By Tom Ulrich

Fitbit, Jawbone, Nike, Withings…a lot of companies are already in the wearable/mobile health technology and data tracking game. But a couple of really big players are stepping on to the court.

At their most recent Worldwide Developers Conference, Apple announced both an app and a framework – Health and HealthKit – that will tie in with various wearable technologies and health apps. HealthKit will also feed data into electronic medical record (EMR) systems like Epic, which runs at some of the largest hospitals in the country. And rumors abound that an upcoming Apple smartwatch (iWatch? iTime? Only Tim Cook knows right now) will carry a host of sensors for tracking activity and health data.

Google also wants to get into the game with a health data framework called Fitthat they announced at their I/O conference in June. Unlike Apple, its strategy seems more focused on providing a standard way for trackers, devices and apps from different manufacturers to talk to Android Wear devices.

What will entry of these big players mean? We asked Michael Docktor, MD, Boston Children’s Hospital’s clinical director of innovation.

Q. Where do you think Apple and Google fit in the grand scheme of wearable health tech and personal health data?

A. I think Apple, Google and also Samsung are all trying to leverage the impending tsunami of data from wearable health and fitness trackers and display that data in a usable form. But they’re taking different approaches. Google and Samsung are being more consumer-focused, while Apple’s efforts to integrate with EMRs create an opportunity to take fitness data to the next level by curating and delivering that data to providers in a meaningful way.

Think of it this way: We could suddenly have an easy and clean way to collect data from patients during their daily lives – as opposed to giving them a medical-grade blood pressure cuff or pulse oximeter – and combine that with an app or device that encourages activity.

Q. A number of sites and apps already allow patients to collect and share their health information, each with its advantages and disadvantages; Google’s own Health platform was an early entry. What will change once Apple enters and Google re-enters the market?

A. I think that all of the wearables coming on the market these next few months will have a real democratizing effect on health care. The technology will give patients a lot more access to their own data – they’ll be generating it themselves, after all – and give them an opportunity to learn more about themselves and their own health. I suspect adoption will be huge.

The opportunity will also be there for clinicians to learn more about the state of their patients’ health in the real world. Ninety-nine percent of a person’s time is spent outside the clinic. For clinicians like me, this could open a window on to what happens in our patients’ lives when they’re not in our offices, which is arguably far more important.

Q. What are some unexpected challenges or stumbling blocks that Apple and Google may face?

A. Information overload could be a real problem, especially for providers whose patients have devices tied in with their EMR. It’s interesting that Apple has created partnerships with Epic and the Mayo Clinic. I hope it’s using that opportunity to find out what information providers would want to have available to them, how to present those data in a meaningful way and when or how to alert providers to potential problems.

I also hope Apple and Google – if they decide to provide data to providers – aren’t too shortsighted in partnering with just one or a limited number of EMR providers. They should use a broad approach to developing tools and interfaces for feeding data.

This is the beginning of a whole new world in medical informatics, patient engagement, and health tracking. A lot of thought will have to go into governance over how one collects and studies the data. There’s going to be a need for education and discussion about who is responsible for monitoring data fed into a patient’s EMR and raising red flags if necessary. And providers are going to be held responsible for securing and acting on those data.

Many thanks to tech blog The Wirecutter for permission to use their fitness tracker roundup photo.