Almost two years ago on this blog, I issued a call for ‘data liberation’ – emphasizing that the free flow of health data should be the foundation for realizing a future of secure, personalized, data driven medicine.  A year later, I discussed the concept again as we began to see the idea of ‘meaningful use’ take shape – with its focus on data exchange for the benefit of physicians and patients.  I see an increasing amount of activity that keeps me optimistic about us realizing this vision for ‘connected’ health. Of particular note are the folks at the Federal level (HHS and ONC) who are increasingly grounding their initiatives in the same concept of data liquidity.  See the re-post below of a blog I wrote for “Microsoft on the Issues” on this topic.

Health has been a huge focus for the federal government over the past year – specifically, how to expand access and drive value: improving care for the same or lower cost.

The Office of the National Coordinator within Health and Human Services (HHS) successfully spurred the industry to action last year with its Blue Button Initiative and worked with private sector organizations to drive the Direct Project. The Direct Project is focused on using e-mail as a secure way to share health information. Microsoft was an early participant in this project along with other companies such as Allscripts, MedPlus and VisionShare.

Today in Washington D.C. at an HHS press event, we announced that next week we will be launching new functionality that wires every Microsoft HealthVault account to use online encrypted patient e-mail based on Direct Project security protocols. To start with, we will enable physicians to transmit a copy of a patient’s clinical information to a new email address created within HealthVault. This information can be read or saved to a patient’s HealthVault account to build their personal health record – a holistic view of an individual’s health history.  In the future, we expect to make this functionality available to providers and to enable secure messaging for physician-to-physician consults and for transfer of patient records. 

At this point, most people recognize that software technology can be a catalyst for connecting the health ecosystem and transforming the ways we manage and deliver healthcare. Healthcare should be a data-driven industry, and software is designed to manage data in efficient, effective – and new – ways. Whether it’s a surgeon who needs access to a patient’s complete history, or a patient who is tracking her health and diet information to better manage a chronic condition – having the right information at the right time is critical to decision-making about health and healthcare – and it’s the key to delivering better value.

Historically, the data has been hard to get. Within the hospital, it is trapped in siloed systems that support different departments but aren’t connected. Within the physician’s office, it is trapped on paper, in hundreds upon hundreds of file folders. For the patient, their personal health data is often inaccessible – since the data is typically collected and stored at the point of care.

At Microsoft, we talk about the need for “data liquidity,” which translates into liberating data from across the health system so that individuals can start engaging with the information and using it in meaningful ways.

The Direct Project is designed to address part of the issue as an easy, secure way to exchange health information. The Direct Project specifies a simple, secure, scalable, standards-based way for participants to send encrypted health information directly to known, trusted recipients over the Internet. This can be physician-to-physician; physician- to-public health authority; physician-to-patient; and on and on.

With the Direct protocols in place, patients can more actively engage with their providers in the ongoing management of their health. And these protocols enable improved care coordination across the health system. Physicians can more easily communicate with each other about patients, and patients can share their personal health information as they move across encounters with different healthcare providers. Putting patients at the center is the vision behind Microsoft HealthVault – so it has made sense for us to be an early participant in the Direct Project.

Step by step, we are liberating the data and bringing patients and their healthcare providers one click closer to the information they need to improve health and healthcare.

I spent most of this week at HIMSS in Orlando – a conference I’ve attended every year since 2006 – which gave me an opportunity to reflect on the significant changes I’ve seen in the healthcare industry over the last few years.

Four years ago at the HIMSS in New Orleans, Microsoft’s CEO, Steve Ballmer, gave one of the keynotes. Steve spoke about the proliferation of clinical data, the need to engage patients in managing their own health, the required move to a more collaborative approach to life sciences research, and Microsoft’s focus on helping to harness technology to drive improvements in health and healthcare around the world. One of the things Steve discussed is the need for “a different kind of working relationship between public and private people, between providers, insurance, and government to really develop and deploy the kind of interoperable systems that will let this vision happen.”

In 2007, when we started talking about different relationships among stakeholders in healthcare and highlighting the important role of consumers as well as interoperability – data liberation and liquidity – in transforming care, everybody thought we were crazy. And now – in the US, at least – it’s the law.

Meaningful use was once again a big topic at this year’s HIMSS since many organizations are focusing their IT investments in order to qualify for federal incentive payments. But, we need to recognize the vision behind the meaningful use of EHRs: an interoperable system of care that increases quality, safety and efficiency, improves care coordination, engages patients and their families in managing their health, enhances population and public health, and ensures adequate privacy and security. Meaningful use of EHRs requires moving beyond the traditional electronic medical record to enable the secure flow of data across the health ecosystem in ways that enable new delivery and payment models to flourish. This is the position we staked out four years ago – and the ongoing focus of our investments. 

Earlier this week we announced an alliance with athenahealth designed to drive better care coordination across outpatient and inpatient physicians and settings, a priority for health systems looking to form ACOs and qualify for pay-for-performance funds.  We’re connecting Microsoft Amalga with athenahealth’s hosted web-based services (athenaClinicals and athenaCollector) to enable physicians to see inpatient and ambulatory information in a single view. Microsoft and athenahealth decided to make these investments because they meet a need our joint customers – specifically, Steward Health Care System in MA (formerly Caritas Christi) and Cook Children’s in TX – have expressed.

Steward is focused on executing on programs like their Alternative Quality Contract (AQC) with Blue Cross Blue Shield of Massachusetts, which is a contract model designed to give providers meaningful incentives to improve the quality of care while conserving healthcare resources. To meet these objectives, Steward is looking to drive efficiencies and deliver truly coordinated care. At Cook Children’s, the goal is to improve the health of every child in their region by providing patients and physicians with access to an information platform that transcends physical location and has the capacity to evolve to meet changing rules and requirements. athenahealth and Microsoft are bridging the information gap – giving clinicians the ability to access patient information from anywhere, regardless of its origination, and enabling a new level of patient engagement.

In 2007, we knew it would take time for our vision to come to fruition – and we’re clearly still at the beginning stages of data liquidity and health information exchange and the innovation these changes will enable. And, the government and private insurance companies need to ensure that the right incentives are in place to drive this move toward greater interoperability and to avoid stifling innovation before it has a chance to take root. But, as these customers and others are demonstrating, the healthcare system can achieve our shared goals of better value – better outcomes for the spend – today by enabling the flow of data and collaborating across the healthcare system in new ways.