Forget the EHR — Your Health Data’s On Your Phone
In 2020, I asked a provocative question:
“What does it mean for the future of health when Apple makes more money from AirPods than the top ten EHR vendors combined?”
At the time, it might have seemed like an unfair comparison—enterprise software versus global consumer electronics. But five years later, it’s clear that this contrast was not only valid, but also predictive of a broader shift: health data—and thus health innovation—has moved out of the clinic and into the consumer’s pocket.
The Real Center of Health Data Is Not the EHR
“We have 50,000 times more consumer health data than EHR data. So where is AI health innovation going to happen?”
The Electronic Health Record (EHR) remains the data centerpiece of traditional medicine. But in terms of data volume, it’s no longer the main source of information about our health. And it’s not even close.
U.S. EHR Data Volume
Each U.S. patient generates an estimated 80 megabytes of EHR data annually, including clinical notes, lab results, and imaging. Multiply that by roughly 250 million Americans interacting with the healthcare system annually, and you get:
→ 20 petabytes per year of U.S. EHR data
U.S. Consumer Health Data Volume - Calculated by Total World Data
There is no question that the real volume, and the real growth, in health-related data is happening outside the exam room, and outside the EHR.
Every day, we generate health-related data through wearables, smartphones, browsers, keyboards, credit cards, sleep monitors, voice assistants, and fitness apps. Not to mention smartwatches, rings, and earbuds.
One way to estimate this is by looking at the total data produced worldwide:
Global data generation reached approximately 147 zettabytes in 2023. If we very conservatively estimate that only 5% of this is health-related consumer data (i.e. somehow related to, or useful for, our health), we get approximately 7.4 ZB/year globally.
Adjusting for the U.S. — which has about 4-5% of world population but likely 10-15% share of digital activity — we can conservatively estimate that the U.S. generates roughly 1 zettabyte (1,000,000 petabytes) of consumer health data annually..
→ That’s 50,000 times the volume of U.S. EHR data
Another way is to look at individual data generated.
For example, everyone with a smartphone — which Pew estimates to be 91% of the roughly 230 million US adults, or 209,000,000 people. Even if we just look at the accelerometer data for those people, leaving out all the other health-related information on their phones (like speech patterns, word choices, grocery bills, etc) continuous low-frequency sampling (1–2 Hz) on an iPhone can generate 1 GB of raw movement data annually. Which is 209 pettabytes for the adult population.
→ That’s still ten times the volume of U.S. EHR data
So even our low-end estimate shows that we’ve got 90%+ of our health data sitting on our phones, not in the EHR. And it’s not hard to believe that if we wanted to predict, for example, cardiovascular risk, using either the average person’s EHR data (which is likely minimal) versus that person’s continuous data on how fast, how far, and how often they move . . . it’s the phone data that will produce a better prediction.
Although as far as I know, no one is yet doing that. Sigh.
Lark health coaching
Innovation Follows Data
If the EHR holds such a tiny part of U.S. health-relevant data, where should we expect most of the next breakthroughs in diagnostics, prediction, and prevention to occur?
Not in the hospital. Not in the clinic. Not in the EHR.
Innovation is flowing to where the data is—in consumer-facing platforms and tools. We’re already seeing this play out in:
AI Symptom Checkers: Platforms like K Health and ChatGPT-based tools provide users with AI-driven assessments of their symptoms, offering preliminary insights before consulting healthcare professionals.
Wearable-Based Sleep Optimization and Stress Tracking: Devices such as the Oura Ring and WHOOP monitor sleep patterns and stress levels, providing users with actionable insights to improve rest and manage stress effectively.
Early Illness Detection: Wearables like the Oura Ring have introduced features such as Symptom Radar, which can detect early signs of respiratory illnesses by analyzing physiological data, enabling users to take precautionary measures promptly.
Fitness and Glucose Feedback Loops: Dexcom G7 offers continuous glucose monitoring that now connects directly to Apple Watch, allowing users to track their glucose levels in real-time. Similarly, Levels and Ultrahuman provide platforms that integrate glucose data with lifestyle factors to optimize metabolic health.
Personalized Coaching and Risk Scoring: Apps like Lark Health utilize AI to offer personalized health coaching, helping users manage conditions such as diabetes and hypertension through tailored advice and monitoring.
Mood Inference and Mental Health Support: Ellipsis Health has developed voice-based technology that analyzes speech patterns to assess mental health, providing insights into conditions like depression and anxiety.
These advances are possible not because of structured ICD codes—but because of rich, continuous consumer data at massive scale.
Conclusion: The Real Medical Record Is Distributed
Ultrahuman metabolic tracking
In 2025, the EHR remains essential—but it’s nothing like central. The richest, most frequent, most predictive health data lives outside the clinic.
And that means the future of health won’t be driven by Epic, or Cerner, or Allscripts. It won’t even be driven by United Healthcare, or Kaiser, or Mass General.
It will be driven by whoever best understands—and leverages—the flood of health-relevant data being generated by consumers, not patients. And that is likely to be the consumer tech companies, both giants like Google and tiny startups or that haven’t even left the garage yet.