Family Health Guy

Great fun --- and a $10k challenge --- at Health:Refactored

Sean Nolan — Wed, 15 May 2013 06:59:47 GMT

I just got back from a great couple of days at the Health:Refactored conference --- a new show put on by the Health 2.0 folks that brings a slightly more technical bent than your typical “Healthcare IT” conference. The Computer History Museum was a great venue (check out my picture of a real life Cray-1… so cool!) and I really enjoyed having a ton of 1:1 time with real developers and innovators.

This morning I did a quick keynote to help start the day off. Because of the audience, I took a slightly different approach than I often do in talking about the industry --- hard to know if it was motivating and fun (the goal) or snarky and obnoxious (the risk), but either way I figured I’d share it here as well in the hopes that it can spark some good discussion.

I uploaded my slides here; but the punchline is encapsulated best in this one picture:

What I’m trying to say is --- there are TONS of great ideas about how to make healthcare better --- and frankly our system is so screwed up that the vast majority of those ideas actually could help. The problem comes in at the point of execution --- too many people get stuck in “pilot” mode, ignoring the ugly, hard, integration problems that are frankly the hard part of healthcare technology:

How do you get the data you need to drive your solution?
How does your solution fit into actual provider and patient workflows?
How can your solution work with all patients (not just the ones with iPhones)?
etc.

Helping innovators get beyond the trap of pilot mode --- and use their startup dollars efficiently --- is what platforms like HealthVault are all about. Honestly, if I hear one more developer tell me that they figured out how to parse a Blue Button or CCD file, or that they connected directly to Withings and Fitbit and ten other devices, I’m going to lose it --- HealthVault abstracts those things away for you. You just ask for data, and you get it --- I put money into keeping my parsers matched to the whim of the VA, Epic or whomever, so that you don’t have to. Take advantage of that!

Anyways --- it’s a hopeful and positive story. Today HealthVault and other great platforms like SMART make it easy for savvy developers to concentrate on their innovations, not the mess underneath them --- and puts them in a position to escape the black hole of the forever pilot.

Enter the $10K Windows 8 & HealthVault Challenge!

…which is a great segue into the other really cool thing we kicked off at Health:Refactored --- a challenge meant to stimulate some great ideas and innovations combining Windows 8 and HealthVault to “re-imagine” consumer health. The only requirement is that you leverage both technologies to do something great --- but time is short! Details are here and submissions have to be in by June 30. GO!

For some inspiration, take a look at our own HealthVault app for Windows 8, or the really great medical image viewer built by Mobile Solutions. We have a super-rich Windows RT SDK with sample code to get you started as well; check it out here.

Win8 has some great features and you should explore them all --- but for my money, the really awesome thing is that it’s the only modern touch platform that makes HTML, Javascript and CSS a first-class, native development environment. My first personal foray into Win8 development was a HV sharing app … and I was simply amazed at how quickly I was doing really sophisticated stuff using all the skills that have served me well on the web for all these years. Really empowering, and should open up Win8 development to thousands of folks that otherwise would have to start their education from scratch once again.

If you have any questions about the challenge, post a question here or just send a note to the challenge email alias at Win8HealthDev@microsoft.com --- and we’ll do whatever we can to help. Oh, one other thing ... we had some free kits at the conference that made it easy for Mac-based developers to work with Visual Studio and Win8 through a VM ... I don't know if we have extras of those but if you want one email the alias and ask ... worth a try!

Can’t wait to see what you create. Thanks to everyone who participated at the show and look forward to doing a v2 of it next year!

What's the story with HealthVault on Android?

Sean Nolan — Thu, 02 May 2013 16:50:41 GMT

Super quick post because it's just too much text to put into a tweet. ;)

We get the question a lot --- with the HealthVault iPhone, Windows Phone and Windows 8 mobile apps --- what's the story with Android? Because we're both app and platform, there are a few dimensions to the answer:

1. We DON'T have a "first party" HealthVault app built by Microsoft for Android. We get this request a lot, and my good friend Umesh keeps threatening to write one behind my back, but the reality for now is that we don't have plans to do this. Not that we don't want to ... we just have a long backlog and it's too far away to put a date to as yet.

