插上FHIR的翅膀，Apple真的能飛起來嗎？

因為Apple在iOS里嵌入了病志管理，一下子好多人都激動起來。他們都說：哎呀呀，之前谷歌、微軟搞的類似東西都是因為數據壁壘，Apple不會步其後塵的，因為Apple有用FHIR呀！！！

KLAS Research的Jared Jeffrey上月底寫了一篇長長的博客1??對Apple的這個舉動進行了分析，從整個文章的介紹上來看，FHIR的出現、標準化、普及對於Apple的這個產品線的確提供了天時地利，目前只欠人和。而對於人和，作者給出了他的三點分析（具體分析請看原文）：

• 首先，普通消費者是不會成天關注自己病志內容的。
• 其次，閱讀病志並不會促使消費者增強健康意識，更不會憑空提高健康水平。
• 最後，單一品牌產品線並不能推動整體行業的快速變革，全世界超過8成的智能手機使用的是Android系統。

在博文下面更是有一條精彩的評論（廣告部分被去除），精力因素就不翻譯了，大意就是用戶行為決定產品成敗，而做個人病志管理的，絕大多數都忽律了用戶行為：

In order for someone to choose to spend time on an app (when there are millions of them in the app store) the user needs to get something in return. And they need to get that return quickly. When I search for a restaurant on Foursquare I get a return (recommendations). When I use OpenTable I get a return (a dinner reservation). When I use WhatsApp I get a return (a conversation with a friend). When I use Spotify I get a return (music).

But what does the consumer get when they upload a bunch of health data into the Apple health record? Nothing. At least not immediately. At least not until they』re sick. Which they hope they never are. There』s no clear return. This is the challenge with patient-driven health records.

In my view, the companies that have failed on personal health records have failed because they didn』t fully appreciate the way consumers engage with their own healthcare and they ignored the core tenets of consumer behavior. People are busy and have been trained to ignore everything unless it makes them feel good or gives them some near instant utility. Unless Apple』s personal health record app can find a way to deliver utility back to the user (quickly) I fear that it may share the same fate as those that have tried and failed.

1. Apple』s Health Records App: A Ripple or a Roar? [Internet]. The cHealth Blog. 2018 [cited 2018 Feb 6]. Available from: https://chealthblog.connectedhealth.org/2018/01/29/apples-health-records-app-a-ripple-or-a-roar/