Entries tagged with healthcare it - Channel 10

Microsoft Healthcare Common User Interface: Now available free worldwide

bcrounse — Tue, 11 Sep 2007 19:48:00 GMT

Anyone who works in healthcare knows that many of today’s clinical software applications leave a lot to be desired when it comes to “user experience”. Unlike ubiquitous, commodity software used in other businesses, healthcare applications are highly proprietary and often based on legacy technologies. Clinicians find that much of what’s available today is often too hard to use. Becoming proficient on these clinical applications requires lots of training and that can mean taking already scarce healthcare workers off-line for days or weeks at a time. Worse yet, even if clinicians become proficient on one vendor’s solution, they are likely to encounter something entirely different in every hospital where they work, requiring even more training. But what if there was a common, more standardized user interface for clinical applications? What if the user experience was pretty much the same no matter where a clinician worked? Would doctors, nurses and other clinical workers be better served?

Last July on this Blog I told you about an ambitious project to develop a standardized user interface to administrative and clinical systems. The project was launched more than a year ago by Microsoft and the United Kingdom’s National Health Service. It is part of a country-wide upgrade of the data spine, clinical and administrative applications used by the NHS.

Based on that work, Microsoft has launched The Microsoft Health Common User Interface (CUI) web site. It provides Design Guidance and controls that allow a new generation of safer, more usable and compelling health applications to be quickly and easily created. In this special video edition of my House Calls for Healthcare Professionals series, we take a look at the the work that's been going on at the NHS and how that work, through the MSCUI, now offers promise to improve worker satisfaction and patient safety around the world. Enjoy the show!

Bill Crounse, MD Worldwide Health Director Microsoft Corporation

Downloads: iPod, MP3, PSP, WMA, WMV, WMV (High), Zune

Program Guests

Dr. Mike Bainbridge is a former general medical practitioner who now leads the Clinical Architecture team at NHS Connecting for
Health, a group that delivers innovations in hardware design, clinical interface design and interfaces to the electronic medical record for both healthcare professionals and citizens.

Stephen Corbett is Head of UI Design for NHS Connecting for Health where he evangelizes the user-centred design approach to building software. Since graduating in Ergonomics in 1988, he has been working in the field of software usability in various industries.

Andrew Kirby is a Director at Microsoft UK where he is responsible for the delivery of solutions and services to the National Health Service which includes the delivery of the Common User Interface Programme.

Microsoft Azyxxi One Year Later; 21 hospitals and counting

bcrounse — Thu, 30 Aug 2007 19:00:00 GMT

A little more than a year ago, I introduced Channel 10 readers to Azyxxi, Microsoft's unified health enterprise platform solution. I also recorded an audio-cast with executives from our Health Solutions Group. A few months ago, I updated you with another audio-cast featuring one of Azyxxi's early adopter customers, New York Presbyterian Hospital. Today, Microsoft is announcing the addition of yet another well known hospital system to the growing list of Azyxxi customers; Novant Health.

Novant will implement Azyxxi throughout the enterprise, initially focusing on intensive care units and emergency departments and then expanding throughout its eight acute care hospitals and an 800-physician medical group. With Novant and NY Presbyterian, early Azyxxi adopters now include 21 different hospitals at academic medical centers such as Johns Hopkins Health System; large health systems such as MedStar Health; and the Wisconsin Health Information Exchange, which will eventually tie together 25 different hospitals in Southeastern Wisconsin.

As we discussed in my most recent audio-cast, New York Presbyterian Hospital and its associated network is using Azyxxi to unify its existing and legacy information systems to create broad accessibility of its vast quantities of information. New York Presbyterian's senior vice president and CIO, Aurelia Boyer says, “As we’ve automated more and more of the processes within the hospital and created more electronic data sources, our ability to mine and utilize that data is becoming more of a priority. Making the data from different systems available in a way that makes good management, clinical and quality sense takes a lot of effort, and is a major goal for an institution like ours. Giving people in the hospital ready access to different kinds of data is priceless to us.”