2. We DO have an SDK that enables Android apps to connect to HealthVault, and there are about a half dozen or so that have done so. Take a look at our app directory and choose "Mobile / Android" to see the list. The most popular right now is iTriage, a great app that provides Android-native read only access to your HealthVault profile (and a lot more). We love Android developers so check out the SDK at http://msdn.com/healthvault and let us know if you run into problems!

3. As a fallback, the HealthVault web site does present pretty well on at least the Android tablet factors like the Nexus 7, and is usable if not ideal on phones as well.

Hope that, while not the answer I know a lot of folks are looking for, at least provides some clarity!

Love the code; Love the crawfish!

Sean Nolan — Sat, 27 Apr 2013 20:45:29 GMT

Good very early morning from gate 1 at Lafayette Regional Airport, waiting for my flight home after a great visit to the second annual Cajun Codefest. As I gushed last year, this is a truly special place with a combination of awesomeness that I’ve never experienced anywhere else. If you can gauge enthusiasm by the amount of late night time spent looking at local real estate on the web --- I like Lafayette a lot.

The HealthVault team was present in force: Phil and Saeed did the hard work, staying up late into the night helping teams integrate HealthVault into their solutions. I got the easy job and just had to try to keep people awake during my presentations and help with judging.

This year, the Codefest theme was “Own Your Own Health.” A pretty wide open idea, and I was frankly a bit worried that without a bit more focus and only 27 hours to work, folks would get too scattered to deliver real results --- but while that happened to one or two teams, it certainly wasn’t the norm. Three standouts for me:

The $25,000 winner, “Team Break Fix”

Inspired by a pretty overwhelming personal story of adverse medication events, this team set out to attack the problem of tracking a deceptively simple question, “are you taking your meds?”

I take one pill every day, and even I struggle to remember if I took it after a morning on autopilot. My wife Lara has a complicated regimen and spends a pretty nutty amount of time every week filling a special pill box to try to keep track. The stats are pretty clear on this one, and the opportunity to make things better is pretty overwhelming.

That said, it’s also a problem many are trying to address, including everything you could imagine from super-gadgets like bio-powered pills to old fashioned phone calls for folks that haven’t even filled their scripts. So what new were we going to see here?

Make it easy to track the event of taking a pill by attaching a cheap (often less than a dollar even at low retail volumes on Amazon) “near field communication” sensor on the pill bottle. Bump that up against your phone as you take the pill and forget it. Nice! There are some real issues here with multiple pills, and NFC isn’t nearly ubiquitous yet --- but the idea is solid.
Involve the care circle --- both professional and personal -- via text message when doses are missed. Again, there’s workflow complexity here to avoid classic alert overload, but the solution was surprisingly advanced given they’d only had a day to focus on it!

The “most market-ready” $5,000 winner, “New Old Schoolers 2.0”

There’s a reason that medicine is so often the setting for television shows --- beyond the obvious emotional draw, healthcare almost always comes down to detective work: what’s the trigger for this symptom or condition? To wit: Is Jan really allergic to Tiger, or (spoiler alert) is it just the new shampoo they’re using?

Less dramatic but just as important is the ability to spot trends before they become a big deal. Relatively minor weight gain in a person recovering from one heart attack can easily add enough stress on the muscle to cause another. Small increases in rescue inhaler use can telegraph an upcoming serious attack. Rising anxiety can cause acute psychological incidents. And so on.

The Schoolers took on this problem by creating a mobile solution built to find correlations and trends in these “observations” over time. First, the app helps collect data conveniently and quickly, using a single screen composed of green-to-red sliders that capture “current state” of anything: pain, stress, nausea, you name it. It also records point-in-time events like an asthma attack or unanticipated need for insulin. And while they didn’t implement it in their 27 hours, the solution plan includes tracking other external factors like local pollen count or air quality.

The “all in one” nature of asking the user for data is pretty key. There are some things we can measure automatically, and that’s great. But many of the observations we need, at least with today’s technology, require asking and answering. And that’s a pain to do every day over a bunch of questions. Having everything in one screen with simple, quick sliders --- that remember your answers from yesterday --- go a long way towards easing the burden of keeping up.

Next, the team recognized that identifying patterns in a mass of variables is really tough even when you DO have the data. So they created color-based visualizations to try to help --- e.g., if the pain measure is “reddest” every Friday --- it’s a hint that may help you find a trigger you didn’t realize existed.

