Health care is in the process of getting itself computerized. Fashionably late to the party, health care is making a big entrance into the information age, because health care is well positioned to become a big player in the ongoing Big Data game. In case you haven’t noticed computerized health care, which used to be the realm of obscure and mostly small companies, is now attracting interest from household names such as IBM, Google, AT&T, Verizon and Microsoft, just to name a few. The amount and quality of Big Data that health care can bring to the table is tremendous and it complements the business activities of many large technology players. We all know about paper charts currently being transformed via electronic medical records to computerized data, but what exactly is Big Data? Is it lots and lots of data? Yes, but that’s not all it is.Continue reading…
Microsoft’s Health Solutions Group (HSG), which has straddled the fence with consumer-facing (HealthVault) and corporate-facing (Amalga), is increasingly moving to the corporate side of the fence. Not that surprising considering that the consumer market continues to struggle (Google Health is in virtual mothball state, consumer adoption of HealthVault is nothing to write home about) and that HSG has now moved out of R&D and is now under the business solutions group, Dynamics. At the end of the day, HSG head Peter Neupert has to show that he can deliver the goods and Amalga is the horse he’s betting on (Note: Sentillion is there as well, but think of Sentillion as the gate-keeper to accessing Amalga).
Yet Amalga has gone through its share of birthing pains with some in the industry beginning to question its value.
Amalga has suffered from two significant problems, both inter-related. The first is that Amalga is an extremely powerful set of data aggregation and analytical tools, but it is more of a toolset then a product and this leads to long implementation time-frames and subsequently an inability to extract value quickly (ROI for Amalga is measured in years). For example, in 2009 Golden Living signed on to adopt Amalga and HealthVault. At last week’s Connected Health Conference, (CHC) Golden Living presented some remarkable results of how they are transforming long-term care through the use of Amalga. But in their presentation, Golden Living also stated that they knew full well when signing on to Amalga that this was going to be a multi-year effort and their implementation team has been given 5 years to put Amalga in place. Five years to fully implement a software solution is a very long-time and similar to the installs of the largest EHR systems. Unfortunately, many early Amalga customers did not have the foresight of Golden Living. In recent conversations with Microsoft, Chilmark has been told that significant resources are now being dedicated to improving time to value for Amalga. We’ll have to wait and see as the CHC sessions we attended on Amalga and HealthVault Community Connect, did not make this readily apparent.Continue reading…
I’m watching ads during the ballgame (I watched the kick-off and the ads—the rest, not so much) and who should be declaring itself a “cloud solution” but Microsoft?!
OK, I’ve gotta admit my gut reaction was: Microsoft in the cloud? Seriously? But my next thought was…YES! FINALLY! I’m watching evolution unfold before my very eyes, and it’s oh so comforting to see others walking upright on two feet, using modern tools, and cooking their food.
What am I talking about? Well, let me explain. Gather round kids for a quick tour of the museum of ancient computing history. There will be time for a bathroom break later.
When I first heard about Augmented Reality, I thought – this is really cool. Let me try and augment mine.
And I had a vision that included Scarlett Johannson (just kidding, sweetheart) and a home totally free of weekend honey-do’s and totally full of perfectly happy, compliant teenage children.
Hell, if I am going to augment reality… I might as well go for it.
Imagine this – in the not too distant future a wearable device will display a seamless series of “helpful” tags on top of what you are actually seeing, so as to make your viewsing more effective.
Maybe you are part of surgical team involved in a complicated intervention, and your technology is superimposing real-time CT scans over your actual view of the operating field, hopefully improving outcomes. O0ps, that is happening now! The tags, and decision support, which will make things even mo betta will happen later.
Or say you are 18 and a Marine trying to repair a complicated hunk of your war machine (or maybe just a flat tire) in the desert or the jungle – special goggles will augment your reality with a layer of digital information that shows you how to fix your stuff in real time.
In previous blog posts, I’ve mentioned an idea deserves its own dedicated post.
Over the weekend, I keynoted the eClinicalWorks National User’s Conference in Florida. One of the attendees emailed me the following question:
“I have a number of questions regarding certain types of patient-level data that might cause us problems in the future of HIE. No one, to date, has been able to answer these and I thought I might ask you.
The first, and easiest, is how we we going to handle the following situation:
1) I am seen in Boston as a child and my mother says that I am allergic to Penicillin (or pick your drug of choice). The nurse-practitioner asks a few questions of my mother, who isn’t terribly forthcoming with information but insists that I am allergic. While he/she has reservations, they record it as an allergy in their eclinicalworks EMR. It goes to the Massachusetts HIE.
