Perot Systems and Philips Healthcare support Microsoft's efforts to build interoperable e-health solutions

Chicago, Bilbao 24 April 2009At the Healthcare Information and Management Systems Society (HIMSS) 2009 Annual Conference & Exhibition, Microsoft Corporation released an updated version of the Connected Health Framework (CHF) Architecture and Design Blueprint and additional solution accelerators in the Connected Health Platform (CHP) to help customers and partners deliver interoperable next-generation e-health solutions. In addition, leading health care solution providers Perot Systems and Philips Healthcare are supporting Microsoft's commitment to deliver to customers e-health solutions built on the CHF and CHP strategy.


"In today's IT environments, heterogeneity is a reality, and we recognize that collaboration is critical to building and managing technologies that will work well for customers in these environments", stated Tim Smokoff, general manager of the Worldwide Public Sector Healthcare division at Microsoft. "CHF and CHP were born out of feedback and best practices from customers, partners and services providers such as Perot Systems and Philips Healthcare, and now as they enrich their offerings, we can further refine our tools to better respond to health care industry needs."

Information technology is a key asset for governments and health care organisations around the world facing an uncertain economic climate and needing to implement cost-effective solutions. Microsoft's CHF and CHP are free resources that health care organisations and partners are using to maximize the benefits and reduce the cost to design, build, deploy and operate solutions supporting the needs of patients, families, care professionals and health care providers.

Perot Systems is one of the largest providers of consulting, business process and technology-based solutions for global clients, including five of the top 25 United States health systems, more than 1000 hospitals and 70 health insurance organisations, plus leading health care supply chain and retail pharmacy companies.

"Our health care clients expect the solutions we deliver to align with their cost and quality improvement requirements. This requires solutions that are adaptable, scalable and interoperable", stated Chuck Lyles, president of Perot Systems' Healthcare Group. "We focus on developing e-health applications that adhere to these principles, and we were pleased that through the creation of CHF and CHP, Microsoft is offering the industry a means to collaborate on these best practices. As CHF and CHP continue to grow in content and adoption, the time to develop and the quality of e-health solutions that provide tangible business value should improve."

"We believe that this is an essential approach, because most health care systems use hardware and software platforms acquired from multiple vendors over a long period of time", Tim Smokoff stated. "By focusing on interoperability, our goal is to bring value to past and future IT investments by developing solutions that can work well in heterogeneous environments, evolve over time and serve the needs of health care organisations to improve patient care."

Philips Healthcare recently introduced the IntelliVue Clinical Information Portfolio (ICIP) Critical Care solution. The solution streamlines clinical work flow, helps improve financial outcomes, and ultimately helps improve and save lives through facilitating compliance to evidence-based medicine guidelines for critical care. ICIP Critical Care is built on Microsoft technology and supports the guidelines outlined in the CHF Architecture and Design Blueprint guidance and the CHP manifestation.

"Providing clinicians with timely and relevant clinical decision support solutions that analyse and interpret patient data - when, where and how clinicians need that care-specific information - is key to improving clinical and fiscal outcomes", stated David Russell, vice president of marketing and chief marketing officer, Healthcare Informatics for Philips Healthcare. "Microsoft is making it easier for Philips to accelerate interoperability and ease of use by making available valuable guidance and tools as part of the Connected Health Platform that we can use and innovate upon to build solutions for our customers. With everyone on the same page, the opportunity to develop truly collaborative and innovative solutions exponentially increases."

The CHF provides solution architects both a business pattern and a reference architecture to design and build health care and associated systems in a platform-agnostic way. Since published in 2006, the Microsoft Connected Health Framework Architecture and Design Blueprint and the associated Connected Health Platform have been downloaded more than 20.000 times and are widely used by health care providers and independent software vendors in more than 30 countries.

