I work for one of the large clinical systems software companies and have for the last four years, and admit that I have been awaiting an entry into this market by the (what I consider) 800 lb gorillas that have or can obtian the resources needed to successfully enter the healthcare IT vertical, Microsoft being on the top of that list =).  I watched Amicore relatively closely(backed by Microsoft, Phizer, and IBM, a powerful combination), but haven't heard much about broad acceptance, they aren't mentioned much in the press at all, perhaps because the scope of the software is physician practice vs. hospitals.  I had always assumed that there would be a progression to the enterprise setting for Amicore, but that never happened either, I am assuming because the solution wouldn't scale.  Given how ripe the market is and has been, I cannot fathom any other reason!  My point is that Microsoft has already been involved in this market to a degree, but against my intuition I didn't see the success that I see with darn near anything else Microsoft attempts, it honestly doesn't look like they really tried either.  What are the plans for Amicore?  Is this aquisition another attempt to enter healthcare for MS after a previous failed one?  This is not a negative stab by any means... I very much admire Microsofts success and the capabilities of this company are extraordinary... just curious what happened :).

With this aquisition, Microsoft takes another step into the healthcare vertical, but from what I see, Azyxxi doesn't really do anything but integrate other clinical systems that must already be implemented, adopted, and used 100% of the time.  There is great value in this, don't get me wrong, but how does this eliminate the need for the clinical systems themselves like charting solutions, billing solutions, pharmacy solutions, lab analysis solutions, patient tracking solutions, automated drug interaction solutions, workflow management, and on and on... the implementation of which that Medstar apparently "threw in the towel" on?  If I don't already have an EMR/EHR solution, a digital imaging solution, etc. to integrate then what can Azyxxi do for me?  Many hospital still rely on pen and paper today... and I do not see how Azyxxi replaces those tools, it just eases the access to the data that those other clinical solutions have facilitated digitizing... those solutions that really DO replace the paper chart.  Heck, replacing the paper chart is just the start of the value most clinical systems provide.  To me, Azyxxi looks like a robust version of X1 Search, with interfaces to clinical systems instead of Outlook and Eudora =-).  Am I missing something?

1/8th of a second access time to data housed within a 13TB database though... that is quite impressive =)!

Mike,

Thanks for your insightful comments.  To answer your question about Amicore; the company was recently purchased by Misys Healthcare.  I had the privilege of delivering the opening keynote at the Misys Users Conference at the Reno Hilton last week where Microsoft was also awarded the Misys "partner of the year" award.

Regarding your other questions specific to Azyxxi, and all of the other questions posted on this Blog, I have decided to devote my next House Calls audio-cast on Microsoft.com/healthcare to this topic.  Joining me on the program will be representatives from Azyxxi and the Vice President of our Health Solutions Group, Mr. Peter Neupert.  We hope to post the program sometime around the end of August.  I'm sure it will be popular with HealthBlog readers and listeners.

Best always,

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

Hi,
I am not sure I understand the Azyxxi offering all that well - Who are the users of this tool? Is that something MSFT will take to the RHIO market or is it intended for the IDN market? Or is it intended for developers maybe?

Thanks.

As someone who has been involved in Healthcare IT for getting on for 15 years, I agree with PatriotB's comments regarding this acquisition.  Over these years I have seen a number of big players (Oracle,  IBM, HP) come into the Healthcare vertical applications space and leave again and in some case re-enter and leave again.

Microsoft is excellent at providing the enabling development tools, enabling technologies and thought leadership to partners both large and small to allow them to develop these for their customers and should continue to do so.

Due to this announcement, healthcare application vendors will be more guarded in their working with Microsoft.  Considering their are 100's of healthcare applications vendors that work with Microsoft and now Microsoft owns one small scale integration piece of software - how will this help the industry?

The getting access to the information is what healthcare application vendors have been providing for years - this is not something new.  People may comment that they have failed; that may be unfair, but it is probably true that they haven't always delivered the vision.  It would be very naive to say that this is something this acquisition and Microsoft can fix in the short or medium term.

P.S> The analogy of driving a car to global healthcare applications is amusing.  Very few healthcare application vendors have been able to globalise their applications - the closest to managing this have been Cerner (www.cerner.com) and iSOFT (www.isoftplc.com) and even these have had limited true global success.

The country of origin bais around all healthcare IT blogs including this one for the US highlights how "local" healthcare people think.

Dave,

Thanks for sharing your thoughts.  One thing we (Microsoft) are not is naive about the complexities of the healthcare IT industry or building solutions for the industry.  As I've traveled the world, one thing I've noted is that clinical work-flow (the work of doctors and nurses) is much the same the world over.  We interview our patients, we examine them, we order tests if they are available, and we recommend treatment once a diagnosis or probable diagnosis has been reached.  We all struggle to keep up with the explosion of information in the medical and scientific literature.   We do our best to avoid harming our patients.  In one way or another we document what we do, so the patient or others who care for the patient in the future will know what has been done previously.

