This morning I came across a couple of articles that I believe could have profound implications for health and healthcare delivery. The first article, 88 Acres-How Microsoft Quietly Built the City of the Future, tells the story of how Microsoft manages the 125 buildings and other assets across the company’s 500-acre campus in Redmond, Washington. The second article in Automotive News, explores the work that Microsoft and other companies are doing to improve, monitor and continually update the software that manages virtually everything in the cars we will drive in the future.
It was that first article, however, that really triggered something in my brain. From something called the Redmond Operations Center (ROC), a small team of Microsoft engineers has been able to unify an incongruent network of sensors that have been installed in the company’s buildings over several decades of campus expansion. Software now strings together data coming from literally thousands of these sensors reporting out information the operation of heaters, air conditioners, fans, lights and other equipment. It harvests billions of data points every week-data that is providing deep insights to the health and operation of every facility on campus. Engineers now have monitoring and diagnostic tools that are helping them make better decisions because they are “hyper-aware” of how every building is performing. The software is not only saving energy. It is saving millions of dollars in maintenance and utility costs due to smarter decisions and greater efficiency.
So, what can we in the health industry learn from systems and software that are creating intelligent buildings and smarter cars? Whether you call it eHealth, mHealth or something else, we know that scientists and technologists are developing an array of inexpensive, miniaturized sensors that can monitor and report out information on a wide variety of physiological parameters that determine health and well being. Our smartphones are becoming platforms for applications that can interpret and forward this data to monitoring centers in much the same way as those HVAC systems are reporting their health to engineers in Microsoft’s ROC.
One of my pet peeves about what I see written on mHealth sensors and applications is that too much emphasis is being put on what the consumer can do with all this information, and not enough on how I think it could be used to change the game at the core of the healthcare delivery system. One of the failings of the personal health record (PHR) movement is that we are expecting humans to do too much of the heavy lifting. I know from many years of practicing medicine, that most people really don’t want to spend a lot of time thinking about their health. If they are feeling and looking OK, they would much rather spend their time focused on other things. They don’t want to enter data about every lab test, medicine, or health problem they’ve ever had into a computerized record. Likewise, the majority of people probably aren’t interested in constantly checking a screen to see if physiological data streaming into their smartphone from a bunch of sensors is indicating a potential health problem. But, wouldn’t it be great if a highly intelligent, centralized monitoring system was constantly analyzing this data, making adjustments and bringing things to our attention that might improve our health and well being long before an illness or chronic disease sets in?
Is there a future when all humans will be seamlessly connected to healthcare delivery systems that function much like Microsoft’s ROC—monitoring, analyzing, reporting, and notifying each and every one of us about our health status in real time and proactively making adjustments to our physiology or suggesting things we should do to improve our health? Some will say that is far too Orwellian to ever happen. Then again, a few decades ago it would have been impossible to imagine that our buildings or automobiles would be continuously monitored, controlled and improved by remote control.
Bill Crounse, MD Senior Director, Worldwide Health Microsoft
Hello, I am the manager of HealthWorks Collective, a healthcare website in the Social Media Today network. I really like the content of your website and I would love to repost some of your articles on our site. Would that be possible? Please let me know. Thanks, joan justice joan[at]socialmediatoday[dot]com
The use of this data would require providers to shift their focus from single data points to a longitudinal view of a patients stats. Even systems with CDS, evidence based medicine and best practices are not geared to dealing with this data for an individual. Healthcare providers will need to be trained and re-oriented on how to balance the data which effectively becomes a sample size of n=1 versus population based statistics. From my perspective this will be the most difficult aspect of the transition to personalized medicine.
Thanks for sharing your comment. I agree this will be a major shift for providers. However, I also believe that most of the real-time monitoring and analysis of the longitudinal view will be done by machines, leaving clinicians time to focus on the n=1 of a more personalized, preventive healthcare system.
Thanks for writing. I always welcome re-posts or syndication of HealthBlog content so long as the source and author remains very clear. I will also notify you of this in a separate e-mail.
Bill Crounse, MD