Version 2 of CHF targets lifelong well-being and covers the full continuum of care - from the individual to health professionals, health institutions and payers. Because health is not about just hospitals, this version of CHF has been updated to do the following:

  • Support both social care and lifelong well-being scenarios.
  • Focus on the needs of families, care professionals, care providers and the funders of care services.
  • Include the use of federation methods for identity management, authentication, authorization and data integration.
  • Enable legacy applications to participate in the service-oriented architecture of the CHF.
  • Provide more use case examples and step-by-step design guidance.

Coupled with the revised guidelines of CHF, the Connected Health Platform helps health organisations maximize the benefits and reduce the cost of designing, building, deploying and operating the Microsoft platform and its infrastructure capabilities in their solutions or environment. CHP contains more than 55 architecture, design and deployment guides, tools and solution accelerators such as the Integrating the Healthcare Enterprise Cross Enterprise Document Sharing reference implementation and the Common User Interface component.

In Spain for the Local and Regional Government Solutions Forum (LRG), Tim Smokoff said he's hearing a lot of interest about the new offerings and their implications for helping public health organisations promote improved citizen health and wellness. "If we want to accelerate the uptake of e-health applications, we need to freely distribute an architecture and design blueprint along with bits of code and guidance papers so that people can use them", Tim Smokoff stated. "Partners can easily build their own versions and keep the intellectual property because CHF and CHP are free to use and open to innovate on top of."

Version two of the connected health offerings is widely expanded to cover the entire continuum of care, with an emphasis on promoting lifetime health and managing chronic diseases - areas where a great deal of savings can be achieved from automating routine tasks such as monitoring blood glucose levels in diabetic patients.

The extensions announced in Chicago include an enhanced design blueprint, which updates and expands the thinking about long-term care, social welfare, social care and other wellness programmes, along with a number of new accelerators and guidance. According to Tim Smokoff, the changes were driven largely by a shift in philosophy surrounding health care in the Western world. "For the most part, health care has been focused on waiting for people to get sick and then curing them", he stated. "So much of health care costs in developed nations result from the management of chronic disease such as diabetes, obesity and pulmonary disease. Today we're shifting that focus toward prevention, and technology needs to keep pace."

How can technology help manage disease and facilitate healthier lifestyles? According to Tim Smokoff, as patients and doctors increasingly buy into the philosophy, a new class of applications is emerging to make better use of information about patients and their conditions. "Information is a key asset in facilitating better health, but health organisations have too often kept data locked into their own systems and applications", Tim Smokoff stated. "By liberating the information from those silos, you give consumers the ability to manage their own health, and you give organisations the ability to work cooperatively for better patient outcomes."

Tim Smokoff said personal health applications such as Microsoft HealthVault have been a hot topic that allow people to take charge of their health, but that is just the beginning of a transformation taking place in health care. New applications capable of freely sharing data might help co-ordinate complex procedures such as surgeries where the surgeon, anaesthetist, nurses, patient and the facility itself all must be scheduled and briefed.

Applications can also be created to help patients manage a chronic condition over time. With diabetes, for example, it might track the patient's historical blood glucose levels, logging each test daily and providing a picture that can identify trends and help to prevent an acute episode. Someone who could be diagnosed as "pre-diabetic" could use tools to track exercise, keep her metabolic index down, and prevent her from developing diabetes at all. Patients with health problems arising from obesity can track diet and exercise routines.

"It's about capturing physiological information and providing the useful and personalized tools to help patients keep up with a specific dietary, exercise or drug regimen", Tim Smokoff stated.

According to Tim Smokoff, standards and interoperability are a key element of the new connected health platforms. The new versions of CHF and CHP feature more code accelerators to help applications work well with information residing in many different places, and the architecture can be used with any software that supports Web services and services-oriented architectures (SOAs). The new features, compatible with federally recognized standards, were demonstrated successfully in February at the Integrating the Healthcare Enterprise Connectathon 2009 in Chicago.