Whereas New York Presbyterian is looking at Azyxxi as an administrative tool to guide organizational decisions, Novant Health is working to implement Azyxxi in support of its clinical operations. “I’ve seen estimates that say a physician spends most of his or her time collecting information about the patient before they deliver the care,” says Rich McKnight, Novant’s CIO. “Our goal is to dramatically reduce the amount of time in information gathering, and increase the amount of time in taking care of the patient.”

It has been my personal pleasure to attend many Azyxxi customer briefings with executives from our Health Solutions Group. I can tell you that the solution is generating lots of excitement in the industry. I also remember very well sitting with a senior finance executive at MedStar Health in Washington, D.C., as he was extolling the virtues of Azyxxi for revenue cycle enhancement and recovery. The system gave Washington Hospital visibility to millions of dollars in high-value procedures and tests that were being improperly coded and therefore not collected by the hospital; millions of dollars that can now be spent delivering care to patients.

As Azyxxi liberates healthcare data from the constraints of silos and systems that don't "talk" to one another, I can only imagine the implications for providing cost and quality transparency in the industry, and our potential to improve the efficacy and efficiency of the care being provided by clinicians.

Bill Crounse, MD Worldwide Health Director Microsoft Corporation

Saving money, saving lives: Vanderbilt's perioperative information management system

bcrounse — Fri, 24 Aug 2007 21:31:00 GMT

Does information technology really improve care quality and safety? Can well designed and implemented clinical software applications really improve physician satisfaction? Can healthcare information technology really have a positive return on investment? For Vanderbilt University Medical Center's perioperative anesthesia department the answers are yes, yes, and yes!

While not every IT solution in healthcare clearly demonstrates results as stunning as those I'm about to share, here's what I gleaned from a keynote presentation made by Dr. Paul St. Jacques earlier this week at the MSHUG Tech Forum 2007 in Redmond. Dr. St. Jacques shared the stage with me on day one of the conference. I delivered the opening keynote, and he provided the close.

Dr. St. Jacques is Associate Professor and Director of Anesthesiology Informatics in the anesthesiology department at Vanderbilt. Vanderbilt's perioperative information management system, VPIMS, serves as "master control" for the medical center's 60 operating rooms in 6 suites, handling thousands of surgical cases each year. You may be surprised to learn that less than 5 percent of all surgeries in America are fully managed and documented electronically. That's right. In the year 2007, 95 percent of the "life and death" work-flow processes in surgery are still done on paper.

So what's to be gained by going electronic? How about a 100 percent improvement in on-time cases starts, or a 90 percent compliance with perioperative antibiotic protocols resulting in an 1 percent decrease in surgical wound infections. How about a 67 percent reduction in chart errors. How about the average time to produce a billable chart moving from 12 days to 1, with a $1 Million plus improvement in formerly lost revenues. Or how about a 10 percent yearly increase in case volume without adding capacity, keeping in mind that every additional case per day generates more than $1 Million in revenue per year.

VPIMS handles everything from surgery scheduling, to perioperative documentation, to billing. In addition, a module called Vigilance provides real-time monitoring of every operating room in the facility with multi-view streaming video, patient vital signs, alerts and reminders. It might look like something out of Star Wars, but what it does for patient safety and staff satisfaction is priceless. And did I mention there's a whole lot of Microsoft technology under the covers?

Greater detail on VPIMS is beyond the scope of my Blog. Let me just say if you ever want proof that information technology in medicine saves lives and saves money, look no farther than the very fine work going on at Vanderbilt. And yes, VPIMS has been so successful at Vanderbilt that the medical center is exploring options to commercialize and sell it. And with 95 percent of the market still doing perioperative management on paper, they should have no problem finding customers.

Bill Crounse, MD Worldwide Health Director Microsoft Corporation

PS If you would like information about some of the other presentations at this year's MSHUG Tech Forum, my good friend and colleauge who serves as Microsoft's senior technical strategist for our worldwide health group, Roberto Ruggeri, provides play by play coverage on his Healthcare IT Blog.