And finally, they realized that the uses for this tool can extend beyond individual care into public health and other research realms. In Louisiana near to where we were coding, they burn off sugar cane fields every season. Wouldn’t it be useful to have people across the community report back on coughing, asthma attacks and other air-quality related symptoms during this period? By correlating these with location and time we might be able to mitigate community-wide issues we doing really even know are happening.

The student $2,500 winner, Geaux KNES

On its face this was just a really well-executed iPhone-based exercise companion that helps suggest exercise programs given your personal situation, and then uses GPS to track walks and runs. But beyond the fact that these two (yes, just two) students built a metric TON of code and great design in the 27 hours --- their app has some really powerful new ideas.

First, they didn’t track only distance and speed --- but build their system around exercise intensity. By combining speed with grade (elevation gain/loss), they computed how hard the user is working, which is a key factor in understanding the benefit you’re getting from a given session. I’ve seen simple elevation tracking in quite a few apps, but not this use of intensity as a combined metric.

Next, they took those intensity numbers and translated them into language that match the guidelines we all know about: twenty minutes of vigorous exercise three times a week or whatever. But what is “vigorous” to me may not jibe with what those guidelines mean --- it’s a pretty subjective word. The Geaux KNES app does this translation for me, so I can keep myself in “moderate” or “vigorous” range in real time. Nice!

HealthVault as an enabler for “suites of innovation”

In parallel with the coding, we got to hear and interact with super-smart folks like Farzad Mostashari and Brian Sivak. This was my first time meeting Brian in person, and it was a lot of fun --- he’s a great guy. I will forever regret that I was too pooped out after the long days to visit Festival International with him and the gang this year … but at least Saeed made it last night, and I guess that just gives me one more reason to come back next time.

Farzad made a point that was incredibly relevant to HealthVault. There is a huge amount of innovation going on, but if you want to see that innovation really make a difference at scale and in the real world … you need to make it easy to adopt. Docs are being bombarded by hundreds of niche “apps” that may be awesome, but can’t possibly all be integrated one-by-one into clinical environments and workflows. We need to find a way for these apps to fit into a “suite of innovation” that reduces the overhead of adoption.

Um, this is why HealthVault exists!

We work all day, every day, to help make it easy for apps to integrate with the healthcare system. We do the hard work of moving data between enterprises and their patients or members bi-directionally:

OUT of clinical systems, pharmacies, labs, Blue Button, HIEs, monitoring devices, etc. etc. INTO a platform where your apps can use it. So your app can be auto-populated with data from the providers without ever even knowing who those providers are.

INTO clinical systems OUT of your app where providers and care managers can act on it. For example, the Schooler’s app generates a ton of data and tries to help the individual find the patterns. Often a provider is going to way better at identify the patterns. One option to get that data to the provider would be a new “app” for the doctor to look at, but this is a non-starter --- docs have enough screens to log into and look at --- you have to be integrated into their workflows. HealthVault will help you get that data back into an EMR where it can be most valuable.

A very telling moment for me during judging was when Brian asked the Geaux KNES team --- who had implemented a slick two-way sync of exercise data with HealthVault --- if they’d considered connecting to devices like the Fitbit. The poor kid started explaining how they could do that because Fitbit has an API, etc. etc. --- and I couldn’t stop myself from shouting out, YOU ALREADY CONNECTED TO FITBIT AND 200 OTHER DEVICES --- because Fitbit is already part of the HealthVault ecosystem. Any user with Fitbit data will AUTOMATICALLY see it in the Geaux KNES app, and they didn’t even realize it!

Sheesh. This was funny in one sense, but really just a bummer, and I wish I could figure out how to make people “get” what it means to connect to a true platform like HealthVault versus a million one-off APIs. Ah well, we’ll just keep swimming and delivering the message again and again until it sticks.

The other thing we learned about HealthVault --- was that our current Java SDK has fallen behind the curve of development and needs work. Not sure how we’ll address this … whether we should keep on the strategy we have there or just reset with a newer-style REST API that’s easier to consume without an SDK. I got some strong opinions on this during the sessions. ;)

This post is already way too long, so I’ll refrain from waxing lyrical about the amazing Crawfish boil, the incredible music of Terry Huval and his sons, breakfast with boudin and cracklings, and all the other great stuff that makes me wait all year to come back to Lafayette. Suffice to say that it was an amazing time, I was energized by the enthusiasm and great work of the coders, loved catching up with new and old friends, and am humbled by the hospitality Lafayette’s leaders show to a Northwest interloper like myself. I carry my “Honorary Cajun” title with a great deal of pride!

