Strategic Informatics

A blog about the strategic application of technology

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Gulf Coast Region IT Departments Brace for Gustav


As tropical storm Gustav approaches hurricane strength and heads toward the Gulf Coast, the IT lessons learned from the devastating Hurricanes Katrina and Rita that smashed New Orleans and other areas in 2005 are on the minds of many worried IT managers. Disaster recovery plans are critical in weather prone areas such as this. Even if you aren’t prone to weather conditions as those of the gulf coast region a well laid out DR plan will help curb any unnecessary downtime after the storm.

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Microsoft Developing Its Own App Store for Windows Mobile?

It appears that Microsoft, noticing the success of the App Store from Apple, is set to launch its own app store for windows mobile platforms given a recent job posting on computerjob.com. The description states the senior project manager will ead a team that will “drive the launch of a v1 marketpace service for Windows Mobile.” The success of the iPhone App Store is a sure way to drive traffic from a mobile platform. I must agree that searching the app store is far simpler than scouring the Internet in search of an applicaiton for your mobile smart phone. While I’ve certainly had my fair share of issues with the iPhone v2 firmware at least Apple has recognized and actively fixing issues which is a far cry from the issues I’ve experienced on Palm, Windows Mobile, and yes even Blackberry Mobile Operating Systems.

I’m seeing a steady increase in the use of iPhone’s in physician hands. With apps like ePocrates hitting the Apple App Store it won’t be long before more and more physicians take advantage of the quick search capabilities offered by Mobile Safari and reference tools such as ePocrates. At the Microsoft Health Users Group meeting this past week I would say I noticed about 1/3 of the users were iPhone owners. I spoke with the CIO of a healthcare portal company and he is actively developing an application interface for his product. If healthcare application developers would focus more on the interface of their apps I think physicians and clinicians alike would adopt the iPhone as a valid platform. The sheer number of developers for Windows Mobile is tremendous and Microsoft has made it very easy to develop in this platform regardless of your programming language of choice. The iPhone has several enterprise related issue to address before IT managers adopt this as a platform worthy of supporting in larger organizations.

Source: CNet

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Health Monitoring Solutions for Patients

Dr. Touch will soothe your HMO pains

Intel Health PHS5000 is not the first implementation of an in-house health monitor but if I were to judge by the looks of the User Interface I would say this device may have some promise for monitoring one’s health at home so long as you stay home most of the time. Currently being trialed in Asia this device will monitor and check for problems related to chronic diseases, diabetes, blood pressure, etc… Assuming that smiley faces are good and you know what the resulting charts mean in terms of your physicians plan for you I think this might prove useful in visualizing a patients health.

While I agree that devices like this are useful they do not address the primary issue of not being with the patient all of the time. I think devices such as the iPhone will prove far more useful in terms of being an enabler to patients to monitor their health. Its interface is more in tune with providing easy input and quickly being able to enter data, send progress updates to a personal health record, and of course contacting your physician office by phone if necessary.

iPhone Keyboard Typing Email

A mobile iPhone solution can easily offer patients:

  • Reminders and Alerts to take medication or perform blood-checks
  • Secure connections with PCP’s can enable physicians access to real-time data
  • Mobility will not confine you to your home but rather be in your pocket ready to go
  • Software updates via the App Store will also provide easy updates as necessary

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Conversation with Bill Crounse, M.D.

I had a great discussion with Dr. Bill Crounse, Director of Worldwide Health at Microsoft about their direction and focus on healthcare initiatives.  I’ve followed Bill’s blog for about a year and his insight into the ways Microsoft is innovating in healthcare is insightful.  He mentioned working with Robert Scoble, Microsoft’s former blogger extrodionare, and the need to show the world outside of Microsoft the innter workings of their relative verticals (e.g. healthcare, development, and R&D)  and how they have taken a core approach to technical interoperability and how it addresses business needs.  I do think they are strategicially looking at healthcare and not trying to blanketly push their technologies into this space without clear end-goals.  While this conference has been very tech heavy, it has thankfuly addressed several issues we deal with in our discussions with clients on a regular basis such as content management, business processes, user processes, and workflow tools.  Dr. Crounse has traveled abroad several times and offers his perspective on implementations Microsoft has done in other coutries such as China and Spain.   Especially insightful is his conceptual applications for technologies coming out of Microsoft’s R&D department.  While I’m quite doubtful for touch technology in their latest table implementation there is some value as you will see in the video I posted yesterday about it’s “Minority Report” style display tehnologys for interacting with the vasts amounts of data patients accumulate throughout their continuum of care via different multitouch displays.  Take a look at his healthcare  blog at Microsoft and his past entries for some perpective and technologies in place in other organizations.