Diagnostic software: Improving patient safety around the world

bcrounse — Wed, 22 Aug 2007 18:23:00 GMT

I'd like to draw your attention to a new video that we've just released as part of my House Calls for Healthcare Professionals series. The program takes a look at diagnostic software developed by Robertson Technologies.

I met Dr. Joel Robertson about five years ago. I and others from Microsoft (most notably Dr. David Heckerman at Microsoft Research) have been advising Dr. Robertson during the development of his company's software. The result of this work, NxOpinion, is one of the most significant, accurate, responsive and intuitive diagnostic programs I’ve seen.

I believe there are many applications for its use in emerging markets where physicians in rural villages or lesser-trained individuals working in public health need diagnostic support. I believe there is also a role for diagnostic software in developed nations to improve patient safety and the quality of care in settings such as nurse call centers, community clinics, retail clinics, and urgent care settings. There is also the potential for this technology to be used by consumers in evaluating personal health issues at home.

Enjoy the show!

Bill Crounse, MD Worldwide Health Director Microsoft Corporation

See Video

A Common User Interface to Clinical Systems

bcrounse — Sat, 14 Jul 2007 00:47:00 GMT

On October 21st, 2005, I wrote an entry on this Blog about the need for a more common and intuitive user interface to clinical information systems. Here's part of that entry:

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Jim Lynch, R.N. is quoted by Health Data Management's on-line news service on remarks he recently made during a presentation at the 77th Convention and Exhibit of the American Health Information Management Association. In his address, "Electronic Medical Records: Expect the Unexpected", Mr. Lynch recounts the plaudits and pitfalls encountered at Oklahoma City-based Integris Health during the implementation of their EMR. He says, “A major part of the problem was that the electronic record was not easy to use--the interface is not as simple as Microsoft Word, and many physicians had absolutely no computer skills.”

Indeed! Why is it that EMR interfaces have to be so challenging for clinicians? The typical community physician in many American cities admits patients to more than one hospital. In my own community, it's not unusual for docs to call on three or four different hospitals. One hospital might use Meditech; another IDX; another Cerner; and yet another something else. Even if any one of these systems had the "perfect" user interface, how can a clinician become proficient on all of them? How much training would that take!

Bill Crounse, MD

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I am now extremely pleased to tell you about something that I believe may be the tipping point in moving us toward a common user interface to clinical systems, perhaps worldwide. For the past couple of years, Microsoft has been working with administrators, clinicians and other experts in the United Kingdom to design a common user interface for clinical and administrative systems at the National Health Service. With the consent of the NHS and its Connecting for Health initiative, the design guidelines and tools are now being made available to developers around the world with the launch of the CUI Website.

As noted on the website, design guidance has been produced through a rigorous user-centred design process that incorporates primary and secondary research, usability testing, consultation with software providers and integrated hazard assessments. Patient Safety Assessments (PSAs) are continually performed to ensure the Design Guidance meets safety concerns.

The guidance is targeted at both existing clinical applications and those that are being designed and architected right now. The second part of this release is the implementation of much of that guidance in the form of control libraries for both WinForms 2.0 and ASP.NET. The website contains explanation and samples for each of the Web controls with the Codeplex project hosting a download of both the Winforms and the ASP.NET Control library.

Example of Common User Interface Design

If you are a developer of applications used in healthcare, an IT professional, or just someone who is passionate about clinical information systems, I urge you to become familiar with this excellent work, and help us make it even better by joining the dialogue here on CodePlex (http://www.codeplex.com/mscui). Take a look at the CUI Website and be sure to watch the introductory video.

My thanks to our Microsoft UK team and our colleagues at the National Health Service for providing leadership in addressing a much needed solution that will improve patient safety while providing a much easier to use, more consistent interface to clinical systems.

Bill Crounse, MD Worldwide Health Director Microsoft Corporation

Commodity software; the next wave in contemporary hospital information systems

bcrounse — Thu, 21 Jun 2007 03:30:00 GMT

Hospital de São Sebastião

Earlier this year, I shared the amazing story of Torrevieja Salud Hospital in the Valencia Region of Spain. Hospital IT staff at Torrevieja Salud had built a very robust, end-to-end hospital information system using commodity, off-the-shelf developer tools, software, and technologies from Microsoft. They did it for just a fraction of what is typically spent in American hospitals on solutions from the big HIS vendors.

