TECH: Microsoft Healthvault

Microsoft released its new Health Vault system this morning. You can read lots about it all over the Internet (NY Times article here).

Briefly the Health Vault allows you to save searches and information you’ve collected on the Internet, also data from devices like blood glucose meters and peak flow meters, and finally the ability to store data from various places (e.g. PHR companies, EMRs etc). I’ll be checking in with some of those partners later in the week.

Microsoft swore blind to me that this has been vetted by the privacy crowd (including the more, ahem, extreme among them) and that all this data will be totally portable to other storage applications.

The money will come from people using search, not from (as Peter Neupert said at Health2.0) putting a toll between patient and doctor.

So with Intuit already making noises, Dossia possibly back on track, Microsoft launching, and Google still working on something similar, the games really are beginning. I’ll be back to comment later.

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  1. uh…to be fair, I did keep trying and after leaving the HealthyCircle website, re-booting and logging back in, I was successful in backdating some sample weight data. I also succeeded in entering updated weight data for today, though much to my chagrin, it went in 3 or 4 times…but still can’t delete them.
    Not a quitter in any sense, and will just see how it really works out in the long run

  2. After playing with the HealthVault website and finding it quite user-unfriendly, I will probably remove the (Microsoft) software and use the space for a game.
    Discovering that after making a couple of entry errors (on it’s HealthyCircle partnership website), I found that my data charts will be forever skewed as there is no way to change the entered (and incorrect)data. Likewise, I find there is no way to enter data for a previous day (perhaps broken software). Any gap in data will then be charted as a straight line which would of course remove any “peaks and valleys” occuring in the unintended missed day(s). No vacations for you if you want good metrics!!!
    Most infuriating is having to calculate certain metrics before entering (amount of insulin) into Their preferred values, or entering md/gl on website, only to be displayed as mmol/l on the other (Healthycircle vice HealthVault). Time is displayed as Pacific in history (do your mental math) but as 0:500:00 every day despite the time the metric was imported from HealthyCircle. The thought here is that HealthVault is intended to be the “one stop shop for data records,” but in fact, you have to go back and forth between websites to get the data you will want in the format you (and perhaps ones physician) would prefer. The user-unfriendliness is that there is no option to select the parameters that one may be familiar with….
    While so it seems that the (HealthyCircle)site has a penchant for an “international flavor” (metric) why then is weight done in pounds? BP is done okay, but no entry point for pulse (which results in an error flag stating MAP cannot be calculated – without it).
    As I said in an email to Microsoft and HealthyCircle, why would I want to have to calculate data and maintain a faulty database / charts / metrics if I cannot correct parameters. As I said to to them, it will be easier to build a Excel spreadsheet with more meaningful (and correctable) data.

  3. It thought one of the purposes of the CCHIT was to develop standards to allow EHR’s to import and export data from/to different EHR software products. I see no mention in any of Healthvault’s online SDK info about using this as a standard. So much for cooperation . . .

  4. Not saying has a great point. As we enter an era of consumerism in medicine, we must start to cater to the consumer mindset– the same one that makes BMW spend a lot of time on getting the “thump” of closing the door just right and made Volvo add curves to a previously boxy (but extremely safe) product.
    This brings up an interesting point–what is sexy when it comes to healthcare?

  5. Hmmm … for once it looks like Microsoft may have an edge over Google. You get the feeling they’re not going to have face quite the same level of criticism over their privacy policies as Google will.
    WSJ did something on this today … the money quote:
    “Consumers are just not that excited about these” services, said Elizabeth Boehm, an analyst at Forrester Research Inc.
    The evidence suggests that the American public does not buy things it thinks are boring. Ever. So how do you solve that?

  6. I’m curious about the privacy features–I guess I’ll need to open an account to see what there is (though I worry about what kind of personal profile I’ll create if I go dink around).
    Where is the lab data? Where is the medication data? Why aren’t these companies partners? Perhaps getting paid for valuable data is the issue, but I’m sure everyone will blame the complexities of consent. Ask for emr uploads, and the doctor’s office becomes the data entry resource for the project.

