In my last blog, I discussed my perspective of what "Software + Services" means - to sum it up: coarsely grained business services that are interacted with via client applications (in some cases, multiple types of client applications).  Gee... I should've kept it that brief on the first blog.

The best way to demonstrate S+S, though, is to look at a real example... and Microsoft just came out with a doozy: Microsoft HealthVault - www.HealthVault.com 

Personally, I couldn't be more excited about about HealthVault as a Microsoft employee/evangelist as I think it can be a tremendous success, but even more so as a guy who values the health and wellness of his family.  A solution like this is waaay too long in the coming.

First - let's outline the problem: Health and Medical information is everywhere... but nowhere. 

That is, I can name dozens of organizations that know my most intimate details, but all of that information is completely locked up where I can't even get it.  This makes it impossible for me to manage my own health effectively, and every time something new arises, I have to start over from the beginning.

In addition, whenever I visit a new doctor (and sometimes even when I visit the same one multiple times), I'm required to re-submit all of my personal information to them... usually in pencil on a fuzzy copy of a health history questionnaire loosely held on a wooden clipboard. 

This is an utter waste of my time, not to mention embarrassing as I not only can't recall what year I had surgery... I can't even remember what decade it was.  It's also humiliating as the other patients in the waiting room gaze over my shoulder to see my selections under "bowel disorders."  I'm apt to leave the section blank no matter what... even if the information would be vital to the upcoming exam.

I contrast this to my financial situation... where I have access to every teeny detail of every cent I've ever earned or spent... along with tons of applications to aggregate this information, plenty of analyses to tell me how poor I am, etc.  I have total transparency into my financial life... but no control over my personal health.  That just never seemed right to me.

So a waste of time and incomplete, invalid information is a result of the current situation. 

But it gets worse...

I'm responsible for my family's welfare... and one day it's possible I'll be in an emergency situation where I'll need to provide vital information about my children (allergies, weight, medical history, etc.).  For someone like me who has trouble remembering his own blood type (B-positive... wait... maybe B-negative), this can be a real problem.  Under tremendous pressure of the moment, I may forget or get it wrong... or I may not even be there to give them the information. In situations where seconds mean life or death, delays getting this information cannot be tolerated.  But today... they are.

But wait... the problem is even worse than that.

Preventable in-hospital medical errors account for between about 100,000 and 200,000 deaths EVERY YEAR (source: HealthGrades and the Institute of Medicine) in the US. 

That's about 400-500 people dying - EVERY DAY.

The estimated annual cost, in the US alone, of this problem is $6,000,000,000.

The statistic is absolutely stunning... note that these are PREVENTABLE medical errors.  The majority of the "errors" fall into areas such as "failure to rescue" (i.e., not recognizing when a patient is at severe risk until it's too late) and post-op complication (like sepsis) risk management.  There are also the stories of medication errors - which, arguably, are a smaller percentage (thanks, in part, to Computerized Prescriber Order Entry barcoding) - but are still serious.

The following quote is taken from the Patient Safety and Quality Healthcare site in their "What Really Ails Us" article (http://www.psqh.com/julaug05/ails.html) - emphasis is mine:

"Errors of omission, on the other hand, are errors that occur as a result of a step not taken or when an appropriate step is left out from a process. The traditional use of the phrase has referred to the omission of a diagnostic test, such as routine mammography at a certain age or failure to administer a form of prophylaxis or therapy, such as giving aspirin to a patient with a strong indication, such as an acute heart attack.

Yet, other deficiencies in care also represent errors of omission. Consider this scenario: a doctor making rounds can't find the clipboard with the vital signs and as a result, doesn't know that the patient had a fever the night before. That night an even higher fever spike occurs — the infection has now been untreated for another day — and the patient goes into septic shock, which might have been avoided if the patient had received prompt therapy."

With that in mind - it's clear that one way to help PREVENT these "preventable errors" is to provide more timely and accurate information about the patients, as well as better information about patient health trends and courses of action.  This is strikingly apparent in the hospital scenario - but equally as important for the family practitioner as well as those who are managing their own health at home.

Which is my final point in this lengthy diatribe about the problems with Health information today.  We have a generation of boomers who are fiercely independent and are entering the age where health issues are going to be a bigger concern.  Many of these folks will want to care for themselves - and those who do a good job will likely remain healthier.  Of course, they need the devices (bp monitors, etc.) and tools (recording, reporting and trend analysis tools) - as well as the expertise (i.e., understanding what it all means) to do it right.

Right now the devices are out there, the tools are out there, and the expertise is out there... but they're all totally disconnected.  There's nothing that brings it all together and makes it easy for them... and that makes home health management difficult.

Lots of problems... one very good solution:

Enter: Microsoft HealthVault

From the Healthvault site (www.HealthVault.com):

Microsoft HealthVault is a new personal health platform that lets you gather, store, and share health information online.

With HealthVault, you control your own health records, so you can privately share your health information with family, friends, and health care professionals, and have access to trustworthy online health management tools.

Microsoft HealthVault Search is a new health search for the Web that helps you to discover, learn, and act on answers to your health questions.

Basically, HealthVault is a set of SERVICES for personal health information management, PLUS some SOFTWARE that interacts with those services to upload device data and allow people to easily manage their information.

The HealthVault site allows you to create an account, manage and share your information - as well as interact with PROGRAMS from other vendors (almost like plug-ins) for health management.

The HealthVault Connection Center is a rich client application that allows you to manage your information and connect to devices such as:

What's really cool about HealthVault is that it's not just for uploading, storing, and sharing information... it's for actively USING the data via programs.  Some examples of HealthVault partner programs include:

  • American Heart Association - allows you directly take your data from HealthVault and track your blood pressure
  • CapMed's ICEPHR - allows you to make your HealthVault data to healthcare providers available in case of emergency (ICE)
  • PureWellness - allows you to perform online health risk assessments and leverage wellness tools with your HealthVault information
  • Many more (Programs Directory: http://www.healthvault.com/applications/index.htm?rmproc=true)

In a nutshell, Microsoft HealthVault is a SOFTWARE + SERVICE solution that that allows you to:

  • Upload your health data,
  • Store this information securely
  • Share the information
  • Connect with other systems and programs
  • USE your information to better manager your health.

Oh - and FINALLY... and probably most importantly to developers like me... HealthVault is open to developers. 

This is great for developers in companies small and large (or hey - maybe even a great opportunity to start a new company) - as it will allow you to participate in this market and leverage the capabilities in HealthVault for your own solutions.

HealthVault provides the SERVICES... you can provide additional SERVICES for developers and consumers, or you can build some SOFTWARE that consumers and businesses can use to interact with HealthVault.

In summary:

  • Microsoft HealthVault is a great example of Software + Services
  • HealthVault can be a large part of the solution to making health information available in a secure, manageable way... and this will greatly improve the quality of healthcare, reduce preventable deaths, and help those who manage their health at home succeed
  • HealthVault is open to developers - and represents a great business opportunity for those looking to build SOFTWARE for health information management, or SERVICES that provide additional value to businesses and consumers

Personally, I hope that all of my health providers and insurance companies get deeply involved with HealthVault, it'll make my life a lot easier... and healthier.  In the meantime, I'm going to search the web to see if I can figure out what my blood type really is...

-Dan