While these kinds of applications are showing a great deal of promise in promoting "self care" and patient wellness over time, there is much that health care organisations can do to become leaner as well. And according to Tim Smokoff, there are many obstacles to overcome before the health care industry as a whole is able to really digest technology the way that other industries have.

For one thing, the sensitive nature of health care information and subsequent government regulation of how that data is used, which varies widely by country, creates an enormous emphasis on privacy and security that any enabling technology must fully address. "Today regulation and innovation must work in harmony to allow connected care systems to free data so it can be used by individuals and their health care systems, while at the same time protecting the information from misuse", Tim Smokoff stated.

In Germany, for example, information created inside a hospital cannot be duplicated and stored in another location, creating the need for technologies that can access patient data from various locations. Such regulations, while critical to the industry, amount to additional hurdles for technology aimed at enabling health care information-sharing.

"Security of information is incredibly important", Tim Smokoff stated. "It's imperative to help the industry with this issue, so a big part of the infrastructure optimization outlined in the CHF and CHP deals with securing access and providing aggregated views of health information, whether it's in the hospital environment or federated outside to other agencies for effective co-ordination and post-care."

This issue of systems federation is another that looms large for health care. The industry consists of thousands of clinics, hospitals, laboratories and public agencies, each of which has its own systems and its own segment of a patient's overall medical profile. Complicating this issue is the prevalence of "legacy" technologies, outdated systems that may go as far back as the green-screen era but which still contain valuable and pertinent medical information on patients.

"Interoperability is probably even ahead of privacy and security as the biggest issue facing health care technology", Tim Smokoff stated. "We talk about liberating data. There is a lot of information out there, but historically systems have not talked to each other. Only in the last couple of years have standards for health care interoperability been accepted."

Tim Smokoff compared the situation to railroads in Australia or the early American West, where different gauges of track meant that trains could only make part of a crossing before entire cargoes would have to be offloaded to another train. "When these systems are not consistent, it becomes very costly to integrate them", he stated.

This issue is also gaining increased attention of late, as a new presidential administration looks at ways to reduce the cost of health care delivery in the United States. "As the stimulus comes out, we have to focus on separating the data from applications and organisations, and using the technology capabilities we have now to give people a holistic view of their health history", he stated. "To do that, the medical community also has to be on board, so another key element is, what is the incentive? For this to work, we have to look at rewarding doctors and clinics that are ahead of the curve in terms of technology and efficiency."

Tim Smokoff agreed that building better information and communications technology into health care is a classic technology story with the dual benefits of greater process efficiency, and better information, both of which help organisations do what they do best. "There is a real need to help these organisations be more efficient", he stated. "We've seen so many systems that were built up piecemeal and suddenly the organisation is juggling a dozen different applications. They're burning their IT budgets just keeping the lights on."

According to Tim Smokoff, the architectures and toolkits provided by Microsoft can help reduce the cost of running a system while simultaneously improving its agility, allowing organisations to invest that savings into more innovative technologies to support practitioners, or to simply reduce IT budgets so more of that money can go elsewhere.

For most people who work in health care, though, the ultimate goal isn't to "create efficiency" in and of itself, but to deliver the best possible care however they can. And it's there that IT really has potential to make a difference, both in the lives of individuals and in the economies of nations. By providing more information, and better access to it, effective IT can actually facilitate better care delivery.

"With access to all the different information about a specific case, providers can make more informed decisions", Tim Smokoff stated. "So by embracing these modern architectural principles, organisations not only save money, but are able to deliver better care." And with a renewed focus on wellness, technology has the potential to take things a step further and help people take charge of their own health. Stated Tim Smokoff: "Even more importantly, by empowering people with better information about their own health, they too can take control, be more pro-active, and hopefully lead healthier lives."

Founded in 1975, Microsoft is a global expert in software, services and solutions that help people and businesses realize their full potential. More company news is available in the VMW October 2008 article AllOne Mobile to provide access to Microsoft HealthVault using mobile phones.

Source: Microsoft

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