Matthew Holt

Kaiser tiptoes into HealthVault & tells THCB about it, with UPDATE

Kaiser Permanente signed on this morning for a pretty extensive pilot with Microsoft,
allowing its 159,000 employees to copy their online health records into HealthVault. This is a big coup for Microsoft and a fairly ambitious move for KP which to this point hasn’t said much publicly about the data transferability it was going to provide for its members. This is a clear signal.Kp

Assuming that the pilot is a success, presumably all Kaiser members using My Health Manager (over 2 million now and heading to 3 million at years end) will soon be able to move their data to HealthVault. We are potentially seeing the first real example of mass scale data interoperability onto a platform not connected to a health care organization. And obviously, Google is playing in this same space too.

Once the data is collected in HealthVault, there are lots of possibilities for what can be done with that data, and what services can be offered.

Back in the days when Justen Deal was causing havoc with HealthConnect, I had a somewhat unorthodox interview with Permanente’s Andy Wiesenthal — in which (without KP’s PR folks knowing) I called him in a taxi on a cell phone late on a Friday night. Perhaps it’s a mark of how far THCB has come (you decide if it’s good or bad) that in regular business hours on Friday, KP’s publicity machine lined me up for a pre-release interview with Peter Neupert, Corporate VP of Microsoft Health Solutions Group and Anne-Lisa Silvestre, VP of Online Services at KP.

I spoke with them about what they intended to do, why they were
doing it, and where they thought that it was taking American health
care.

Here’s the interview.

UPDATE: I apparently missed something quite important in a comment
made by Anna-Lisa Silverstre.  Here’s how Steve Lohr reported it in the
NY Times:

Kaiser chose the Microsoft technology, even though Ms. Silvestre is
a member of a group of health professionals advising Google. Ms.
Silvestre said Kaiser also looked closely at Google, but was
particularly impressed by Microsoft’s technology for protecting the
privacy and security of personal data. And she noted that Microsoft and
Kaiser are using the same Web-based format, called a Continuity of Care
Document, or CCD. Ms.Silvestre said Google is initially focusing
its efforts on a different format for Web health records, called
Continuity of Care Record, or CCR.

But these different Web
standards, analysts say, are not a long-term obstacle to consumer
health records from rival companies being able to share and view
information. Google, for example, is committed to supporting both
formats, and so is Microsoft.

“Google will certainly be a player
in this, and we look forward to working with them,” Ms. Silvestre said.
“We’re all for consumer choice.”

However,
some people are reading rather more into this choice in formats.
Apparently the CCD format makes the data viewable rather than
delivering discrete data elements that would make it interoperable. I’m
hoping that some who know more than me will chime in here, but my
impression is that it’s the equivalent of moving a copy of an html file
than handing over a full database. Please comment on this below.

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Phil GianuzziJNFerreeBillMGTroysterr Recent comment authors
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Phil Gianuzzi
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Phil Gianuzzi

In response to the anonymous rant:
Actually according to the HealthVault sign-in page, they accept openID from at least two providers. I’m going to assume they aren’t lying on the sign-in page.

JNFerree
Guest

As for Authentication of the Individual, does this mean that the we all need to update to the new MS Passport routine for Secure access to their HealthVault PHI data?
I’ve had MS Passport since `99. When I populated my PHR data, I was required to re-configure my Passport codes to their new more robust alphanumeric password code set.
Does this mean all users will need to have a MS Passport in order to share their PHR on the MS platform?

Bill
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Bill

Great news for the future of Personal Health Records.

MG
Guest
MG

One clarification – Be Well seemed to be largely scoffed at by a number of people in the blogosphere when it was announced but some of the ideas and use cases were very interesting even if it is a ways before truly implementing them.

MG
Guest
MG

Attended the Microsoft Conference and some points: – Number of Sr. Senior Engineers there so you know that a number of vendors and partners are treating this quite seriously. Vendors don’t commit scare resources like this unless they really think it is something worthwhile. – Much of what Troysterr said is true from a technical perspective. Have to really read more posted on the Microsoft site but one of the biggest potential biggest issues I see down the road is that Microsoft is building the data elements in a very ad hoc fashion (now up to 32 distinct data elements… Read more »

Troysterr
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Troysterr

I don’t have a horse in the race, but I feel compelled to clarify/correct some of the comments by “Anonymous”: 1. Yes, Microsoft is the author of .NET. However, it’s in use by millions of developers the world over, so its proprietary nature is hardly a hurdle. 2. False. Microsoft .NET is not necessary to develop for HealthVault. It uses industry standards, and Microsoft is even developing toolkits for Java and Ruby. They do provide richer toolkits for .NET, but that doesn’t preclude anyone from using Perl, Python, COBOL, or whatever they wish. http://blogs.msdn.com/familyhealthguy/archive/2008/04/14/opening-up-the-vault.aspx Also, Visual Studio Standard edition is… Read more »

Matthew Holt
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I’m grateful for all comments. My sense is that what Jamie Ferguson says directly contradicts what little bit I understood about CCD. And I stress I was going off what I was told by someone else. Many of Anonymous’ criticisms of Microsoft are true, but I don’t think they are relevant. The fact is that despite the success of the open source movement the vast majority of software is not open source, and of course those vendors including Microsoft are not going to release the code. So their attendant business and security issues are what they are. There are two… Read more »

Anonymous
Guest
Anonymous

Over the next few days and weeks there will be a media love fest over the recently announced partnership between Kaiser Permanente and Microsoft HealthVault. The two large corporations, one not-for-profit and the other very much for profit have agreed to exchange Kaiser Permanente health data. The details of the actual mechanics are not widely konwn other than Kaiser Permanente and Microsoft touting that the exchange will take place via XML schema of CCD. Why is this bad for Health 2.0, Web 2.0 and the FOSS movement? Oh let me list the ways: 1. Microsoft coding technology is proprietary to… Read more »

Jamie Ferguson
Guest

As the Kaiser Permanente director of health IT strategy and policy, I am more than a little familiar with these formats. Probably few would care about this detail, but the reporter actually got that last bit exactly backwards. CCD represents the data in HL7 v3 CDA XML for improved interoperability. CCD is the recognized federal standard for interoperability of medical summaries, required in 2008 FEHB contracts and in the 2009 CMS call letter, and it has greater specificity than the competing standard chosen by Google. Both of these standards may deliver discrete data elements and both may be viewed as… Read more »

jd
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jd

Matt, I’m no expert on the technical details, but I’m sure that the difference between CCD and CCR is not that one provides interoperability while the other does not. The point of both of these standards is to make data transmittable across systems and thus produce interoperability. CCD (I think!) transmits data in xml format, and thus is more ready-made for web viewing. It is also broader than CCR in that it incorporates HL7, which (I think again!) provides a much richer set of clinical categorizations. In other words, the sense that I get is that CCD is more advanced… Read more »

Anon
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Anon

At the Microsoft Healthvault Solutions Conference and interested to see what they have to say over the next two days. Agenda is full of a pretty varied group from all segments of the healthcare community. Even the big national health plans have set some senior people which is a surprise to me.
About the only notable absence I can see from the list of attendees is Epic. Even some token representation from Cerner (which is kind of ironic given the tongue lashing that their CEO gave PHRs just about a week ago).