NEW ORLEANS, Feb. 6, 2001 — In a traditional visit to the doctors office, the patient is experiencing a health crisis of some sort — lower back pain, for example, or persistent flu-like symptoms. During the appointment — scheduled with an assistant over the telephone — the doctor gleans information from a number of sources: written records stored in files assembled over the years, the doctors personal knowledge about the patient and what the patient tells the doctor — information that, especially if the patient is ill, could be incomplete, disjointed or void of clues that might provide the key to the patients condition.
This is what a doctors appointment could look like in the not-so-distant future: a patient emails the doctor to explain the symptoms and request an appointment. By simply placing the cursor on the email message from the patient requesting the appointment, the doctor can instantly access the patients entire medical history. The electronic medical records are in perfect order. They can be arranged and sorted chronologically, by the type of visit, or by dozens of other criteria. Paperclips never fall out of these records, and the files dont sit on shelves waiting to be processed by an insurance company, pharmacist or specialist to whom the patient is referred. The information is there, and its instantly accessible to everyone throughout the process who is authorized to see it.
As a step toward transforming this vision into a reality, Microsoft today unveiled the healthcare-specific implementation of its Digital Dashboard at the 2001 annual conference and exhibition of the Healthcare Information and Management Systems Society (HIMSS), held Feb. 4-8 in New Orleans.
The Physician Digital Dashboard was developed to function as a time-saving tool that allows caregivers to assemble information sources by using a collection of Web parts in a synchronized, intuitive manner. The dashboard of a car displays information particular to the automobile — the speedometer, the odometer, engine temperature, the level of fuel. In the case of the Physician Digital Dashboard, the patient “is” the car, the entity reflected in the information displayed.
In developing the Physician Digital Dashboard, Microsoft and its partners have built on top of the technology of a digital dashboard — which, much like its automotive counterpart, synchronizes information in one visible, easy-to-read place — a custom-crafted tool for the healthcare industry. Used in a hospital setting, for example, the Physician Digital Dashboard gives doctors, nurses and clinicians access to consolidated personal, team, hospital, patient and external information with single-click access to analytical and collaborative tools.
“The healthcare environment has become difficult for doctors to do their jobs because they have to fill out so much paperwork and file claims and all kinds of other bureaucratic things,”
says Davide Vigano, director of public sector and healthcare for Microsoft.
“Doctors want to improve care. Doctors care about their patients health, but they only have a few moments to focus on that. The Physician Digital Dashboard provides the doctor with a consolidated view, giving him everything he needs to know about a patient before, during and after the visit. It allows doctors to build a unique environment tailored to exactly what they want to see.”
The Physician Digital Dashboard, Vigano says, is a perfect example of Microsofts .NET vision — computing any place, any time and on any device — developed specifically for healthcare.
“What the Microsoft .NET vision really means here is that we want to empower the consumer to take better control,”
Vigano says.
“We make decisions based on what consumers want to do with their own healthcare.”
Technology Developed Specifically for Healthcare
Clifford Goldsmith, MD, who worked on the development of the tool, says the goal was to make it as easy as possible for physicians to make decisions about patients.
“Our goal in developing the Physician Digital Dashboard was to make it possible to display key data with a single keystroke to help make a clinical decision about a patient,”
says Goldsmith, a managing consultant with Microsoft Consulting Services (MCS) Healthcare Practice.
Goldsmith, who practiced for nine years as a pulmonologist before entering the technology industry, says he noticed a drive for greater efficiency in the healthcare industry.
“To provide a reliable, efficient and cost-effective mechanism of communication among different applications was very difficult, but Microsoft has a huge base of products, services and customers within the healthcare space,”
he says.
“Our ability to network all the resources makes it much more cost-effective to provide the connectivity thats needed.”
Goldsmith says the tool Microsoft unveiled for healthcare contains four key enhancements.
“First, it has the ability to provide a connection to an active patient task list,”
he says.
“The patients go on and off the list automatically, based on criteria the physician has set.”