The first week of June, I visited another hospital that has taken a similar approach. The hospital, Hospital de São Sebastião, is located about 30 kilometers outside of Porto, Portugal and services a total population of about 383,000 people. I visited Porto to speak at our EMEA Health Leader's Forum. The first day of the two-day event, we were treated to a tour of Hospital de São Sebastião provided by the hospital's CEO, Dr. Hugo Meireles; CIO, Rui Gomes; Internist, Dr. Luis Pedro, and ER physician, Dr. Jorge Teixeira.

Hospital de São Sebastião is a 317 bed, acute care and trauma facility built in 1999. From the very beginning, hospital planners wanted an organization that would be a significant cut above other public health hospitals in Portugal. Rather than buy a hospital information system, CIO Mr. Rui Gomes and his small but dedicated staff of 11 full-time employees set out on a quest to build the IT foundation, business, and clinical applications that would best serve the hospital and the people who worked there. It has been an iterative project that appears to be serving hospital workers and the patients they care for extremely well.

Internal Medicine specialist Dr. Luis Pedro shows me how he accesses patient information and documents his work while caring for patients at Hospital de São Sebastião located just outside of Porto, Portugal.

Over the years I have toured some of America's so-called "most wired" facilities. In fact, the Seattle area hospital where I served as Vice President, CIO and CMIO for many years was often cited in that most-wired category of leading American institutions. But quite honestly, I must say that I have rarely toured a hospital where I have seen physicians so seamlessly using information technology as I observed during our tour of Hospital de São Sebastião. This is all the more remarkable when one considers that they built most of the solutions they are using all by themselves. And, they did it using commodity software that costs just pennies on the dollar compared to equivalent solutions used in US hospitals.

Doctors roamed the halls with Fujitsu Tablet PCs while wirelessly connected to the hospital's network. They had complete access to all patient data including imaging, lab results, etc., and they performed all of their charting from admission to discharge electronically.

Screen shot of HIS solution in use at Hospital de São Sebastião

Nurses and other caregivers also used the hospital information system. In the emergency room, an electronic triage system not only helped to prioritize treatment, but timed and tracked exactly how that treatment was delivered; sending gentle reminders to staff whenever patients were left waiting longer than necessary

Screen shot of ER triage application at Hospital de São Sebastião

To be fair, the system didn't have all the bells and whistles that might be found on big vendor solutions used in American hospitals. CPOE was still a work in progress although doctors were using an electronic prescribing solution. But that is precisely my point. The system was designed to do exactly what the staff really needed most. It has an interface and tools that make it intuitive, fast, and highly functional. What it lacked I would place in the category of "nice to have" rather than "have to have". And perhaps that is why the home-built HIS solution in use at Hospital de São Sebastião is so popular with physicians and other caregivers at the hospital.

In case you are wondering, some of the Microsoft products and solutions IT professionals used to build the HIS at Hospital de São Sebastião include; Active Directory, SQL Server 2005, SharePoint Services, SQL Reporting Services, Balanced Score Card Manager, ISA Server, BizTalk, Exchange, .Net Framework, and Visual Studio 2005.

My congratulations to Rui Gomes, his IT staff and caregivers at Hospital de São Sebastião!

Bill Crounse, MD Worldwide Health Director Microsoft Corporation

The Mobile Clinical Assistant; a new category in Tablet PCs for healthcare

bcrounse — Thu, 17 May 2007 08:01:00 GMT

Over the past few years Microsoft partner, Motion Computing, has focused on serving the healthcare industry. In February at HIMSS, the company introduced an entirely new category of Tablet PC; the Mobile Clinical Assistant, also known as the C5. In March, Motion introduced a new full-sized Tablet PC, the LE1700. It not only offers a touch screen for data input but is also fully capable of running Windows Vista with Aero glass graphics.