Thanks again to everyone in Lafayette, and see you next year!

Medical imagery comes alive on Windows 8!

Sean Nolan — Thu, 18 Apr 2013 06:50:00 GMT

Hands down the most underutilized feature of HealthVault to date has been our ability to store and share full-fidelity DICOM images. Not only is medical imagery incredibly valuable for diagnosis and tracking purposes, it’s also super-expensive and generally non-trivial to acquire --- something I relearned just the other day when I spent the morning inside a CT machine with a contrast IV line.

Using HealthVault Connection Center, you can easily upload images from a CD or DVD into HealthVault, where we’ll keep them safe, enable you to share them with others online, and burn as many new copies as you need for second opinions or referrals. If you’re lucky, your imaging center may be able to sidestep the CD altogether and send directly to HealthVault using a solution like this one from Candelis. You should be doing this!

And now, a new app from Mobile Solutions --- Medical Image Vault --- provides an incredibly rich viewing experience for your images on your Windows 8 laptop or tablet. These folks have already created great apps on Windows Phone and Android, but their new touch-first interface on Windows 8 is really something special. Just take a look at a few screenshots from my account (click to enlarge):

The detail you can see by pinch-zooming is just amazing. Downloading images can take a few seconds, but that’s just a matter of bandwidth --- there’s just a lot of data to fetch. And the app does a great job of on-demand loading so that it only pulls down what you’re looking at, so it’s not a big deal.

Of course, the app is meant for personal, not professional, viewing. But having the ability to pop open your laptop and give a preview to a specialist or other caregiver is a huge win, and if they need to do a “real” read, just burn them off a copy and you’re good to go.

Medical Image Vault is the perfect companion to our own Windows 8 application --- together they turn your device into a powerful tool to manage health and wellness for you and your family. So…. What are you waiting for?

A (much) better approach to patient identification

Sean Nolan — Mon, 25 Mar 2013 04:07:51 GMT

Unlike some others, I’m optimistic about the creation of CommonWell and its potential for making more information available to caregivers where and when it’s needed. Not because it’s a new idea, but because I’m lucky enough to have worked with many of the specific individuals involved in the project, and they are simply great folks. If anybody in our community is going to make something real here, it’s these people. So … woo hoo!

That said … their focus on creating a national EMPI has spun up that tired old argument about national patient identifiers … and this one ticks me off because it’s just silly. We have absolutely no need to share a common patient identifier, whether created top-down or synthesized from demographics up. The solution is staring us in the face.

All we need is patients and their existing relationships with providers. This is one of the key transformations that HealthVault offers, but few recognize until they see it at work. When that light bulb does goes off, it’s pretty cool. To see what’s going on, let’s walk through the evolution of a HealthVault record.

When I create a HealthVault record, it isn’t connected to anything. It’s just this empty bucket up in the cloud that I control. I can put my own stuff into it, connect devices like a fitbit or glucose monitor, and so on. So it’s useful, but not particularly exciting. Looks kind of like this:

Now say I get some tests done at LabCorp, and I use their Beacon Portal to get a copy of my results in HealthVault. The Beacon site does some knowledge-based identity proofing to match me to my LabCorp information, and I (the patient) authorizes the link to HealthVault. A “link” is formed between HealthVault and LabCorp, and data can travel between the systems with high confidence:

Now here’s where things get interesting. Say I’m going to visit a new provider and want them to have access to my lab results. Either by giving me a PIN code or leveraging an existing patient portal, that provider can obtain my consent and link my HealthVault record to their internal chart. They can now peek into my HealthVault record and read out the results deposited there by LabCorp, as well as any other relevant information.

This process repeats at each provider and service I visit, creating a personal Health Information Exchange that provides all the capability we need to ensure that the right information is available when it’s needed and relevant, because every linked provider can see (subject to my OK) information from every other participant I’ve linked to my network.