Information technology solutions that address the needs of clinicians have been evolving for decades and will continue to do so.  No one technology or solution is going to change the industry overnight.  But with each year that passes, whether it's innovations around mobility, devices, data input, machine intelligence or other breakthroughs; the story gets better.  I'm very proud to be associated with a company and a rich ecosystem of partners that are leading the way in solving some of the toughest issues confronting the healthcare industry.

Again, thanks to everyone for weighing in.  For more information about Azyxxi, I will direct you to the audio-cast we have planned in coming weeks.  When it becomes available, I'll be sure to mention it here.

Best always,

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

Epic rules!!!

I've read all the comments which really show that there is a need for someone with a large footprint in the software world to enter the healthcare arena in a big time way.  I'm truly happy that Microsoft has chosen to be that large footprint company with the purchase of Azyxxi from Washington Hospital Center.  Since WHC has a Windows based PACS that was designed by myself and a colleague I know that the Azyxxi software has the  potential to  add great value to the information a user sees from a patient encounter and improve the Windows experience as well as the patient present.  Also with the future release of Windows Vista users will have even more reasons to want to join the Windows Healthcare bandwagon!  

We've been working at the largest medical center in the world. From a dearth of information to an overload, clinicians in critical care (which remember is the bulk of the costs of hospitals budgets and over a point of US GDP) want treatment protocol indicators to improve the time differential from knowledge to treatment change. When we began data integration was a huge deal, now our time has come. What the heck do you 'do' with all that data coming so fast in critical care? Wait for a chart review? Turn off one more crashing alarm? Waste RRT resources constantly? Weird 'bubbles', nice but who has the time? It is interesting to see the 800 lb gorilla get serious about healthcare. If they are interested in critical care, let’s talk.

Few HealthBlog entries have drawn as much interest as the piece I wrote on Microsoft's acquisition of...

Dear colleague: I am very happy and excited that Microsoft has bought Azyxxi, we need the help of a large company that already has a number of software development tools and expertise. We physicians and our information issues are nothing unusual, nothing extrordinary. Every other industry has the same needs, information instantly at your fingertips, and from everywhere please. That applies to manufacturing, Logistics, sales, wherever. Microsoft office actually has almost all the tools or the rudiments of the tools that you need to creat an excellent electronic medical record for the physicians office (which is my primary concern, since I am a practicing Ob/Gyn). When will someone come up with an "EMR" add-on to Microsoft office, just like Excel or Powerpoint? It could use SQL server as database, some modifications for word for writing, Excel for graphing, a modified Outlook as patient scheduling and communication tool and some Paperport like technology to scan and process and distribute reports, fax prescriptions to pharmacies etc. All parts of Microsoft office easily conncet to the web, and you could have one button connections to databases that check drug interactions for example. A modified journal keeps track of all changes for legal purposes. And so on. Once you get a third company involved, they need to make good money building this and have the communication issues with Microsoft. Microsoft itself could easily modify Office and sell and "EMR add on" for a much more affordable price, since they would only have to tweak their product slightly. I see this as a large advantage. Please, Mr Gates, come out soon with the OFFICE EMR ADD ON! And, should you need help in designing it, I would not mind assisting. Your Matthias Muenzer, MD muenzerus@yahoo.com

It all sounds very good and I know of other hospitals that have accomplished similar things with other custom developed software whether based on the Microsoft platform or not. The Microsoft platform is great for developers and there is no question about it. The problem is not there. With the wide variety of systems in Hospitals and their differences in implementation and customization, there is virtually no way to build a "plug and play" product. Some of the larger vendors have developed APIs for partners to interface with their systems, but depending on the versions etc... there is no real standard out there to exchange data. Protocols are different from vendor to vendor. Lots of tools can do reading of data (and this is already a great thing) from various sources (which is why I understand this to be) but how about writing of the data? Will the physicians still need to go out into the indiviudal disparate systems to make edits? Finally, Hospitals systems are currently not integrated with the physicians' practices systems. Aggregating data from Hospitals is great, but most of the patient's history and overall medical record resides in the small practices EMR systems...those are the ones that need to be integrated back to the hospital systems! So having Microsoft invovled is a good thing overall as they have the skills to provide the developers with lots of tools to integrate those various systems, but until there is a standard set to exchange data...it won't be the solution to all problems I am afraid.

Technorati tags: Microsoft , Azyxxi , New York Presbyterian Hospital , Johns Hopkins Hospital , Novant

Technorati tags: Microsoft , Azyxxi , New York Presbyterian Hospital , Johns Hopkins Hospital , Novant

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