Everywhere I go, I get questions about Microsoft's acquisition of a technology and company known as Azyxxi from MedStar Health in Washington, D.C.. Last summer, shortly after the acquisition took place, I invited company founders and Microsoft executives to join me in an audio-cast discussion about the technology and why it attracted Microsoft's attention. Since then, there's been a great deal of speculation about who the first customer or customers might be.
Azyxxi is a unified health enterprise platform that helps improve cross-organizational access and insight to clinical, administrative, and financial data. It was recently announced that New York Presbyterian Hospital, the nation's largest not-for-profit, non-sectarian hospital, selected Microsoft Azyxxi. A short time later it was revealed that Johns Hopkins Hospital and Medical Center will also be an early customer and development partner for Azyxxi.
In this edition of my House Calls for Healthcare Professionals audio-cast series, we get an update on what has happened since last summer, and explore why a prestigious hospital system like New York Presbyterian decided to implement it.
To listen to the program, click on the links below:
Microsoft Azyxxi update: Development partner and first customerThis program is also available in MP3 for download.
Aurelia Boyer is Senior Vice President and Chief Information Officer of New York Presbyterian Hospital.
Dr. Bruce Forman is the Director of the Business Solutions Group in the Information Services Department at New York Presbyterian Hospital and Associate Clinical Professor of Biomedical Informatics at Columbia University in New York City.
Steve Shihadeh is General Manager of Sales and Marketing for the Health Solutions Group at Microsoft. He is responsible for the company's worldwide healthcare go-to-market strategy, sales, services, and partner execution.
I tend to believe that Azyxxi is a vaporware even though it has been in use at Medstar. One thing is writing software for internal use and the another have a customers pay for it. Microsoft does not have expertise in building solutions for vertical markets (name any vertical MS product). Yes, they have great products made by Server and Tools division and Office suite which is riding wave on Windows monopoly, but everything else is a joke. Microsoft is very good at marketing and unfortunately currently run by salespeople who understand little technology and engineers long have been underappreciated. It will take years for Microsoft to learn how to do solutions for vertical markets.
P.S. I work for Microsoft
This blog is open to all comments (except for folks who just want to advertise a web site). So, I very much appreciate you taking the time to share your perspective.
I disagree that Azyxxi is vaporware. I don't think prestigious institutions like New York Presbyterian or Johns Hopkins would be interested in vaporware. Yes, Azyxxi needs to be commercialized and that's where the work with NY Pres and Hopkins will prove valuable.
Regarding our work more generally in the healthcare industry, you are correct that most of the health industry "verticalization" is done by our rich ecosystem of partners, which is as it should be. As I've traveled the world it has been my pleasure to see some truly amazing healthcare industry IT built by vendors and sometimes the hospitals and clinics themselves using our platform, products, and solutions.
Thanks again for writing. I think you'll see growing evidence that Microsoft is, and will continue to be, an important force in improving the quality and safety of patient care and the satisfaction of those receiving and providing that care.
Bill Crounse, MD
>I disagree that Azyxxi is vaporware. I don't think >prestigious institutions like New York Presbyterian or Johns >Hopkins would be interested in vaporware. Yes, Azyxxi >needs to be commercialized and that's where the work >with NY Pres and Hopkins will prove valuable.
This is all marketing - hook up prestigious intitutions so that they serve as reference for future sales. Has there been any single technical person when contracts were signed? I very much doubt so.
The main reason why Microsoft is going into medical informatics is because healthcare market capitalization which amounts for trillions of dollars. To quote one of the Microsoft execs - Microsoft does not go into markets unless it plans to earn around bilion of dollars there.
Microsoft has not yet demonstrated expertize beyond writing shrink-wrapped software. It takes around a decade for the company to mature any technology and there are numerous examples of it. Operating systems (think Windows) business started around 1992 and it was not until Windows XP released in 2001 that product became good enough. Database business started in 1988 and it was not until SQL server 2000 when technology matured to enterprize level. Same for Office. ERP solutions (Dynamics etc) are still in their infancy at MS and accounts for small fraction of market share.