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Microsoft Health Users Group Tech Forum 2008


Today’s keynote was given by Steve Aylward, General Manager, Health & Life Sciences for Microsoft Corp. He discussed how focused Microsoft is in the healthcare space and how they really see this as a long-term investment to which they are investing a large portion of their resources to this vertical. While he couldn’t disclose exactly how much he did say it was significant and historically once Microsoft puts its weight behind something they usually do it full force. I had no reason to believe this wasn’t true as their focus is clearly providing the framework by which healthcare transactions are completed. While Microsoft is prevalent in many industry verticals healthcare historically has not been a strong suit. The inpatient Amalga hospital information system they acquired and developed is being implemented overseas in countries where single solutions prove the most value. Healthcare companies in the U.S. are notorious for having fragmented and disparate islands of applications and data most of which are critical to the overall IT infrastructure and thus merit’s a different strategy that Amalga’s single solution product can’t easily satisfy. Therefore, Amalga will be marketed and sold as the Amalga Unified Intelligent System incorporating existing healthcare application and data stores into the mix as a different platform.

Below is a video of Microsoft’s “vision” for the future:





HealthVault also received a lot of attention during this forum. I sat in on the Health Payers track which outlined in great detail Microsoft’s take on providing PHR’s and becoming the central hub by which information can be passed between providers, payers, and patients. It is clear that Microsoft want’s to own this space by providing the infrastructure by which the data flows and allowing as much integration with existing and future applications as possible. You can access the framework through technology neutral API’s or web services. They have even gone so far as to offer a set of Java API’s opening the doors to other non-Microsoft solutions. It is certainly possible to offer such solutions but they are leaving the integration and development including data and vocabulary translations to system integrators and providers to offer end-users. There were several comments from valued partners that Microsoft brought this out a little early due to pressure from Google’s offering in the same space. I was skeptical of their framework offering however I walked away impressed with the thought that went into this and allowing a platform agnostic interface into the HealthVault cloud.

One thing is clear after this first day and that is Microsoft is looking to providers to utilize the tools they have provided within Visual Studio, and other server offerings such as BizCom, SharePoint, Office, Vista, Communication Server, etc… to create solutions in this space at least until they can develop vertical specific solutions such as Patient Server 2009. How will Microsoft succeed? I think the most successful case studies will be those that show integration between all applications and if Microsoft continues development in this area and makes it easy to implement core solutions using their technology as the underlying platform. Their vision is expansive and sounds great but the challenge remains in addressing the how people can implement and integrate Microsoft technologies into their healthcare practice.


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Day 1 at Microsoft HUG Tech Forum

The keynote to start this years MS Health User Group tech conference focused on the possibilities of what can be done in healthcare. I’ll be reporting more this evening. I’m in a developer track now and will be hopping between the IT Pro and Informatics tracks.

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Jump in Consumers Seeking Health Care Information Online

According to a new study released by the Center for Studying Health System Change (HSC), approximately 57% of American adults, or more than 122 million people, sought information about a healthcare releated topic.  The old addage of a digital divide is rapidly disappaearing as consumers across many different demographics are quickly seeking to become more informed.  While there is an uptick in the amount of individuals 65 and older who seek information online the delta compared to the younger population is still quite significant.  An important aspect of this study was the fact that half of those who participated said they changed their overall approach to maintaining their health.  Even more telling is that 4 out of 5 said that the information they found online helped them understand how to treat their condition.  This should be a signal to physicians that managing their patients and providing the resources for patients to find this information extends far beyond the routine office visit.  To make informed decisions throughout the continuum of care physicians will have to also manage or at the very least facilitate the information flow to patients.

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Teens to take embarrassing ailments to Second Life doctors

Spanish health authorities launched a virtual portal through Second Life designed to help young people too embarrassed to speak to a doctor about sexually transmitted disease or a drug problem. “This idea started as a way to connect real health professionals and adolescents and to give internet users a reliable space to get health advice.”  If you can’t get the patients to come to you then you go to where the patients are, and with the wild popularity of online communities such as Second Life this is another way for physicians to reach out to the community, especially for embarrassing conditions.  I’ve seen similar research work done with an academic medical center client of mine where patients would answer a series of direct clinical questions delivered by an animated bird at a free-standing kiosk with much more candor than patients who were being evaluated as part of a nurses or physicians initial assessment.  read more

Another Second Life location I found online was HealthInfo Island offering a similar social location within Second Life to communicate and share information.

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Computer Systems Wouldn’t Have Helped in Texas NICU Overdose Case

Technology can offer a lot to help the quality of patient care but it can’t possibly provide oversight for all clinical safety activities.  After 17 babies got overdoses of the blood thinner heparin at a Texas hospital, a hospital-quality group pointed to the incident as one more reason to push for computerized systems for ordering drugs within hospitals but CPOE alone could not have helped in this instance.

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Emergency Room Stroke Exam with a Webcam

Telemedicine is starting to make inroads into more rural hospitals.  If a stroke specialist can see and hear their patient, zoom in on their pupils and facial muscles, and ask them questions, they are far more likely to offer the right advice. In fact, experts who examined patients with the web cam made the right decision 98 percent of the time, compared to 82 percent when they simply talked to the emergency room doctor.

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