  7. One quick comment to Dr. Levin, actually there is a PHR that is built to use HealthVault as a ‘data source/target’: it is CapMed’s PHR (which my company helped CapMed build). The current version that launched with HealthVault is ‘icePHR’, with a more full-feature version coming very soon.
    jd makes a great point that is right on the money. In my experience on both the clinical side and the patient/consumer side, the PHRs will click once there is very tight integration with EMRs (and payer too, for that matter). CapMed’s approach addresses this, I believe, as HealthVault is treated as one among many data sources. There are partnerships with a multiplicity of other data providers that include, in fact, some providers of EMR data directly to the CapMed PHR.
    Of course, this all bring up an interesting issue concerning data liquidity: namely, as we break down the data silos and more PHI sloshes between multiple systems, this would seem to tend to degrade the guarantee of privacy and security that Microsoft is promising with HealthVault. Bill Gates has an interesting op-ed piece in todays Wall Street Journal that I think results in a sort of cognitive dissonance. I have some more thoughts on it in a blog entry here:

  8. Gary, what do mean you wonder whether payors will reimburse for it? What is there to reimburse? Payors are interested in whether physicians have EMRs, not PHRs, because the EMRs can be used for efficient and accurate data aggregation for quality measures.
    The main limitation of this PHR, and any clinical PHR for the large majority of Americans, is that very little clinical information right now is stored in a searchable database. You need widespread use of EMRs before this is really useful, because people aren’t going to take the time to enter their own data by hand.
    I think this is years away from being able to compete with health plans’ claims-based PHRs in terms of completeness of information. Eventually the web-based, patient-owned, auto-populated clinical PHR will win out, but probably not for 5-10 years.

  9. As a practicing physician, I’m really excited about this application and have signed up for a personal account. My plan is to start enrolling my patients with the hope of consolidating their medical data.
    I found however that the application did not have a place for me to enter my past medical history, medication lists etc. I think, for this application to work for my patients, this feature needs to be in place. Perhaps this feature already exists. If this is the case, it needs to be more obvious to the user. I know this is in beta, so I’m willing to wait. My hope is that the Health Vault is a true PHR.
    Mark Singh MD

  10. Didn’t mean to just sound critical. This develop does address several shortfalls with the current generation of PHR solutions. Additionally, Microsoft seems to be realistic about how customers will use and adapt these solutions. That is a positive step for the industry. It is particularly interesting that they got the primary privacy gurus on board too.
    It should be interesting as you said.

  11. I also noticed that none of the really large acute EMR vendors (Epic, Cerner, and GE) hadn’t signed on either. Going to make it tough to get data from hospitals with these systems I imagine.

  12. Sounds like a really interesting tool but I was most intrigued by the list of partnerships that Microsoft signed and the supposed open development.
    There are some impressive partners on board including a few of the leading vendors in the PHR space (CapMed, Medem, etc) and a few of the leading EMR vendors. One thing I don’t see is a single health plan, clearinghouse, or PBM on board.
    This likely means no access to claims data of any form. Fairly predictable since the one real value point that payers are sitting on right now – especially the national guys – is their mountains of claims data. They aren’t about to just give this data over to Microsoft, Google, or anyone else free of charge.
    It just affects too many areas that health plans regards as core competencies such as underwriting and medical management. This may change if the policy environment shifts radically changes for some reason but I have my doubts.
    The other interesting area is letting developers take a crack at developing apps for Health Vault. I wonder how much access Microsoft is going to give to developers but this is a good strategy. Let the guys and clinicians who knows what works sweat the tough stuff and adopt the best of breed consumer tools.

  13. Its interesting that so many data companies are coming into this space– they will pull health information in formats that can be mined– and how that interacts with future payment models will be interesting. You may expect that insurance underwriters will go crazy trying to get at this information– and likely increase the dispersion of health premiums between the healthy and those most at risk.
    It will also be interesting to see if a de-facto standard like XML rises from these data-warehousing efforts. The other alternative is the continuation of the format wars we have today, which would mean that none of these efforts would amount to anything…