up with the Alexa Skills Kit, people can schedule same-day appointments at urgent care facilities and provide post-op recovery updates to health care teams.

Are people really using these new technologies? Well, PatientsLikeMe.com, a well-known patient support website, has more than 600,000 participants. Anyone I know who is under 30 years old uses voice recognition to query Google or Alexa for anything they are looking for. It appears that as of January 2019, one-hundred million Alexa devices have been sold.

How do podiatrists get in the game with this technology? How can solo practitioners get a foothold here? I am hoping that the American Podiatric Medical Association (APMA) will seek out the Alexa Skill Kit and become the authority on foot health information, and look at ways that podiatric medicine can engage in these arenas. I have requested an Alexa Skill Kit for my practice and will see if I get an invitation to do some market testing research.