Microsoft health reform actually works

We increased the time between visits 35-50%," with no reduction in care quality.

Microsoft's vision of health reform is simple. Connect systems so patients can participate in their own care.

That's the idea behind HealthVault, which corporate vice president Peter Neupert insisted at HIMSS yesterday is not a Personal Health Record (PHR) at all but a secure method for creating them, and allowing data patients create to be combined with what their doctors have.

He said this while standing in a small conference room next to incoming HIMSS president C. Martin Harris who delivered results from a project  the Cleveland Clinic performed on over 250 people with chronic conditions like hypertension and diabetes.

Some 75% of the nation's health care dollars are going to such chronic conditions, said Harris, who is also CIO of the Clinic.

The Clinic gave patients simple devices to measure their ongoing condition -- scales, blood pressure cuffs, blood sugar monitors -- and taught them their use. This data was combined through HealthVault with what their own Electronic Medical Records (EMR) showed, and alarm conditions were monitored. When called for, doctors called patients and adjusted medications or instructions.

"The process measures were the biggest change we saw," said Harris. "We increased the time between visits 35-50%," with no reduction in care quality.

For those with active heart failure (former President Bill Clinton and former Vice President Dick Cheney both fall in that category) office visits went up. "They came into the office rather than the emergency room," he said.

"We can fundamentally rethink how we deliver care to the aging population, delivering care more affordably, and in a way that's consistent with how people live their lives."

Harris cautioned that this is not a study ready for journals. A double-blind trial will come next, with about 1,200 people, testing this active approach against current care. That will then go through peer review before publication.

But the big news, what put a smile on Harris' face, was this new form of care can be ramped-up within months to large populations, because the tools with which to do it all exist.

Neupert and Harris then took questions, each leaning on the side of a small podium (above). They vamped along to reporter queries like a jazz duo.

Neupert admitted that some work needs to be done on client devices. Monitors need to become small enough to be worn comfortably, so patients aren't just checking themselves at home but doing it automatically through the day.

"Patients are extremely mobile," Harris added.

The Clinic will also be looking for a little more proof of concept. "You can manage the present standard of care," with just HealthVault and home monitors, said Harris. "We want to prove this improves outcomes for the patient." He seemed confident they will.

So did Neupert. "We learned a lot of lessons about the dirty quality of the local IT environment and how to get around it. We want to make it something that others can plug in and play."


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