In this special video edition of my House Calls for Healthcare Professionals series of streaming audio and video programs, I’m joined by Joel French, VP for Motion Computing, and Dr. Michael Blum, VP and CMIO of UCSF Medical Center. We take a first look at these exciting new Tablet PCs and discuss how these devices are being used by clinicians around the world.

If you’re thinking about Tablet PCs for your hospital or clinic, you’ll want to watch this 20-minute video program featuring the newest devices now on the market. To watch the video, just click HERE

Bill Crounse, MD Worldwide Health Director Microsoft Corporation

Program Guests:

Joel French, is Vice President of the Health and Life Sciences group for Motion Computing, Inc. Mr. French is a leader in wireless products and services designed for mobile professionals in vertical industries.

Dr. Michael Blum, is Associate Clinical Professor of Medicine, a practicing Cardiologist, and Chief Medical Information Officer for the University of California San Francisco Medical Center.

A hospital electronic patient record built with Microsoft Office System

bcrounse — Wed, 09 May 2007 17:31:00 GMT

In previous HealthBlog entries, I've told you about the growing trend of hospitals using commodity software to run the enterprise including electronic medical record systems based on Microsoft standard products. Most of these examples come from outside the United States where perhaps there's more emphasis on spending precious public funds wisely. Most recently I profiled Torrevieja Salud hospital in Spain as an example of this trend. You can read more about what they did by clicking here.

One of my colleagues sent information about a public hospital system in Switzerland that has taken a similar approach to implementing electronic patient records. The hospital system is Solothurner Spitäler AG, a consortium of canton Solothurn's six public hospitals that are located in different locations across the region and are now centrally managed.

The healthcare system had been relying on a rudimentary electronic patient record solution built with Filemaker. It had been developed by the hospital’s own enterprising doctors and programmers. After reaching a size of some 75,000 patient records, the homegrown solution was becoming unstable and programmers realized it wouldn't scale for the future. Working with a local IT consulting company, afca informatik, the hospital system settled on a centralized electronic patient record solution based on XML. It is accessed by web services and uses Microsoft Office InfoPath on the client side. The solution is called INFOPath-DOC.

Speaking about the solution, Dr. Pascal Walliser, CIO for Solothurner Spitäler AG said, “INFOpath-DOC gave us a new foundation for an electronic patient record solution based on Microsoft standard products. It is an effective, reliable tool that supports everyday administrative work in our hospitals. At the same time it has given us a platform to develop innovative solutions that will allow us to go even further in our efforts to deliver consistently patient-oriented medical services.”

As the world embraces open standards and the advantages of XML web services, could such solutions in hospitals and clinics become more common? When one considers the fiscal constraints of our healthcare institutions and their primary mission to deliver the highest quality of care at the lowest possible cost, it seems like a reasonable assumption. Why would you spend hundreds of millions of dollars on an IT system when much lower cost and frankly much more contemporary solutions can be built using commodity components? Food for thought!

Bill Crounse, MD Worldwide Health Director Microsoft Corporation

New Audiocast: Collaborative solutions for better patient care and a healthier bottom line

bcrounse — Thu, 29 Mar 2007 21:15:00 GMT

Back in January, I wrote a piece entitled Big Healthcare Savings from Surprisingly Simple Solutions. I profiled some excellent work at Childrens Memorial Hospital of Chicago where they are using solutions built with Microsoft SharePoint, Microsoft Office, and InfoPath to absolutely delight clinical staff and add of ton of money to their bottom line.

This story is especially compelling because it didn't take expensive consultants or a lot of IT support to make it happen. In fact, it originally started with one clinician who thought he could improve some scheduling and work-flow processes in his unit using software the hospital already owned. He did much of the work himself in his spare time. Some projects took only a few days to implement. Now, clinicians and business leaders across the organization are launching their own projects based on the simple premise of using very powerful, intuitive and proven commodity software to tackle some of the big issues in healthcare.

I wanted to share this story with more of you and decided to feature Children's Memorial Hospital of Chicago in my next House Calls audio-cast. And, who better to tell the story than the clinicians themselves. I hope you enjoy the show and I hope you'll share this with colleagues across the nation and the world.

