From clinical care to continuous care

How Medable’s Synapse enables continuous, connected care anytime and anywhere.

By Michelle Longmire, MD

As a doctor, I have the honor and privilege of helping patients along their health journey. Often this journey involves new diagnoses, new medications, and even surgical procedures. Yet, while physicians strive to make the best decisions and perform the safest surgeries, when patients leave the office or the hospital, the quality of care is diminished. Why? Because there is an enormous gap in communication between the clinic and patients’ day-to-day lives. This week, digital health has made an important advancement to address this problem with Apple’s new CareKit. I am honored and excited that my company, Medable, is a part of the solution. Apple’s CareKit addresses the care gap by connecting patients and providers on mobile. Our product, Synapse, enables healthcare systems to leverage CareKit securely and at scale with analytics capabilities that open the door for digital personalized medicine.


CareKit advances healthcare because it closes the care gap by enabling doctors to provide patients clear and easy to follow guidance, in an app that tracks and trends the patient’s progress and relays health information back to the doctor and the medical record. This enables patients to receive up-to-date information, anytime, and enables doctors to make decisions based on data from their actual day to day lives, rather than sporadic clinic visits. With CareKit, after a patient has surgery, the surgeon can send patients home with an app that provides clear guidance about medications and wound care and the patient’s recovery can be tracked and trended in real time to identify complications like wound infections, so that care can be optimized and readmissions can be prevented.

Synapse allows healthcare organizations to leverage CareKit by handling complex technology issues — like HIPAA compliance and medical record interoperability — that have historically limited widescale adoption of mobile in healthcare. This sort of enabling technology is very important if digital technologies are going to have an impact in healthcare like they have had in finance, transportation and retailing. Healthcare systems can use Medable’s Synapse to create one, or many, CareKit apps for mobile care, such as managing diabetes, breast cancer, heart failure, or everyday health. We believe CareKit and Synapse can unlock the power of mobile in healthcare and help close the care gap, potentially dramatically improving the communication issues that costs the healthcare system $1.7 billion every year due to suboptimal outcomes and avoidable readmissions.


I am also excited about CareKit because it helps open the door to a new era of healthcare. Personalized medicine is expected to shepherd the next era of healthcare. However, there are not many real-world examples of personalized medicine in digital health because of a lack of digital data across diseases and across populations; I call this “the digitome.” Compare the digitome to the human genome. We now have massive genomic representations of human health and disease. Genomics is at the forefront of personalized medicine because we have enough data to derive relevant differences between individuals that track to health and disease, which can be leveraged to make medical decisions. We are far from having a comparable digital data set, but technologies like CareKit open the door to building the human digitome. Apps and connected devices can now gather symptom, medication response, and device data across the 60,000 medical diagnoses. Digital technology will soon enable the digitome, making it similar to knowing the gene and understanding gene variance we leverage in genetics-based personalized medicine.


And perhaps the most important aspect of CareKit: it creates a true conduit for information flow between the patient and the healthcare system. Currently, CareKit relies on healthcare providers to analyze the patient data and make specific changes. These changes can be relayed in real-time back in the app with an updated Care Plan. Soon analytics and machine learning will provide insights back to patients directly, alerting to high risk behaviors and providing guidance to optimize outcomes. Whether it is a doctor or an algorithm, mobile closes the care gap and creates critical connectivity for continuous healthcare.


So what does the future of healthcare look like? In healthcare, we think of clinical care, but digital enables continuous care. And that’s a really important shift. Continuous care opens the door to receiving healthcare in our daily lives, healthcare that is personalized, and healthcare that can leverage analytics to identify disease and complications earlier to optimize outcomes. The future goes beyond clinical care; the future is continuous care.