Thoughts, comments, news, and reflections about healthcare IT from Microsoft's worldwide health senior director Bill Crounse, MD, on how information technology can improve healthcare delivery and services around the world.

Microsoft and Azyxxi: What does it mean to our industry?

Microsoft and Azyxxi: What does it mean to our industry?

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So what does the announcement of Microsoft's acquisition of Azyxxi mean to the healthcare industry?  In my opinion, it is an important first step in a journey that will produce huge benefits for clinicians and patients.  First and foremost, it signals an important change in strategy for our company.  I'll let you read the article in the New York Times for more on that. 

More importantly, I believe it takes healthcare information technology and those who build solutions for the industry in a whole new direction.  If you've followed my Blog and some of the articles I have written, you've seen my rants on the clinical systems commonly in use today.  You've read why I believe we must evolve to a more common user interface that is so intuitive; clinicians need little or no training to use it.  Community doctors move from hospital to hospital.  Nurses move around as well.  We are becoming increasingly mobile and we need solutions that work no matter where we are or what device we are using.  We cannot expect healthcare professionals to change the way they work depending on the particular hospital they are visiting, or for that matter, the state, region or country they are practicing in.  It is difficult enough to do patient care without having to learn a dozen different ways to do the work-flow depending on what clinical information system or systems are in use.  Think of the analogy of driving a car.  You may need a little time to familiarize yourself with the controls for a given make and model and then adjust for regional variations by country (traffic signs or what side of the road to drive on) but once you know how to drive a car, you can generally jump in and start driving it no matter where in the world you are.

The Azyxxi solution came about, as most good things do, out of sheer frustration.  One of the physician developers told me his hospital had spent hundreds of millions of dollars on clinical systems the doctors working there couldn't or wouldn't use.  Using commodity software and the latest technologies from Microsoft, they built a solution that aggregates clinical information from all the disparate systems in use.  With sub-second response time it securely delivers patient information in a standardized and intuitive format to enable clinical decision making, business and clinical analytics, bio-surveillance, and more.  Furthermore, the solution opens up ways to take advantage of the information worker tools, and communication and collaboration technologies our company is famous for.  Frankly, I sometimes think better solutions to facilitate communication and collaboration in healthcare are perhaps more important to the industry and to patient safety than tools that simply help us assimilate and document patient information.

I'll have more to say on this in future entries.  You'll find a bunch more information about Azyxxi and MedStar on-line including videos, articles and case studies.  Just search the keywords "Azyxxi" or "Microsoft and Azyxxi".  Now, if I could just learn to spell Azyxxi without having to look at the word each time I type it :)

Bill Crounse, MD    Healthcare Industry Director    
Microsoft Healthcare and Life Sciences

  • I can't see how this is good news for anyone.

    Microsoft's roots are platforms and development tools, and the farther they stray from that into specific industries, the more it hurts the third parties that have built their products on top of Microsoft's platform.

    I should know, I used to work on health care software (specifically, at one of the companies mentioned in the NY TImes article).  Large parts of our software were built upon Microsoft platforms and tools.  However, many of the "top" people at the company did not particularly care for Microsoft; I think they would see your latest move as a big threat and would increase their distrust of MS and increase their investigation into alternative platforms and tools (e.g. Java).

    You might counter this with, "It will help improve patient care!"  The best way that you, Microsoft, can help with that is to continue to provide the best platform for third parties (whom you often refer to as "partners") without making those third parties feel like you are trying to take over their business.  *Enable* third parties to make the best products they can (via platform/tools, MS-HUG, even participation in HL7 and other industry standards), but *don't* insist that you have to have a piece of every niche market.

    Yes I know Microsoft is running out of growth areas.  But what is next?  CAD/CAM software?  Bank or stock market software?  Stick to what you do best and provide the platform for third parties without alienating them.
  • P.S.  I'll be interested to watch the videos that you mention in your last paragraph.  I remember watching the "Longhorn in Healthcare" video and having a good laugh.  The concept from at video might help out a 5-physician practice, but could never scale to even an individual hospital, or to an organization with dozens of hospitals/clinics and hundreds of doctors.
  • PatriotB wrote:
    The best way that you, Microsoft, can help with that is to continue to provide the best platform for third parties (whom you often refer to as "partners") without making those third parties feel like you are trying to take over their business.  *Enable* third parties to make the best products they can (via platform/tools, MS-HUG, even participation in HL7 and other industry standards), but *don't* insist that you have to have a piece of every niche market.

