In a recent note, I discussed how 23andMe was beginning to recruit clinical trial subjects as a new business opportunity (see: 23andMe Moving into Clinical Trial Recruitment, a Potential Source of New Income). I emphasized in the note that this was a lucrative new enterprise because drug companies offer high reimbursement for recruiting research subjects. Subsequent to posting this note, I came across another article that speculates that Apple has been eyeing the medical research market with the potential to radically change some aspects of it (see: Apple Is Going After The Healthcare Industry, Starting With Personal Health Data). Here is an excerpt from this article:
By having a relationship directly with consumers via the iPhone, Apple is able to reduce the friction of signing up for a study, as well as identify eligible candidates using their health record. Moreover, participants in ResearchKit [and CareKit] studies are not geographically constrained and can come from around the world. But while simplifying the sign-up process and increasing accessibility theoretically means a broader population demographic to take part in trials, it’s still limited to the demographic of iPhone users, who tend to be more affluent.
By simplifying recruitment, the size of the studies on ResearchKit are much larger than traditional studies. The Apple Heart Study has recruited more than 400,000 people in a year. A mobile Parkinson’s study known as mPower has more than 10,000 enrollees. For reference, The Michael J. Fox Foundation’s Parkinson’s Progression Markers Initiative (PPMI) study required ~$800 to recruit each participant to Parkinson’s trials in 2010, and is tracking fewer than 1,000 people.
I myself am enrolled in the MIPACT study sponsored by Michigan Health and Apple that provides a free Omron blood pressure monitor plus cash incentives to participate. Here are the goals of this study:
Collecting and evaluating data from:
* Electronic health records (EHR)
* Participant survey data
* Genetic information
* Blood pressure measurements
* Apple Watch activity and clinical data
The bottom line for me from all of this is that the Apple health ecosystem (iPhone + Apple Watch + downloaded hospital EHR records + medical devices that interface with the iPhone) has the potential to revolutionize medical studies and clinical trials because, firstly, it simplifies the process of enrolling a subject in a study. Secondly, it integrates the hospital EHR data of a subject into the study. Thirdly, it enables the research subjects to gather much of the data at home. As more diagnostic monitoring devices come to market, the power of this approach will expand. Fourthly, complex genomic testing can be included in a study based on blood draws at a local hospital. This is the case for the MIPACT study referenced above. Finally and as noted in the first excerpt above, the Apple ecosystem enables research studies with a huge number of enrollees. Big data can only serve to enhance the validity of these Apple-enabled studies.
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