They may look unassuming, but all the magic is in the “links” --- those grey arrows in the picture above. Because the properties of those links are what make this a seriously transformational idea:

There is no “fuzzy” matching. Each link is created as a byproduct of a natural exchange that already occurs in the healthcare system: introducing yourself to a new provider, signing up for an online service, and so on. While no system can completely eliminate the risk of a mismatch, our real-life experience with HealthVault shows it to be dramatically more reliable than traditional EMPI techniques.
Privacy, liability and HIPAA issues between providers COMPLETELY GO AWAY. Each link represents an independent agreement between the patient and a single provider. Information that goes from ProviderA to HealthVault and is then read by ProviderB requires no relationship between A and B whatsoever, because the information is brokered by the patient.
This does not mean that the information can be faked. HealthVault contains extensive audit information, visible to all participants, so they can verify the “provenance” of data before accepting it. This is frankly WAY more reliable than getting a fax or a pile of paper.
There is no common identifier shared between providers. The concern about a national identifier boils down to a fear that we’ll be easier for bad guys to track. In the HealthVault model, every “link” uses a different patient identifier … so the ID that ProviderA uses for me is completely different from the one used by ProviderB. Of course, buried within HealthVault there is a connection, but the system is built to never expose it to linked applications.
And just for the conspiracy theorists out there … the HealthVault terms of use even restrict Microsoft from digging into this data without user consent. And those terms are enforced by the FTC and other agencies … it’s not something we take lightly or can just renege on.

So let’s recap. The HealthVault model is in production today, delivers better quality patient linking than other approaches, eliminates inter-provider privacy, liability and HIPAA concerns, doesn’t require a common patient identifier, puts citizens in greater control of their personal information, and enables more informed care TODAY.

Hmm.

Yeah, we’re making progress and connecting more folks to the network every day --- but I’m not sure how to end this post without screaming in frustration at how slow folks move in this industry. We NEED this NOW, people!

More Windows 8 “Sharing” and HealthVault

Sean Nolan — Fri, 15 Mar 2013 15:08:00 GMT

In my last post, I talked about how our Windows 8 HealthVault app integrates with the new “Sharing Charm” to do some pretty cool stuff, like sharing photos and other files directly from the Camera to HealthVault. But as great as that stuff is, there is an even better feature hiding in our Sharing implementation that I wanted to spend some time on. Fair warning --- this is a geeky developer zone, so feel free to bail now if that’s not your bag.

You can read a ton about Windows 8 Sharing here, but the core of it is simply that applications can register to “receive” sharing requests for certain data formats. Common formats are text, images, etc. --- but applications can also define their own formats.

Other applications then make their data available for sharing. For example, when you’re looking at a picture in your photos library, that app makes the picture available for sharing. If the user chooses the Share charm, they’ll see a list of applications that can accept them. The user picks one, the target app is activated and passed the data, and we’re off to the races. Basically a super-clipboard.

OK … so the cool thing we did with the HealthVault app is to register to receive any HealthVault-formatted items, and automatically push them up to the right HealthVault record in the cloud. In other words, Windows 8 apps can use our HealthVault app as a programmatic channel to push data up to HealthVault – with no HealthVault software or “go live” involved.

Want to build an app to upload blood pressure values from an Excel file? No problem. Are you that reviewer that wished we let you set your height from the app? Kachow. This isn’t a substitute for using the SDK to build great, interactive HealthVault experiences --- but it opens up a TON of cool stuff with virtually no hassle. Pretty awesome.

To make this happen is crazy simple. Here’s how it works in Javascript:

1. Register yourself as able to provide data for Sharing.

var dataTransfer = Windows.ApplicationModel.DataTransfer; var dataTransferManager = dataTransfer.DataTransferManager.getForCurrentView(); dataTransferManager.addEventListener("datarequested", dataRequestedHandler);

2. Implement the handler to return data when requested.

function dataRequestedHandler(eventInfo) { var thingXml = /* construct your healthvault xml here */ var request = eventInfo.request; request.data.properties.title = "HealthVault"; request.data.properties.description = "Information to share with HealthVault"; request.data.setData("HealthVault.Types.RecordItem", thingXml); }

3. If you want, manually kick of sharing at the appropriate point in your application. Note that Microsoft discourages using this method in most cases, because we’re trying to teach people to use the sharing charm to initiate the action. But there are times when it makes sense; you can do so with a simple call:

Windows.ApplicationModel.DataTransfer.DataTransferManager.showShareUI();

The only part of this that’s at all challenging is building the HealthVault XML in the right format. For the super-hardcore, our “thing” XML is defined in our service specification and there’s a full reference to all of the type-specific XML here on MSDN. But it’s much easier to either use our Windows 8 SDK to build the XML from objects --- just use the Serialize functions on the HealthVault.Types.RecordItem class.

