Family Health Guy

In which Sean talks about HealthVault and other cool ideas in Personal Health

Watch out for the black helicopters…

Watch out for the black helicopters…

  • Comments 2
OK, let's just get this over with once and for all. Why haven't we joined Continua? And why did we move forward with a device strategy for HealthVault if we (raise one eyebrow here) aren't out to corner the world market on peak flow meters? Pardon the sarcasm, but jeez, give me a break.

HealthVault is about delivering and enabling solutions that improve real people's health. A big part of that vision is about care outside of traditional care settings --- at home, at the gym, at school, and so on. By now we all know the statistics about costs of chronic disease, and the incredible opportunity to save lives and money by keeping people out of acute care situations in the first place. Monitoring devices do and will play a huge part in a shift to preventative medicine - they are super-important. Getting started with solutions now is even more important.

Back when we started this project in 2006, some key leaders from the Windows for Portable Devices team (hey Oren, hey Bert) came to Health Solutions and said --- we built the WPD standard to support device classes beyond media players and cameras. We think it can apply to healthcare, and we want to make it happen. Seemed like a good idea, so off we went.

Now - a few months later, along comes Continua with a plan to create a bunch of new committees and new standards. No timeframe for delivering anything concrete, but a few rather unsettling terms in the invitation that they sent our way. I'm no lawyer, but here's what we saw when we read the bylaws:

  1. They contain a whole bunch of special privileges for the eleven "original promoters," including amongst other things permanent seats on the board. Now, realize that the board has final approval rights over all guidelines that come out of Continua, so in 2006 and 2007 the original promoters had a complete exclusive on all final votes. In 2008 the board size was expanded to 15 members, so now after the 11 original promoters, there are a grand total of 4 seats available to distribute between the 25 (current count from their website) other promoters. Sounds like being Cameroon on the UN Security Council. Woo hoo!
  2. They also contain some pretty toxic obligations around IP and patent licensing. There's good reason to be careful that open standards don't contain hidden patent issues, of course. But the way Continua approaches this is with something called "negative disclosure" - which means that with a very broad brush, participants implicitly give up rights to their IP unless they commit significant resources to evaluating every guideline, even those that they do not participate in. And this requirement applies beyond the health domain to the participant's entire portfolio. As a company whose only real asset is intellectual property - this is a burden that we can only take on when we're ready to commit serious legal and technical resources to the process.

Hmm. So the next step was to go back to our device team, who at this point already had code working and were engaged with a number of device manufacturers - many of them part of Continua - who felt that what we were doing with HealthVault made sense too. We got an education in the way that the WPD infrastructure really works. Because it is uses a "meta driver" model that can sit on top of any underlying transport, the team was confident that when the Continua standards did emerge, we would be able to layer in something called a "class driver" that would enable them to work with our existing system. And we also were reminded that WPD isn't bound to HealthVault at all - anybody can work with our devices on Windows without any HealthVault software at all - even Google and Dossia.

So, the choice before us was pretty simple. On the one hand, we could join Continua at great resource cost and limited influence, with an unspecified time horizon for getting solutions into the market. On the other, we could make devices available as quickly as possible, leveraging existing open standards, with the knowledge that when Continua devices became meaningful in the market we had a simple path to include them in our infrastructure as well.

A year later, with more than fifty devices in the market, and watching real people building real solutions on top of our infrastructure - I think we made the right choice. I'm thrilled to see Continua starting to demo some connectivity, and that Google and Dossia appreciate the potential for home monitoring. Will we join Continua at some point? Who knows, we're always re-evaluating things. But right now ... we just don't see the point. That's not a slam against folks who have joined, it's just a belief that membership for us is a non-issue.

As we've always said - we'll hook up to these devices when they start to matter in the market. Until then, you can go to Amazon.com or your local drugstore and get a device that works, today. Maybe a blood pressure monitor. Or a scale. Or a glucose monitor. Or a peak flow meter. Or a pulse oximeter. Or a heart rate monitor. Or a pedometer.

Now I have to sit down with my absentee ballot and vote. Where's my tinfoil hat?
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  • Sean,

    Thanks for the clarification.  As a former Intel employee from DHeG who was busy recruiting fitness companies to join Continua, I'd heard many rumors, but this is the most concise response that I've read.

    Further, based upon the successful connectivity by many of the companies who DID join Continua yet also function with WPD, I think MSHV has done a great job of displaying real world connectivity.

    It's an exciting time.  Technological, political (well, at least a few), and personal barriers continue to fall, thus enabling better personal health management through new products and services.

  • HealthVault, Dossia, and Google Health with their remote device monitoring will play an important role in not just managing at home or skilled nursing faciity patients, hospice or home care  patients, but as or even more important, the walking healthy or those with conditions such as hypertension, COPD, Diabetes,obesity to monitor and be monitored on a daily basis in their normal environment. Many patients have not been monitored in this manner.  The daily readings would seamlessly be integrated into their EMR for evaluation on their next doctor visit, and if critical would set off a warning at the doctor's office.

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