Divergent Approaches in Digital Health: Apple's ResearchKit Emphasizes Scale, Google's Baseline Study Focuses on Depth

Not long ago, Apple released the medical research platform ResearchKit, causing quite a stir. In fact, Google also launched a large-scale medical research project called the Google Baseline Study in July 2014, which uses mobile health tools to collect unprecedented amounts of health data from participants.

Not only are the two strikingly similar, but their similarities and differences are also quite intriguing. Headlines typically read: “Two tech giants at the forefront of mobile technology have both set their sights on addressing challenges in global medical research and clinical trials.” Moreover, Apple has pointed out that current practices in medical research and clinical trials are completely outdated.

Mike O’Reilly, Apple’s Vice President of Health Technologies, stated, “Until now, if someone wanted to conduct a research study, they would likely resort to distributing large volumes of flyers, hoping that interested individuals would note down their phone number. This approach has seen no fundamental change over the past few decades.”

Innovation in clinical trials is nothing new to researchers in the medical field, but it always raises the question: What will the outcomes be when clinical trials leverage mobile platforms?

Whether Apple or Google, both are moving closer to addressing various challenges in medical research, in line with public expectations. For instance, Google has launched an independent, large-scale “Moonshot” research initiative, while Apple has established a framework designed to enhance the progress, efficiency, and data quality of diverse research projects.

Both initiatives are built upon a major innovation in mobile health: the ability to continuously collect personal health data, thereby constructing a more complex and comprehensive health profile than what can be achieved through periodic, simple data collection. Moreover, these two projects are complementary. Part of the value of Google’s Baseline Study lies in comparing data from healthy individuals with that from patients, which is precisely the type of data that the five projects launched under ResearchKit aim to collect.

Of course, Google is also collecting genetic data in its Baseline project, which is definitely not part of Apple's current plan. As an open-source product, ResearchKit may have a more profound impact than Google's initiative, although the latter may be more pioneering.

Stanford University School of Medicine is one of the rare institutions collaborating with both ResearchKit and Google Baseline. Dr. Alan Yeung, a Stanford researcher involved in MyHeart Counts—one of the initial apps developed for ResearchKit—stated that the difference between the two initiatives lies solely in their depth and breadth, although he was not directly involved in Google Baseline.

Yueng believes that these are merely two different approaches, but it is undeniable that both are highly important. Google Baseline conducts in-depth studies on a relatively small cohort, yet the volume of data collected is substantial. Moreover, the research findings provide insights into the participants’ prior health histories. Last summer, they recruited 175 participants, with plans to expand the cohort to 1,000 in the later stages. In contrast, Apple’s approach leverages data from a much larger population, with researchers aiming to enroll up to 100,000 individuals and comprehensively record their physiological data. The challenge lies in the extreme complexity of the data and the presence of certain errors, as some users may not be fully proficient in using smartphones and related devices for data recording. However, due to the large number of participants, researchers can extract valuable information from this massive dataset.

Although both initiatives employ similar novel approaches to data acquisition, the issues they seek to address differ significantly.

For instance, data collected through ResearchKit enable us to understand the relationship between heart health and physical exercise; however, it is evident that ResearchKit does not collect genetic data or detailed medical histories. In contrast, Google Baseline can select data from a subset of individuals to gain deeper insights into the relationship between an individual’s heart health and their genetics. The “Baseline Study” project is led by Andrew Conrad, a 50-year-old molecular biologist who joined Google X in March 2013 and assembled an expert team of 70 to 100 members spanning the fields of physiology, biochemistry, optics, imaging, and molecular biology.

Apple and Google are not competing in the field of clinical trials, at least not yet. Even if competition arises in the future, there remains ample room for both to operate. Medical research is undoubtedly a slow-moving field that requires careful risk mitigation. Changing existing practices in medical research will require great doers. Perhaps even the combined forces of tech giants Apple and Google may not be enough.