Bill Crounse, MD Worldwide Health Director Microsoft Corporation

Click below to listen to the program:

Collaborative solutions for better patient care and a healthier bottom line
This program is also available in MP3 for download.

Are clinicians and business managers in your organization hindered by poor communication? Do gaps in daily work-flow processes overwhelm your hospital and reduce your bottom line? Despite the IT systems you have in place, do you still rely on paper forms and processes? Simple and cost-effective communication and collaboration solutions can reduce these problems for you, your care teams, managers, and patients. In this audiocast, Dr. Bill Crounse and his guests discuss how Children’s Memorial Hospital of Chicago is using information technology solutions from Microsoft to transform their business and improve their bottom line.

Panel guests

Dr. Cynthia Rigsby, is chief of Body Imaging at Children’s Memorial Hospital and co-chair of the Department of Medical Imaging. She also serves as professor of Radiology at Northwestern University.

Dr. Andrew De Freitas, is attending physician in the Cardiology division at Children’s Memorial Hospital, is also a professor of Cardiology at Northwestern University.

Eric Gasber, is a Registered Nurse in Surgical Services with the Nursing Sedation Team at Children’s Memorial Hospital.

Doctors write their own prescription for healthcare IT

bcrounse — Fri, 16 Mar 2007 20:24:00 GMT

This past week I've come across two examples of why I believe we are finally at a tipping point in healthcare IT solutions; solutions that are meeting the expectations and work-flow requirements of clinicians. Both solutions were designed by clinicians for clinicians rather than by computer science engineers. That likely explains their success in delighting the clinicians who use them.

One of these solutions I've written about before on this Blog. It's the solution known as Azyxxi; a technology acquired by Microsoft about 9 months ago from MedStar Health in Washington, D.C. and currently in use across MedStar's seven-hospital system. We are now in talks with a number of customers who want to be early adopters of this technology. Earlier in the week, I accompanied our Azyxxi team for executive discussions with a few of those customers in Arizona and California. All I can say is that most everyone we talk with totally "gets" the clinical and business value proposition of Azyxxi and why this system delights clinicians and provides insight to information as never before. Stay tuned for more announcements about Azyxxi in coming months.

The other solution that warrants mention, just like Azyxxi, was born to address clinical work-flow requirements in a large academic teaching facility that weren't being met by the facility's existing vendor solutions. Doctors and residents at UCLA Medical Center were frustrated by not having adequate tools to access needed information and document their findings during patient rounding and for patient hand-offs at shift change. Once again, it was the doctors themselves using readily available commodity software that came up with the solution to address their own work-flow pains. Dr. Neil Martin, chief of neurosurgery at UCLA who I had the opportunity to chat with at HIMSS in New Orleans a few weeks ago, tells the story best in some recent correspondence with me. He writes;

Rounding and progress note generation is a time-consuming everyday requirement for any physician managing inpatients. It involves "hunting and gathering" the clinical data required for daily patient assessment (lab results, vital signs, test results, etc), making a rounding list with key information, finding all the patients, examining each patient and analyzing all the data, generating a daily plan, and writing a daily progress note. Much of the work for rounding involves low-cognitive-value clerical-level data retrieval, and transcription onto the rounding list and into the progress note. This is particularly time-consuming and onerous at tertiary academic medical centers (AMCs) with a large high-acuity patient population. Traditionally the clerical aspects of rounding and note generation have been done at AMCs by interns and residents - but with new mandatory resident work-hour limitations, the time available for this sort of clerical work has disappeared.

At UCLA Medical Center, we have designed and deployed a software application that automates rounding list generation, and provides a templated daily progress note partially auto-completed with data (labs, vitals, etc). The automated list/note application saves interns and residents 45-90 minutes per day for each clinical team. When the time-savings associated with this application became apparent to the interns and residents, its use expanded from 100 users to more than 1200 in less than a year, with very little in the way of formal announcement or training - the spread was by word-of-mouth and was virtually "viral". More than 25 clinical service teams now use this application for rounding daily. Interns, residents, and many attending staff physicians now use and depend on this application. A modified rounding application has also been developed for ward charge nurses - and this is currently in a pilot phase. A conservative estimate is that this application at UCLA saves more than 7300 hours of clinician time annually, with a value of approximately $ 365,000/year. In this presentation we will describe the application, discuss its development, and examine its current real-world clinical utilization at an academic medical center.

