Apple’s new project, Healthbook, has been the subject of rumors about the Cupertino, California company’s expansion into digital health. It appears that Apple is picking up the challenge of identifying health parameters with health tracking tools to analyze blood pressure, blood glucose levels and other health data.

Peripheral devices have been developed to date by third party partners like AliveCor or Glooko, that enable collection of data like a cardiac rhythm strip or blood glucose levels with a peripheral glucometer.

Speculation centers around questions of whether or not the company will continue to source the peripheral monitoring hardware from third parties, or if they will develop their own tracking peripherals like the recent iWatch patented by Apple to track fitness.

As early as September of 2009, Apple applied for a patent on a peripheral pulse oximeter for the iPhone.

However, Apple sources stated that Apple had no plans to develop peripherals for monitoring, and they have instead encouraged the development of third-party peripherals.

Apple did not produce the pulse oximetry app, but various companies in competition in the App Store have developed their own versions for the iPhone.

Perhaps Apple has changed their corporate plan?

The company announced in January that they had hired Michael O’Reilly, M.D., the former Chief Medical Officer who worked primarily at Masimo on their iSpO2 Pulse Oximeter, a device that connects to the iPhone with a companion app and provides detailed information about the oxygen saturation of the blood and pulse rate.

Hiring notable experts in small device development, fitness and medicine in recent months, some of who have worked on health sensors and fitness suggests that Apple may become the dominant force in the field.

We have seen Apple let other companies take the lead in peripherals for monitoring medical parameters like the AliveCor heart monitor.

With its innovative technology, AliveCor would appear to be a natural partner with Apple for development of new functionalities in cardiology.

FDA approval of these peripheral tracking devices is a hurdle companies hoping to develop new monitoring capabilities must overcome.

Apple’s Vice-President of software technology met with the FDA in December to discuss “mobile medical applications” The New York Times reported that month, as the meeting was on the agency’s public calendar.

Existing wearables could be easily incorporated into one device and Apple may use combinations of accelerometers, altimeters and heart rate sensors in the iWatch in combination with new technologies to analyze blood work and cardiac output or blood pressure.

There is a Cambridge startup, MC10, that has developed a skin patch that can detect hydration status; a similar patch would be easy for Apple’s experienced engineers to develop for incorporation into the iWatch and subsequently record data into the Healthbook.

With recent hiring, Apple can easily incorporate innovative monitoring technologies into the iWatch, but some parameters will be difficult to incorporate in one device that is wearable on the wrist.

However, with the innovative capabilities and vision that have always placed Apple at the forefront of mobile technology, it seems that Apple is a natural contender for domination of this type of interactive health monitoring that may someday become a force in the healthcare sector that makes up 17.9% of the national GDP in an increasingly aware consumer population.

The potential is captivating, especially considering the way Apple’s innovation in iOS technology has been a game-changer in the way we live now.

In what possible ways will Apple leverage its own extraordinary engineering resources to dominate digital health monitoring?

The question we should be asking now is how will this plethora of wearable monitoring devices help or hinder conservation of scarce healthcare dollars?

What are the costs versus the benefits?

Will doctors and patients profit from constant monitoring or is it another cause of potential liability, time and money for physicians?

Will constant monitoring be of questionable value for patients, a potential source of unnecessary worry?

Given that patient education about diabetes still leaves many patients bewildered at slight fluctuations in their blood glucose level, how many patients will be calling daily with reports of mildly elevated blood pressure that occur because of a stressor or pain?

One thing doctors are taught in medical school is to “treat the patient, not the numbers.”

Daily monitoring may result in additional information for consumers, but the assumption that all patients can put it in context is misguided. There will be a definite cost for medical practices, and the benefit to patients may be questionable. 

One way to handle information could be to have direct transmission to the medical practice at set times, with the option of patient triggered reporting if an unusual event, like palpitations, occur.

Patients have a different baseline level of health, and their “numbers” will differ. Software can analyze and pick up abnormalities and outlying values.

An ancillary provider, such as a nurse practitioner, can compare the numbers to the patient’s chart to determine if the change is significant to the patient’s history.