If you look at most major players in healthcare software market, Allscripts, Epic, Cerner, GE Medical Systems IT to name a few, their revenues are not in 1 billion dollar mark, more like in 100's of millions with net income of <10 millions. These are good numbers for small sized companies as they are, but I doubt that Microsoft will be happy about such earnings unless I am missing something obvious. And according to publicly available information Azyxxi is not an EMR and requires other information systems to be around to get data from. So, it can only be sold to enterprizes which have such systems in place to begin with which really makes available market even smaller.
It does not seem like there is a big profit margin for Microsoft to go into medical informatics business unless Azyxxi can serve as a selling vechicle for other MS software into healthcare market.
So, I believe it will take at _least_ another 5-10 years for Azyxxi to have reasonable presence in this sector of industry unless they will buy someone big likewise GE Medical Systems did with IDX.
Pardon my humble opinion.
Thanks again for your thoughtful comments. I don't think any of us believes that the healthcare market will be fast or easy. We've already been at it for more than 8 years. We are rightfully taking a slow and studied approach to the industry.
Also, no one said Azyxxi is an EMR replacement or even an EMR. It is a data aggregator. It provides a "single version of the truth" across all of the data silos in large, complex organizations. It provides powerful tools for the analysis of clinical and financial data.
Finally, healthcare is already a billion dollar business for Microsoft and has been for some time.
Bill Crounse, MD
I think you guys might be missing the big picture. In studying how Microsoft develops operating systems one can see that in Azyxxi, Microsoft will position itself to manage and control the middle and the end of the information path within healthcare organizations. Once that is established Microsoft can then pick and choose best of breed front end applications such as CERNER, Eclipsys or IDX and integrate them in the same manner they integrated killer apps such as browsers. Microsoft does not need to build highly specialized apps to meet each services needs. They will absorb what is good for healthcare and kill off what is un-needed, and at some point they will even dictate structure and standards for all of healthcare informatics as they have done in the world of OS's.
As far as whether this is a good business decision for Microsoft....healthcare expense is usually one of the largest line item in most businesses...I think I'm going to buy more MSFT.
I look forward to Microsoft achieving standardization and innovation in the way information is handled in healthcare organizations, afterall healthcare organizations left on their own have not made much progress in this area.
>As far as whether this is a good business decision for >Microsoft....healthcare expense is usually one of the >largest line item in most businesses...I think I'm going to >buy more MSFT.
Then I would suggest buying Allscripts as well since they are the only MSFT healthcare IT shop out there and will interplay nicely with it.
Allscripts is indeed a good Microsoft partner, but we have many, many others as well. Many are 100 percent on our platform and technologies. Almost all use some portion of our technologies in their offerings. Bottom line is that we work with everyone, and provide solutions that add value no matter what the core clinical system or systems in place might be.
Technorati tags: Microsoft , Azyxxi , New York Presbyterian Hospital , Johns Hopkins Hospital , Novant
The acquistion of Global Care Solutions no doubt is designed to act as a feed for Azyxxi.
It would be interesting to understand the MSFT strategy in the area.
I should add that I will be attending the MSFT sponsored CIO healthcare summit in Reading in the UK on 15th January 2008 and look forward to learning of the UK specific and global plans.
Thanks for writing, Guest. We'll finally get a chance to meet as I will also be attending the CIO Summit.
Dear Dr Crounse,
I have just been reviewing other threads on your blog.
Apologies, I believe we have been talking at cross purposes earlier today. Other than two earlier posts, I have not posted previously on this or any other thread with the name Guest. I was using the name "Guest" as I am a guest on your blog.
Kind regards and apologies for any confusion.
No problem "other guest". I'll look forward to meeting you none-the-less.
After reviewing comments from two sides, I think both have reasons. Now, I'm evaluating whether we can adopt Azyxxi to be part of our solution. I understand the ambition of Azyxxi but I also have concern on it. I am not sure I have understood Azyxxi enough or not. So far, it seems to me that Azyxxi is more like a data warehouse, not a daily operation information system. Yes, users may be able find all data there, but it must have some delay, 1 min or 1 hour or more. If users need to modify data, it's better to use the original system, otherwise data inconsistency may happen, a nightmare for IT people. If this is the case, how to convince those busy end-users to use two different systems to finish their job?