Even easier, if you already have an item in HealthVault of the type you care about, just use your browser to view the item at http://healthvault.com, expand for details, and look for the “View as XML” link to get yourself a nifty sample.

Once you have the <thing> element(s) the way you like them, wrap them up in an <ArrayOfThing> tag and you’re good to go. Here’s an example of a very simple weight reading:

<ArrayOfThing> <thing> <type-id>3d34d87e-7fc1-4153-800f-f56592cb0d17</type-id> <thing-state>Active</thing-state> <flags>0</flags> <data-xml> <weight> <when> <date><y>2013</y><m>3</m><d>10</d></date> <time><h>10</h><m>50</m><s>55</s><f>340</f></time> </when> <value><kg>75</kg></value> </weight> <common /> </data-xml> </thing> </ArrayOfThing>

You can download sample code, which is a bit more complicated but mostly just in the window dressing, at my HealthVault Toys site. It’s pretty neat … works like a champ and barely took a couple of hours to get rolling … and did I mention it’s my first real Windows 8 app? Hooray for me….

Relentlessly better every day. That is how we help real people!

PS. One note pointed out to me by our Win8 PM Sam ... the app is able to push any HealthVault type via sharing, even those that the app itself doesn't know how to display (like glucose in my sample). This makes the feature way more useful, but can be a bit confusing. All is well --- that data goes up to HealthVault in the cloud and can be viewed on the web or any other app that can work with it. We'll be adding more functionality to the Win8 app over time as well. Just didn't want anyone to be confused!

Update 3/25/2013 --- the team just posted official documentation on sharing to and from the HealthVault app. Check it out here!

HealthVault on Windows 8 ... amazingly great.

Sean Nolan — Thu, 14 Mar 2013 15:34:00 GMT

HealthVault means a ton to me --- as you might gather if you see me driving around Bellevue in my new Fiat 500C with the totally awesome custom “HealthVault” racing stripes (thanks Jody!). HealthVault is easy to love … moving us towards a better-performing, more efficient healthcare system in a way that respects “patients” as capable, active people participating in their own care. Light years away from so many of the dreary, backroom “solutions” that just trade off service for cost in a depressing (and false) zero-sum game.

Which isn’t to say it’s an easy road, or one where we’ve always made the right choices. But the progress has been steady and --- one of my favorite words --- relentless. HealthVault today is a rich and useful ecosystem with hundreds of connected apps and devices, users in the millions and an expanding footprint that covers almost every part of the world.

And it’s even richer today --- thanks to the incredibly super-awesome new HealthVault app we’ve just released for Windows 8. It’s a beautiful, modern, responsive application that shines on tablets and touch, but works great on my “plain old” laptop too. Go check it out in the store now!

Once you sign in, the first thing you’ll see about the app is that right up front, you’re looking at a clear, immediately useful view of your most current information. There’s a section for tracking key metrics like weight, blood pressure, diet, exercise and cholesterol, complete with mini graphs showing recent trends. Next to that is your health profile: medications, allergies, conditions, immunizations and procedures. Then administrative information like insurance and contacts, and finally a directory of all the apps and devices you can use with your account.

It’s great to have this world-class experience on a platform that has sold 60 million licenses --- not a bad market (and by the way, there’s a great HealthVault Windows 8 SDK if you’re a developer and want to grab onto that opportunity too!). But it’s not just another platform; we’ve taken advantage of some of the innovations in Windows 8 to make things even better.

It starts with signup. We automatically use the Microsoft Account that you’ve used to log into Windows … so there’s no new password to remember or deal with***.

HealthVault also “snaps” beautifully … want to have a handy view of your information while filling out an online form? Grab the HealthVault app at the top of the window and slide it over onto the left. It’ll dock there in a mini-view that’s completely functional!

We’ve also done some great integration with the new “sharing” charm to make it easy to add information to your records. Open up the camera app and snap a picture, then swipe from the right side of the screen and choose “Share.” You’ll see HealthVault listed there --- choose it and you’ll be able to automatically store that picture in HealthVault without ever leaving the camera. The same works for almost any kind of file, anywhere in the system. Woo hoo!