Dr. Martin will be a featured speaker at the HIMSS Summit in San Diego in June. If you want to learn more about the good work of Dr. Martin and his colleagues at UCLA, be sure to attend his session.

It is thrilling to be involved in an industry with so much potential to improve the quality and safety of patient care, and the satisfaction of those receiving and giving that care. It is also thrilling to see so many of my clinician colleagues using their deep clinical experience and healthcare industry knowledge to drive innovative new solutions to market.

Bill Crounse, MD Worldwide Health Director Microsoft Corporation

Healthcare IT Innovation in the Most Surprising Places: When size doesn't matter

bcrounse — Fri, 02 Feb 2007 00:22:00 GMT

I'm back from Kansas City where we hosted a very enjoyable Healthcare Executive Forum event with some of our customers. Every time I get out in the field I'm amazed by some of the great work our customers are doing to improve work flow processes, patient safety, care quality, and the satisfaction of those giving and receiving care. Such is the case at SMDC Health System in Duluth, MN. Barbara Possin, M.S., R.N., Vice President for System Quality & Strategic Alignment, followed me on the podium to discuss how her hospital is using our technologies to make key performance indicators, managerial reporting, and quality initiatives more transparent across the organization. It was very good work indeed!

Also, a few weeks ago I shared information on this Blog about a hospital in Spain, Torrevieja Salud. There was so much interest in the topic of using commodity components to build truly robust yet much lower cost solutions for hospitals and health systems, especially outside of the U.S., that I decided to host one of my House Calls audio-casts on this subject. The program was conducted in both Spanish and English with appropriate translation as required. While this makes it a little more difficult to listen to compared to other programs we have done, I think you'll enjoy the program and the important lessons we can learn from Spain.

Torrevieja Salud Hospital: A lesson from Spain
This program is also available in MP3 for download.

A fully functional, contemporary hospital information system was built using readily available, lower-cost, commodity software. Does it sound impossible? That's what was done at the newly opened Torrevieja Salud Hospital in the Valencia region of Spain. How did they do it? How long did it take? And what did it cost? The answers may surprise you.

Panel guests

Luis Barcia, general manager of Torrevieja Salud Hospital, has since 2003 been responsible for the hospital's ongoing operations. Barcia has also worked as an administrator for the Valencia Oncology Institute Foundation (IVO), and the director for the Hospital de la Ribera. He is a lawyer with Master's degrees in international commerce and healthcare management.

María Martinez, chief radiologist of Torrevieja Salud Hospital, has a medical and surgical doctorate degree from the Universidad de Murcia. She has also worked as a radiologist at the Virgen de la Arrixaca Hospital. She has twice been a finalist for the prestigious Spanish Healthcare "Profesor Barea" awards. Her work spans from lectures and presentations to numerous articles in prestigious Spanish healthcare publications.

Miguel Ortiz, chief information officer at Torrevieja Salud Hospital, is responsible for the hospital's information technology (IT) strategy and making it work flawlessly. Ortiz's prior work experience includes being the director of IT for the Hospital de la Ribera, the sub-director of Alzira, and an Accenture Coritel project manager. He graduated from the Universidad Politéctnica de Valencia and has a Master's degree in healthcare management.

Felipe Pascual, medical director of emergency services at Torrevieja Salud Hospital, specializes in emergency room (ER) care and is the lead trainer for the Spanish Triage Group (GET-Manchester). He is also one of the main trainers for the Spanish Society of Urgencies and Emergencies “SEMES”. In addition, his experience includes work in primary care, work as a clinical director, and giving lectures throughout Europe about ER management.

