Apple still has a lot of room to grow in the $3.5 trillion health care sector

Health, Fitness & Food

Jeff Williams, chief operating officer of Apple Inc., speaks during an Apple event at the Steve Jobs Theater at Apple Park on September 12, 2018 in Cupertino, California.

Justin Sullivan | Getty Images News | Getty Images

Apple has grand ambitions to move into the health care field. The company’s CEO Tim Cook once referred to health as the company’s “greatest contribution to mankind.”

In the last five years or so, the company has built up a big internal team staffed with doctors, health coaches, and engineers. It has developed health-focused software and hardware, and even started medical clinics for its own employees. 

But with a concrete strategy and a biomedical breakthrough, such as non-invasive blood pressure or blood sugar monitoring, it could do a lot more. Ahead of its World Wide Developer Conference (WWDC) next week, here’s what people in the health and technology sector think of Apple‘s influence and achievements so far — and where it needs to go next. 

What it’s done so far

Apple has a slew of products and services in health care.

Its primary product is the Apple Watch, and health is both a major use case and selling point. Its smartwatch device offers activity tracking, heart rate monitoring, an electrocardiogram to detect irregularities with the heart’s rhythm, fall detection alerts, integrations with third-party health apps, and more. 

The Apple Watch has other benefits, but overall, “the greatest use case for Apple Watch still remains health,” said Ben Bajarin, an analyst with Creative Strategies specializing in consumer technology. 

Henrik Berggren, founder of a diabetes-focused virtual medical clinic called Steady Health, said the Apple Watch is most helpful when it comes to tracking exercise and incorporating data from existing blood-sugar tracking devices. Many of Steady Health’s patients already have Apple Watches or iPhones, and the group will look at that data in addition to their blood glucose levels and eating habits. “That exercise part they’re doing quite well today,” he says. 

Beyond the Watch, vice president of technology Kevin Lynch is working to let customers bring medical information, including lab results and medical history, to their iPhones. That software, known as Apple Health Records, is continuing to make strides, but is still held back by the fact that consumers have to remember which doctors and hospitals they’ve been to in recent years and log into those systems separately. 

The company has also developed software kits for third-party developers to build health applications. Among the most widely used is ResearchKit, which helps academics recruit people to their clinical trials via mobile devices. 

Internally, Apple’s California-based employees can use a health-care system known as AC Wellness. The company doesn’t speak about it much and hasn’t said whether it plans to expand those clinics to consumers more broadly. For now, it likely functions as a way for the health teams to learn about the practice of delivering medicine – and not just building tech. 

During the Covid-19 pandemic, Apple teamed up with Google to release contact tracing technology for mobile phones, which public health researchers can use to build apps to track exposure to the virus. The company has seen the most traction for that in Europe and Asia. 

Weighing the pros and cons

Doctors have mixed feelings about the role of consumer health devices, including Apple’s.

While some are bullish on their potential, others say that it’s highly cumbersome for them to analyze this patient-generated information, and they don’t currently get paid for the extra work. Many are simply refusing to look at data from wearable devices.

When John Koetsier, a technology consultant and writer, tried to share his Apple Watch data with a doctor, he was essentially told to keep it to himself. Koetsier had been tracking his food intake, weight and exercise on his own. But his doctor said that he had too many information sources already, and was feeling overwhelmed. 

There are also questions about the accuracy of wearable devices when tracking health data.

“I trust Apple’s step tracking, but heart rate I’m more concerned about,” said Dr. Josh Emdur, a telemedicine doctor with SteadyMD. Emdur said he once admitted a patient into the hospital a few years ago because of an Apple Watch result, but it turned out to be a false alarm. He acknowledges that the data seems to have improved since then, and he’s now using Apple Watches as a heart health screening tool. But he’ll still recommend a medical device, like a Zio cardiac monitor, as a followup. 

“To make the use- generated data actionable from devices like the Apple Watch, it needs to integrate better with electronic health record dashboard so a care team can see trends and it all comes in in a structured way,” he said.

New York-based cardiologist Dr. Jeffrey Wessler says the Apple Watch offers more benefits than harms. “It really was a catalyst for the industry because it was the first time a consumer device began to infiltrate the clinical environment in a high volume way,” said Wessler, who runs preventative heart health clinics called Heartbeat. “

But he notes that it can be frustrating patients come in with a concerning Apple Watch reading but no risk factors. In that case, there might not be a clear treatment pathway, and they’re simply sent back home and told to come in if they develop symptoms.

“That’s taking visits and time away from people who really need us,” said Wessler. 

Bigger bets possible

Apple could make money in health by using it as a way to market and sell more of its devices. But there are much bigger opportunities in the $3.5 trillion health care sector.

The company has already announced partnerships with insurers, like Aetna, where users can “earn off” the cost of a device by engaging in healthy behaviors. It’s also talking to some private Medicare plans about subsidizing the cost of the device for seniors.

Imagine if the company could somehow build a body of clinical evidence to get into the business of taking on risk for a population. If it can truly prove that it could improve the quality of care and bring down costs, that would be a huge opportunity. That vision would take many years to achieve, but it would certainly meet Cook’s goal of having a major impact on health care.

Another game-changer would be if Apple can introduce more sophisticated sensors, including non-invasive glucose or blood sugar monitoring or a blood-pressure monitor. At that point, its device could reach a much bigger market — 6 in 10 Americans – with one or more chronic diseases, as well as prevention.  More than 1 in 3 Americans, for instance, are at high risk for type 2 diabetes. 

“If they came out with a blood sugar or blood pressure monitor that was non-invasive and continuous, it would be a complete game changer,” said Berggren. “That’s what we dream about for the watch.”

“I think there’s a lot of opportunity for Apple still in the space,” said Bajarin. “For me, it’s really hinges on preventative health (as) that really expands the potential of the Apple Watch.”

Other experts suggested the following areas where Apple should go next:

Better sleep tracking: “I’d love to see more in that direction,” said Dr. Calvin Wu, an endocrinologist with Steady Health. “They’re just scratching the surface on sleep.”

Telemedicine: Wessler, the cardiologist, believes that there needs to be an intermediary layer that helps triage patients. Instead of rushing to the emergency room or to a specialist, Apple could direct patients to an online visit and even offer its own video-based online medicine service.

More women’s health focus: Several of the doctors wanted to see more thorough tracking for menstruation, fertility, and reproductive health. 

More interoperability and integration with other medical devices: Apple already has close relationships with companies like Dexcom in the diabetes space, but the doctors agreed that it would be helpful to expand on that. 

More validated clinical trials would give Emdur, the telemedicine doctor, more confidence about the medical features in its products, including arrhythmia detection. Apple has done some trials, but it could double down. 

Food logging: Helping people track the nutritional content of their food is another opportunity. Imagine snapping a picture of the food and algorithms figure out what’s in the food. “It’s a really hard problem but if anyone could solve it, that would probably be Apple,” said Berggren. 

More focus on seniors: The company has a fall-detection feature and many of its heart health features are useful to seniors, but it could do more to make its devices more accessible to older groups. 

Apple Pay integrations: Apple could use its expertise in payments to help people navigate their health care bills. 

More health features in Airpods: For Bajarin from Creative Strategies, that’s an obvious move. It’s easier to measure some vitals from the ear, which could make it a powerful health-focused wearable. 

What’s on your Apple Health wishlist? Let us know at @CNBCTech.

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