    PatriatB, that's exactly what we are doing.  Azyxxi is a health information integration engine.  It was developed for doctors by doctors.  We believe in the vision and path of its developers – to improve healthcare delivery using unique and powerful information technology.  

    This acquisition deepens Microsoft’s commitment and investment in the healthcare industry and to improving personal and population health using information technology, while making a proven solution more widely available to its customers.  It does not displace or replace healthcare IT systems developed by our partners.  It just makes it easier for clinicians to get the information they need, when and where they need it.  Azyxxi was created with Microsoft developments tools.  The system has a proven track record and we plan to replicate that success.

    Bill Crounse, MD     Healthcare Industry Director    Microsoft Healthcare and Life Sciences

  • There is no doubt in my mind that getting big companies, such as Microsoft and Google into healthcare will be good for healthcare professionals and patients. As a doctor I am fed up with limited solutions, difficult interfaces and diiferent systems. MS has the breadth of expertise, to make an excellent system. I hope they commit. Some small companies will falter. Some will continue to provide valued add-ins. Some will be bought and do well. The only disappointment is that they are leaving things so long.
  • How do you reach this Microsoft group that is moving into medicine? We have a prime project for their consideration.
  • I am gone to wait and see on this one.  Microsoft has had a health care vertical for years.  But I have seen no evidence that they have made any impact on the industry- positive or negative.  They, Microsoft, like any company has an interest in selling its core product.  Much like Intel, CISCO, IBM, HP, and other high tech giants.  The product developed by Washington Hospital may be very good…but so was the product developed at Duke or at Brigham-Women’s over 15years ago…..making a scalable and sellable product to a very diverse and almost cottage-like industry is another matter. So I will take a wait and see approach to this
  • Thanks for writing, Bob.  I agree that there is some element of "wait and see" here.  However, the Azyxxi solution was developed "by doctors for doctors" and it has a proven track record.

    I must, however, object to your statement that "I've seen no evidence that they (Microsoft) have made any impact on the industry- positive or negative".  We work with more than 600 partners who deliver very robust solutions built on our technologies to the healthcare and life sciences industries around the world.  Some of the most innovative solutions on the market wouldn't be possible without what we do; communication, collaboration, business and clinical analytics, health information exchange and interoperability, web services, distance learning, and more.  It would be a very different world without Microsoft technologies in healthcare.  And the future, looks even brighter.

    Thanks again for your comments.

    Bill Crounse, MD    Healthcare Industry Director    Microsoft Healthcare and Life Sciences
  • Responding to the comment left by Dr Ralph Grams:

    At the appropriate time, the team from Azyxxi will reach out to evaluate market opportunities beyond MedStar for their health information integration solution.  At that time, Microsoft will provide guidance on how to engage with the team.