Bill Crounse, MD Healthcare Industry Director Microsoft

Employer-driven Electronic Health Records: A needed catalyst for healthcare IT?

bcrounse — Thu, 30 Nov 2006 20:01:00 GMT

I've commented before on this Blog that much of the true innovation I see in the implementation of advanced information technology solutions in healthcare, particularly electronic health and medical records, is happening outside of the United States. There are two reasons why this is so. First, most healthcare in other countries is controlled and delivered through the public sector. Decisions about, and investment in, healthcare information technology are made by regional or national government agencies. Second, many nations are able to jump ahead of the U.S. because they are starting their healthcare industry transformations with a clean slate. By not being burdened with the complexity of integrating a patchwork quilt of outdated legacy systems and the disparate silos of information locked up in those systems or on paper, they are able to use the most contemporary, and often commoditized technology, on the market. The solutions they implement are not only more robust, but far easier for healthcare providers to use. They also tend to be much less costly.

I wouldn't proclaim that the solution to our healthcare IT woes in the U.S. is to abdicate to the government even though there is something to be said for centralized planning, command, and control as observed in other countries. Perhaps, however, there is another very powerful force for solving these problems that is a better fit with our American culture and way of life; Employers. If you read the Wall Street Journal yesterday, you no doubt saw the article proclaiming an initiative by several of America's largest corporations to "provide digital health records to their employees and to store them in a multimillion-dollar-data warehouse linking hospitals, doctors and pharmacies. Their goal: to cut costs by having consumers coordinate their own health care among doctors and hospitals." If we are ever going to reach President Bush's 2004 State of the Union promise of an electronic health record for most Americans within 10 years (now 8 years), this may be the way we get there.

This certainly isn't the first time that major employers have banded together and flexed their muscles to stimulate needed changes in the healthcare industry. The Leapfrog Group has been an effective change agent for hospital quality around a defined set of diseases and treatments. Hospitals had little choice but to tow- the-line when major employers and payors in their markets sounded off. I have no doubt that this newest initiative by employers to stimulate EHR/PHR adoption will help move things along in the United States. I would, however, urge these major employers to make every effort to work closely with organized medicine and care providers in planning and implementing these systems and services so they work equally well and provide an investment return for everyone in the healthcare ecosystem; patients, providers, family members, employees, and employers.

Next week I'll be attending the Health Industry Leaders Forum in Barcelona, Spain, where I'll have an opportunity to deliver an address and get an update on some of the most contemporary healthcare information technology projects in the region. I'll provide a summary in my next Blog post.

Bill Crounse, MD Healthcare Industry Director Microsoft Corporation

The Connected Health Framework: A service-oriented solution blueprint for health IT

bcrounse — Wed, 22 Nov 2006 22:28:00 GMT

I'd like to draw your attention to a very thoughtful piece in HHN Most Wired written by well-known CIO, John Glaser, and his Partners Healthcare CTO, Steve Flammini. These guys are highly respected healthcare IT veterans and thought leaders in the industry. If Glaser and Flammini believe Service-Oriented Architecture (SOA) is the future, and perhaps salvation of applications for healthcare, I'd challenge anyone to say it isn't so. Rightfully, the authors draw our attention to the fact this is no panacea and healthcare organizations and application vendors must move forward with due diligence and some degree of caution. Nonetheless, for all the stated reasons, SOA is indeed where the industry is headed.

With that in mind, I would like to offer a valuable resource to IT executives, chief medical information officers, solution architects, industry solution vendors, and others who have a particular interest in developing or deploying the next generation of SOA healthcare industry applications for business or clinical use. It is the just published Connected Health Framework executive whitepaper and architecture and design blueprint. What is the Connected Health Framework and what is its value proposition to the industry? My good friend and colleague, and Microsoft's senior healthcare technical strategist, Roberto Ruggeri, sums it up best on his Healthcare IT Blog. If you would like to look over the CHF documents and other resources, you'll find them here:

You can also find information about the Connected Health Framework on our corporate site. The landing page on microsoft.com is here. Filed under: Healthcare Integration

My thanks go out to Roberto and our entire extended team across the globe for their very fine work in delivering this important resource. I know the team looks forward to your comments and suggestions. You can share those here: SolShare.net healthcare forums

Happy Thanksgiving!

Bill Crounse, MD Healthcare Industry Director Microsoft Corporation