Examples of criteria include admission to an emergency room, or an abnormal result to a blood test. Physicians subscribe to search engines tailored to the medical world that monitor data based on region, a patient identification number or a specific hospital. The data integrates with the subscriber according to the criteria chosen.
Secondly, the components of the tool are compliant with the Health Level Seven (HL7) CCOW Standard (CCOW). CCOW is a standard devised specifically for the healthcare arena that defines the specifications necessary for creating a multi-application, multi-technology clinical desktop.
“CCOW-compliant Web parts are able to coordinate with any other CCOW-compliant Web parts or healthcare applications — even though they dont know anything about each other,”
Goldsmith says.
“Email from two years ago discussing weight loss or a blood test result that showed high cholesterol is automatically selected for the physician when he pulls up the record of a specific patient.”
The third key upgrade, Goldsmith says, is the Physician Digital Dashboards ability to combine multiple schedules into a single view.
“Its something physicians have been requesting for years,”
he says. Physicians often maintain a personal calendar, a clinical calendar, one for the hospital that may include meetings with the ethics or research committees, and yet another for taking medical students on rounds. All require separate management.
“Now its a single view,”
Goldsmith says.
“And since its CCOW-compliant, it simultaneously coordinates the appointment with other information, like lab results or a picture of the patient so that I know who they are when they walk into my office.”
Finally, in conjunction with the move to services on the Internet, Physician Digital Dashboard allows for the creation of patient-specific Web connections.
“Were getting ready for the day when patients can maintain their own personal records,”
Goldsmith says.
Benefits of this capability, Goldsmith says, include allowing patients to create their own medical records by entering data, for example, on weight loss or gain or dizziness. Since that data is a Web
“event,”
under certain conditions it would automatically trigger the physicians dashboard. It would also allow for devices, such as pacemakers, to be monitored and programmed remotely and automatically, or for a patients glucose level to be closely monitored and, if necessary, adjusted.
“Were moving toward the day when physicians can catch problems and respond to them proactively before the patient is even aware that anythings wrong,”
Goldsmith says.
Context Management
Embedded in the Physician Digital Dashboard, the technology that coordinates the synchronization of the CCOW-compliant Web parts is called Vergence. Developed by Sentillion, Vergence is a context management technology that enables streamlined, intuitive use of computer-based information. When a physician reviews an email message concerning a patient, Vergence automatically coordinates the rest of the Physician Digital Dashboard, as well as other applications on the desktop, so they display information concerning the same patient.
John Douglass, Sentillions executive vice president of marketing, says the collaboration with Microsoft offers healthcare professionals a computer-based tool that is a natural extension of their offline thought process.
“We know that caregivers minds already run multiple systems simultaneously,”
he says. “Physician Digital Dashboard brings multiple information sources together in a single view. Vergence coordinates these disparate information sources as though they are part of a common, linked suite, enabling caregivers to use them in such a way that mirrors their train of thought. This saves the caregiver tremendous time, advances decision-making and, ultimately, enhances patient care.
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Douglass says that Microsofts Physician Digital Dashboard addresses a significant challenge within healthcare IT today.
“Computers and information systems are becoming as commonplace in the healthcare setting as stethoscopes. And the latest breakthrough Web technologies are redefining healthcare delivery. As caregivers increasingly depend upon computer-based information, healthcare organizations must find ways for all of these technologies to work together seamlessly to simplify access and use for caregivers. The Physician Digital Dashboard brings the industry a step closer to achieving this goal.”
Helping Doctors Provide Better Care
The goal in developing this and future versions of Physician Digital Dashboard, Vigano says, is to offer seamless and efficient interaction between technology and healthcare workers throughout the industry.
“The dashboard does a good job of shielding the complexity of technology from the physician, making it a more user-friendly experience for everyone,”
he says.
“Doctors are professionals, but theyre not necessarily technology experts. The dashboard creates a unique environment for them, allowing them to have the information they need arranged in an easy-to-access way. It helps them be more efficient and effective in caring for patients.”