Sharing goes the other direction too. Want to email some information to your doctor or family? Just choose one of the tracking sections in the HealthVault app, swipe and choose “Share.” You’ll see options for email and possibly other tools show up there too.

This functionality is really very rich and makes it way easier for developers to take advantage of the “right tool for the job.” I’m working on a second post on sharing aimed at developers too, because it makes extending HealthVault pretty simple. More to come here!

(One more thing here … I happen to know that we’re really close to having an awesome Windows 8 viewer for medical images in your HealthVault account, too … not being built by us but by a great third-party developer ….. can’t wait for this one to pop!)

I’m really proud of this work (although the real credit goes to the team that conceived and built it; I just get to talk about it)… HealthVault for Windows is a big step up for our service, and is pointing the way towards where we need to be to become ubiquitous. Which we will be --- it’s inevitable (another of my favorite words)!

*** Note that while we do this automatically on Windows 8, you can still use your old Live ID, Facebook or OpenID account with HealthVault. The easiest way to do this is to take these steps before running the new app: (1) log in at http://healthvault.com on the web; (2) click ‘your account’ at the top right of the window; (3) towards the bottom choose ‘manage sign-in information’; (4) choose ‘Microsoft account’ under ‘add more ways…’ and log in with the same Microsoft account you use for Windows. Now when you run the Windows 8 app, you’ll automatically be hooked up to the right information. Whew!

HealthVault, Big Easy style … HIMSS 2013!

Sean Nolan — Fri, 01 Mar 2013 23:28:00 GMT

For the first year in a long time, I’m sitting out the HIMSS show and staying home --- which is awesome since I’m not a big fan of travelling for work, but provides an amazing perspective on just how many folks DO attend. I’ve nearly worn through my keyboard typing “not going this year, but would love to chat after….” Hope you all enjoy the great NOLA tradition of morning Bloody Marys. ;)

That said, HealthVault absolutely is there in force, with a bunch of great stuff we’re talking about. Join us at the Microsoft booth where you’ll find Phil Pennington and Nate Reno repping for HV, as well as a few of our great partners helping showcase HealthVault-connected solutions..

Just a few of the neat things we’re a part of (not to mention a metric ton of other awesome stuff bubbling around the rest of Microsoft):

	Tribridge is showing their HealthVault-connected, Dynamics-based solution for Care Coordination. The solution enables care managers and patients to collaborate around rich care plans and home health measurements. Fostering these kind of rich relationships is critical to outcomes success for emerging ACOs, public and private payers, employers --- a huge variety of organizations that are invested in improving health and reducing costs across a population. Contact Jennie Treby for more information.
	We’re announcing our alliance with NoMoreClipboard and other patient advocates as part of the imPatient movement. Combined with the technology work we’re doing with ONC and the community around Blue Button and Direct, imPatient is a great opportunity to foster conversations about provider/patient collaboration and real, automatic data exchange. Interested in joining us? Contact Rachel Kuna.
	iLink is demonstrating their HealthVault-connected Patient Engagement Framework and wellness/personal health solutions. iLink is a great partner than can deliver custom solutions dramatically accelerated by starting from these proven frameworks. They’re also particularly in tune with the work we’re doing around Windows 8, so be prepared for some pretty cool user experiences! Contact Mahadevan Seetharaman for more information.
	We’re going to be speaking more about the great integration of HealthVault and the Next of Kin Registry, delivered by our friends at DataArt. I posted about this solution a couple of weeks ago when it went live, but it’s just the beginning of a broad story about how HealthVault can play a role in making families safer in emergency situations both large and personal. LOVE THIS! For more information contact Rosemarie Esposito.
	Get Real Health just did a great webinar about their new look and the upcoming 3.0 release of their InstantPHR product. InstantPHR is a fantastic HealthVault-connected “toolkit” that makes it super-easy to compose patient engagement solutions for care management, personal empowerment, and more. GRH technology is the basis of some of the most successful HealthVault projects out there --- from the AARP Health Record to programs at the NHS like SLaM and UHS. For more information contact Kathy Silverstein.
	ONC has been sponsoring some fantastic work on Blue Button + --- a major upgrade of the successful VA and CMS program to share health data with their beneficiaries. The “plus” enables a much more meaningful exchange of data, and adds “set-it-and-forget-it” (nod to Ronco) capabilities so that patients don’t have to manually move files around one by one. HealthVault is ready to receive these messages today (so sign up for your free address!), and we’re part of demonstrations going on at the BB+ interoperability showcase. Contact Peter Ashkenaz or visit the Blue Button + implementation guide for more information.

