Practical Use of Microsoft Healthvault

I have written and spoken about Microsoft’s Healthvault service a number of times in the past few years.  For those who haven’t heard of it, Healthvault is a personal health and medical information repository that is controlled by each individual, not a healthcare provider organization such as a hospital.  Individuals specify who can access their Healthvault and can use it to quickly and easily share personal health information with whomever they choose.

One of the most significant decisions made by Microsoft in Healthvault’s design is that it is  Perhaps the most significant reason is that it is a service, not an application. Rather than build their own health and wellness applications, Microsoft is encouraging others to do so. The result will be a rich and diverse collection of health and wellness applications all using Healthvault to store personal health information.

A recently announced example of how Healthvault can be used is the new the Hawaii Medical Services Association (HMSA), an independent licensee of the Blue Cross and Blue Shield Assoction which provides health insurance to more than half of Hawaii’s residents. This service connects individuals seeking medical care with participating physicians either by phone or online using Web-based videoconferencing or secure chat. The service is highly interactive, with individuals able to have a real-time conversation with a physician and uses Microsoft’s Healthvault as one mechanism for sharing health and medical information with the physician.

According to HMSA, “Online consultations are not meant to replace in-person doctor visits; they simply provide another health care choice for talking to a doctor about a non-urgent condition or getting advice or answers.” In addition to providing advice about non-urgent conditions, physicians can also refill prescriptions, discuss medication discussions, or explain generic drugs.

What do you think of the Online Care service? It is a model that could work in Canada? Do you think that online delivery of specific healthcare services is a viable model?  What about Microsof’t Healthvault?  Will people be prepared to store their information on-line using applications such  as Online Care?

9 responses to “Practical Use of Microsoft Healthvault

  1. I really like the Hawaii model. Very innovative without breaking current relationships between consumers and healthcare providers. I wonder if this would work in Canada? The main challenges would be Canadian consumer behaviour and the politics surrounding such a service. I think the technology “challenges” is relatively straight forward.

    I remember sitting in the HIMSS conference last year in Orlando and listening to Steve Chase (former AOL founder and Revolution Health CEO) talk about his business model. Personal eHealth makes a lot of sense for the US healthcare system, patients are far more likely to be agents of change (demanding their health data) when they are feel like they are paying for the healthcare service via insurance. In Canada, the healthcare consumer is far more compliant. Many Canadians don’t see healthcare as a direct cost coming out their pocket, and also put too much trust in the hands of their doctor and/or the health system, assuming there will be no mistakes. Why would a Canadian demand their healthcare info…its almost unCanadian.

    On the other side of the fence are the traditional healthcare providers (docs, hospitals, etc). The docs they already get enough flack from patients who Google their disease. Where is their upside, will they get paid more? What about the paternalistic attitude of many in the acute care world, where they see vendors and private enterprise as “bad” and part of their job is to “protect” consumers from the vendors.

    Do I think it will work in Canada…my typical Canadian answer would be “maybe”. Depends if the service/application could either get the traditional healthcare providers onside, or get the consumers to act as agents of change. I am looking forward to seeing which model would be more effective, or if in fact a hybrid will work in Canada. Interesting days….

  2. There are two key factors that I believe will make the Hawaii model work:
    1. The doctors get paid by HMSA. Hence, they are incented to participate.
    2. The convenience factor of being able to reach a physician any time of the day is compelling for the consumer. In fact, I contend that it might even be more so in Canada given the number of people who don’t have their own doctor.

    I suggest that the Ministries of Health have a close look at this model as it may be a more cost effective way to deliver services. I would think that HMSA looked closely at the economics of this model before rolling out the service.

  3. I may express my concern about the model, but more specifically based on Microsoft behavior regarding security, a flaw in such a system could lead to serious problems for the patient, also take into account the malpractice problems insurance companies have been involved in. I may be wrong but …

  4. Based on what I have heard and read Microsoft has consulted extensively with the privacy community and has sought endorsements from leading privacy experts. They realize that the privacy of personal health information (and, related to that, the security of this information) is a critical success factor for Healthvault.

    One of the most difficult aspects of designing a consumer health application is ensuring that personal health information remains private. I suggest that only an organization of Microsoft’s size, financial resources, and IT expertise can hope to tackle this problem. By taking care of this major headache, Microsoft will make it possible for hundreds of smaller organizations to develop innovative consumer eHealth applications.

  5. But Mike you are missing the point. This has little to do with the message and everything to do with the messenger.

    The market perception on MSFT is still one of the late 1990’s. Would you trust your personal info or partner with a company that is considered by many to be a monopolist that stiffles innovation.

    Has MSFT changed, one would hope so with Google breathing down their neck. I just hope they get the tech right and we don’t need to wait until version 3 to be of any use. Maybe my perception is outdated, or maybe it is the fact that I spent time trying to trouble shoot VISTA this weekend. 🙂

  6. Oh, I get the point. Indeed, one of the challenges thatn any personal eHealth application /service faces is consumer trust in the provider of the service. With Healthvault, Microsoft is working hard to get endorsements from trusted privacy experts such as the provincial Privacy Officers. Whether these endorsements are sufficient to overcome many people’s natural distrust of for-profit entities like Microsoft remains to be seen. I am convinced that they are taking all the right steps to protect personal health information and not just paying it lip service. Question is, can they convince enough other people?

    • I think that MSFT faces an additional challenge in the CDN market. Competition or lack thereof.

      My question is where is Google in the same space in Canada. I never hear anything about their US play in the CDN market. I think MSFT is really competing against the jurisdictions themselves. I keep hearing rumblings from different provinces that they are planning to roll their personal health record portal for their populations. Just look at what Alberta has started to do.

      As with many things in the Canadian Health IT market it is about perception. We can argue for months about the nuances of the MSFT Healthvault strategy in Canada, but are Canadians ready to deal with non-government entities when it comes to their personal health record info. I strongly support MSFT and any other private player to bring value to their customers. The “Free” healthcare attitude is a religion to Canadians and I worry that this general attitude will have an adverse effect on MSFT and others in this space.

      Mark

  7. Ah, but you are missing the point of what Microsoft is trying to do! They don’t want to compete with the provinces. Healthvault is all about infrastructure, not applications or functionality. Their play is to get the provinces to use Healthvault as a repository (just as Hawaii is doing) on top of which the provinces can develop whatever functionality they want. With Healthvault as the respository for personal health information, patients / consumers can easily share the information stored Healthvault without the province having to deal with the consent issue. By allowing others access to their Healthvalue the patient / consumer has explicitly given consent.

    From what I have heard Microsoft is in active discussions with the provinces and with Infoway. I expect to see at least one province purchasing healthvaults for all their citizens and Microsoft setting up a Canadian data centre within the next 12 months.

  8. Further to my last post, it is essentially a “build vs buy” issue for the provinces. Is it cheaper to build their own repository or use Healthvault? Either way, the province can invest the $’s in the necessary infrastructure and make it “freely” available to all citizens.

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