    Bill Crounse, MD    Healthcare Industry Director    Microsoft Healthcare and Life Sciences
  • Seeing is believing.  I've seen and used Azyxxi and it'll change the way medicine is practiced.  No more will we have to have a dozen accounts and passwords on old and new systems to get the information needed to make decisions about patient care.  You want old records, you've got them in fractions of a second, if they've been scanned and you can read my chart. No more waiting hours while some overworked clerk pulls the charts or going without and flying blind.  Lab results? As soon as the lab machine has the results, Azyxxi has them.  Not only can one access the current labs but any old results that are stored in an electronic format and feed to Azyxxi.  You can graph results, see what their trends are.  Is that an abnormal result for this individual patient or is it their norm?  Azyxxi will show you and let you decide for yourself in seconds.  You want x-rays?  How about seeing them before the patient is back from x-ray.  And talk about research potential?  Azyxxi lets me, as a user, ask questions that I haven’t even thought of while I’m sitting in front of my PC.  Real time!  My biggest concern was that I’d become too dependant on the system and if it wasn’t there I’d be handicapped.  Those guys at Azyxxi have thought of that too.  Azyxxi has more redundancy than a 50 pound sack of peppermint lifesavers.  How about ease of use?  If you can point and click you can use the system, no classes, no learning curve.  You can walk up and use the system the very first time with ease.  Best of all is we don’t have to change our business process.  We can use all the systems we have in place and Azyxxi will suck up the info and present it in a single easy to use interface. The integration with other systems will be the bottle neck from my POV.   This is Windows at its finest.  The only question is how fast can MS get it to all of us?  Will those other IT systems cooperate with the Azyxxi Team or will they play turf wars.  I hope not, this is good for patients good for business.  I’ve heard that Azyxxi is ancient Phoenician for “Far sighted wisdom”.    I don’t know about that but what I do know is that Microsoft shows far sighted wisdom with it’s acquisition of Azyxxi.  Be excited, be very excited, the job of saving lives just got a whole lot easier!
  • Thanks for sharing your insight, Ric.  I couldn't have said it better.  It is obvious, you "get it".

    Best always,

    Bill Crounse, MD     Healthcare Industry Director    Microsoft Healthcare and Life Sciences
  • Thanks for the explanations, Bill and Ric.  That helps to clarify the role of Azyxxi, and clear up the misconceptions I may have had about it.

    But yet, while Azyxxi may be helpful to certain organizations, its existance really exposes how much more improvement is needed in the underlying systems that Azyxxi is aggregating.  Access to scanned records, up-to-the-minute lab results, x-rays, and research trending should all be available through your primary EHR system.  It shouldn't take a separate product--at least in the ideal world.  Since an organization will probably not buy all its systems from the same vendor, there is a use today for a product such as Azyxxi.
  • I agree that this is a very interesting play into HealthcareIT for Microsoft.

    Neil Versel reported:
    ""Microsoft sees it as applicable to clincians and integrated delivery networks, not just a hospital system," Washington Hospital Center ED chair Mark Smith, M.D., said at a press teleconference this morning."

    One thing I don't understand is how this is going to affect anyone but hospitals and large group practices.  If it can't apply to small practices then it won't have nearly the effect on healthcare that people are describing.

    Maybe you could help me understand how this will apply to the small doctors offices.
  • Neil,

    Thanks for writing.  It means a great deal to me that someone who covers the healthcare IT landscape so thoroughly immediately appreciates the value our proven health information integration engine brings to the enterprise.  First and foremost, the system was built by doctors, for doctors.  While it does not replace existing HIS/CIS systems, it does make them more useful by freeing the data locked up in disparate systems.  It provides clinicians with an intuitive, extremely responsive way to view patient data.  It is truly a world-class iteration for the era of knowledge-driven healthcare.

    To the extent that data can be normalized, assembled, and securely distributed via web services, clinicians in all kinds of settings large and small, will have access to information that has previously been unavailable or locked up in silos.  Patients could benefit as such systems populate their personal health record.  The scenario I envision isn't all that different than the way my financial services institutions populate information in my brokerage or retirement accounts.

    Granted, this must play out in stages and we have a lot of work to do.  But I am hopeful that we are on the right course, for clinicians and the patients we care for.

    Bill Crounse, MD     Healthcare Industry Director    Microsoft Healthcare and Life Sciences
  • I think this is inspired.  MS has a chance to help theraputic healthcare outcomes.  The VISTA project is good, but it is way to expensive for small offices to implement and run.  the new functionality that SQL 2005 offers will bring this technology to every office in the country and the world.

    Dr. Crounse, will you please take a look at

    I am so glad that Microsoft is attacking this problem rather than wait for someone else to build it.
  • I think one of the things that I would like Microsoft to do is to send a clear message to their own employees as well as to their customers.
    Are they a company that wants to create solutions for various markets or would like to continue to be the company which creates tools to assist in the solutions being created by their partners. To me, some of the messages I am getting from Microsost are confusing.
    I have no doubt that Microsoft will add value to healthcare market in a positive sense but the real question is whether the value add will be incremental or "game changer". No marks for guessing which one I would like for it to be. :)
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