Whew! This is just a small sampling … our folks are busy and I’m sure you are too. The big takeaway for us is --- persistence pays off, as we’re seeing incredible momentum towards the (yes it should have been obvious from day one) observation that patients MUST be key partners in any successful health reform, not just in the United States but everywhere in the world. We are loving our position in this emerging market and invite you to jump in with us and see how we can help!

Wow … a thoughtful piece on Patient Activation!

Sean Nolan — Tue, 12 Feb 2013 01:03:02 GMT

I have to admit to a certain amount of impatience with most debates about patient engagement. Much like a conversation about gun control or abortion, many people have established their opinions without a lot of critical thought and conversations devolve quickly into repetition.

In this environment, it was super-refreshing to read Judith Hibbard and Jessica Greene’s commentary on their Health Affairs article, “What the Evidence Shows about Patient Activation.” With apologies in advance, I’ll try to boil out the key points of the article:

You can objectively measure “Patient Activation” – how able and willing individuals are to manage and participate in their own care.
Evidence shows a correlation between this score and better outcomes.
Emerging data indicates a correlation between the score and lower costs, although there is less data here to draw conclusions from.
Interventions can impact an individual’s Patient Activation score.

Taken all together, the message of the piece for me is something that we see anecdotally with our HealthVault partners every single day: investing in creating more educated, informed and empowered patients (citizens/individuals/members) will help make people healthier, and reduce their healthcare costs.

HealthVault can help you there. Whether you build full-fledged programs to support chronic care, or simply help folks jumpstart a personal record and point them at great tools like those built by AARP or AHA … there is a way for our work to benefit yours.

The evidence is increasingly clear --- so I hope the day is near when I’ll stop hearing “patients don’t want” or “patients aren’t able” nonsense. Instead, let’s concentrate on identify the best interventions, and scale them up to really make things better!

Welcome BlipCare to the world of awesome health devices

Sean Nolan — Wed, 06 Feb 2013 08:36:00 GMT

When it rains it pours! What with NOKR, 1212, MS-HUG and our new iPhone app, seems like I’m writing a new post every twenty minutes. But the good news keep coming, so here’s another one….

Over the holiday, I happened upon a new project on Indiegogo, the new wifi blood pressure cuff by BlipCare and I had to check it out. Turns out that Blip is a new subsidiary of Carematrix, a great device company that has been working with HealthVault for some time. So I signed up for their “just in time for Christmas” deal, got my unit running and have been totally impressed so far.

As regular readers know, I love my Withings scale. What Withings figured out with the scale was that being truly wireless in the home, the scale can live in the bathroom and be a totally natural part of day to day life … very different than the “plug me into the USB port of your computer” models of days gone by.

Blip has taken that same approach with their BP cuff … with fantastic results. The unit stands completely alone in the home, not tethered to a computer or even a phone, which makes a huge difference. Ours is on the side table next to the couch --- I slip on the cuff, press the button, and I’m done. The unit is absolutely perfect for giving to an elderly parent that you’re trying to monitor, because you can manage the setup and they never have to do anything but maybe replace the batteries once in a (long, it seems) while.

Blip has also upped the ante on the bootstrap/setup process. The unit includes a built-in wifi access point, so you don’t even need to wire it up to a computer to get started. You just use your own computer’s wifi to connect to the BP unit itself, use your web browser to tell it about your home network, and you’re done. Super-convenient.

Blip has add some other great innovations, too --- particularly their built-in alerts and reminders that you can configure at their website and are delivered to your phone. Their initial research shows that these things really can keep people engaged, and having them as part of the package is a great plus. And OF COURSE it’s HealthVault-connected, so combine it with something like AHA Heart360 and you’ve got a great all-up self-management solution.

They’ve also got a really nice looking scale --- haven’t picked up one of those yet but it’s on my list. What is so fantastic here is that the innovation is clearly moving beyond what is “cool” into what really works and can fit into peoples’ lives. That is the kind of innovation we need right now.

Congratulations to Sukhwant, Deepak, Preety and the rest of the BlipCare team!

(Please visit the site to view this video)