Early Adopters of Apple Health Records at a Large Academic Medical Center: Results of a Cross-Sectional Survey Of Users (Preprint)

BACKGROUND Mobile applications offer a new approach to personal health records, internet-based tools for patients to consolidate and manage their health information. The University of Pennsylvania Health System (UPHS) was one of the first health systems to participate in Apple Health Records (AHR), a prominent example of this new generation of personal health records. OBJECTIVE To characterize early adoption of Apple Health Records among UPHS patients and understand user perspectives. METHODS An email-based survey with fixed answer, Likert scale, and open-ended questions was administered to all UPHS patients using Apple Health Records in the first 10 months of participation. Survey data linked to the UPHS electronic health record system was used to analyze responses. Multivariable logistic regression modeled the association of patient characteristics with user ratings. Content analysis was used to analyze open-ended questions. RESULTS At the time of the survey 1,458 patients had used AHR at least once. Mean age was 47.5 years, 66.3% were male, 70.9% were white, and 80.8% had private insurance. Response rate was 26%. 46.3% were very satisfied with AHR and 67.7% described it as very easy to use. The most commonly utilized features were lab results (82.9%), clinical vitals (67.5%), and medications (64.7%). No patient characteristics were associated with reporting high satisfaction or ease of use. Most common reason for using AHR was convenience/ease of use and 55% of users reported allowing no other apps to access their health information, citing privacy as one consideration. CONCLUSIONS Early adopters of Apple Health Records were demographically white, male, and privately insured. Convenience was an important facilitator and users were selective in which apps they allowed to access their health information.