HIE stands for Health Information Exchange. Sometimes the term HIE is used to describe the act of exchanging health information, sometimes HIE is used to describe the infrastructure which enables the exchange to occur and sometimes HIE is used to describe an organization that owns the infrastructure which enables the act of health information exchange. HIE (the act) is supposedly the holy grail of Health Information Technology (HIT) and the enabler of “an EHR for every American by 2014”, which in turn, will bring about better health care at lower costs and, by leveling the playing field, will reduce disparities in care.
The Government, through ONC, has awarded over $547 million to various States to create regional HIE (organizations). The fledgling new State HIEs (the organizations) are busy screening and purchasing HIEs (the platforms) and defining the rules of their local HIE (the act). There are several HIE (platform) vendors, notably Medicity and Axolotl (recently acquired by Ingenix), but even Microsoft and IBM are trying to make inroads into this fairly new market. In a parallel process, ONC is busy defining national standards and regulations for HIE (the act).
There are two basic models for any information exchange and HIE (the act) is no different.
The Centralized Model – All information creators/editors/contributors push their content to a centralized repository, preferably in real time, and all users/readers pull the information on demand from said centralized repository. This is the infamous “database in the sky” which houses every American’s medical records. Conceptually, this is the simplest model to understand. The Government will buy enough hardware to set up clusters upon clusters of databases, define the exact data elements and documents to be stored, assign a national identifier to all of us (physicians too) and finally publish specifications for pushing and pulling data securely. Every EHR vendor and medical information supplier (such as labs and pharmacies) will build the necessary web services and integrate them in their technology and we will all live happily ever after. However, other than the obvious monumental technology challenges involved in maintaining such infrastructure, Americans tend to experience significant discomfort with the concept of Uncle Sam having unfettered access to so much personal information and the obvious privacy issues it raises.
Google Health has seemingly been stuck in neutral almost from the start. Despite the fanfare of Google’s Eric Schmidt speaking at the big industry confab, HIMSS a couple of years back, an initial beta release
with healthcare partner Cleveland Clinic and a host of partners
announced once the service was opened to the public in May 2008, Google
Health just has not seemed to live up to its promise.
Chilmark has looked on with dismay as follow-on announcements and
updates from Google Health were modest at best and not nearly as
compelling as Google’s chief competitor in this market, Microsoft and
its corresponding HealthVault. Most recently we began to hear rumors
that Google had all but given up on Google Health,
something that did not come as a surprise, but was not a welcomed rumor
here at Chilmark for markets need competitors to drive innovation. If
Google pulled out, what was to become of HealthVault or any other such
Thus, when Google contacted Chilmark last week to schedule a briefing
in advance of a major announcement, we were somewhat surprised and
welcomed the opportunity. Yesterday, we had that thorough briefing and
Chilmark is delighted to report that Google Health is still in the game
having made a number of significant changes to its platform.
My final interview from my trip to Microsoft was with Nate McLemore, who is Director of Business Development for the Health Solutions Group and also involved in Microsoft’s policy & lobbying work. Nate talked about Microsoft’s role in the ongoing deliberations on meaningful use, ARRA and all that.
Continuing my series of interviews from my trip to Microsoft the week before last (before their conference) I met with Michael Raymer. Mike is a long time health IT veteran who’s been at Microsoft for about six months and is in charge of the Amalga product line. Amalga includes a standard HIT clinical product aimed mostly at the Asian market, and an enterprise integration product aimed at large hospital organizations in the US. What that means exactly, and how Amalga fits into the EMR ecosystem, Mike explains in this interview…
Technical note: If you’re having trouble with this video in IE, you may need to download the latest FlashPlayer version. Unfortunately our video service Vimeo is having some problems that appear to need the latest version of
FlashPlayer. You can do that here. Alternatively Firefox seems to work fin (but don’t let the folks at Microsoft know that I told you that!)
Continuing my tour around Microsoft’s HealthVault team I met with Bert van Hoof. Bert is the devices guy who showed me lots of ways to get data into HealthVault. If you’re interested in how a power user links devices and data (and if you excuse my amateurish video work), you’ll like this one!
If you’re having trouble with this video in IE, you may need to download the latest FlashPlayer version. (Sorry, our video service Vimeo is having some problems that appear to need the latest version of FlashPlayer. You can do that here. Alternatively Firefox seems to work fin (but don’t let the folks at Microsoft know that I told you that!)