.NET for Healthcare Embraces New Internet Standards to Revolutionize Healthcare

REDMOND, Wash., Oct. 3, 2000 — Sooner or later, everyone’s a consumer of healthcare. Whether it’s a broken bone, allergies, an irregular heartbeat or something more serious and potentially life threatening, our bodies will at some point require the care of a medical professional. While technology will never replace the expertise and compassion of a living and breathing doctor, it can — and already does — have a tremendous impact on the process.

“We all have a vested interest in solving the problems on the healthcare continuum,”
says Davide Vigano, director of healthcare and public sector for the Enterprise Solutions Group at Microsoft, which is hosting Windows on Healthcare 2000, the annual meeting of the Microsoft Healthcare Users Group (MS-HUG) this week in Las Vegas. The annual conference draws a range of healthcare professionals — from providers and payers to suppliers and application developers — so that they can address the challenges and opportunities of the Internet and Web-enabled technologies for the healthcare industry.

Healthcare — along with manufacturing, financial services and the retail and supply chain — is one of the core industries of focus for the .NET platform and Microsoft’s partners’ solutions. Conceived on Microsoft’s vision of empowering people through software at any time, any place and on any device, the .NET platform takes advantage of the increasing integration of advanced computer technologies, Internet connectivity, line of business applications and processes and Web services into nearly all electronic devices — the catalyst for what the company calls the
“Next Generation Internet.”

.NET for Healthcare is the latest in a series of initiatives set forth by the company to enable customers and partners to build and integrate healthcare applications. This focus on integration allows providers, payers, employers and consumers to collaborate through the Internet, improve integration across healthcare services and reduce industry inefficiencies.

“We’ve had a dedicated team on healthcare since 1995,”
says Vigano, adding that Microsoft now has about 100 employees in the U.S. focused on the issue.
“Our vision speaks specifically to improving the quality of care and of life and lowering costs.”

With the goal of reducing healthcare costs, improving the quality of patient care and streamlining business processes, Microsoft developed Windows Distributed interNet Architecture for Healthcare, or Windows DNA for Healthcare. Announced in 1999, Windows DNA offered architectural guidance, blueprints and technology empowerment to healthcare providers, hospitals, managed care organizations, developers and IT industry professionals.

.NET for Healthcare takes this approach to the next level.
“Windows DNA was about eliminating gaps in the system,”
Vigano says.

.NET goes beyond that by providing partner solutions, development and user scenarios to map to the requirements of people, patients and care givers. It also embraces new standards such as eXtensible Markup Language (XML) to securely exchange data and orchestrate Web services to program the Internet. Today you’re just viewing the Internet. .NET will allow you to program the Internet to take full control of your health. It’s a powerful revolution.”

Imagine using the Internet to create and manage your own healthcare plan and your own medical records. Or to keep you on schedule for taking prescription medicine. Or even checking up on the condition of your pacemaker and communicating with your cardiologist. Vigano says that .NET for Healthcare helps link together different areas of the industry to make these scenarios possible.
“There are consumers, there are healthcare organizations — including hospitals, doctors and payers, who financially manage the risk in healthcare — and then there are pharmaceutical companies and lab result companies,”
he says.
“Today, they’re not all linked in a single environment where they can share information, reduce errors and inefficiencies and ultimately improve quality of care.”

With .NET, that’s all about to change.
“.NET is all about the personal experience,”
says Vigano.
“Today, you don’t have the tools to own your medical history, records or information. The technologies coming out of .NET for Healthcare will allow people to access and manage their own information.”

.NET, Vigano says, empowers the user to be in charge of a unified view across the continuum of care –from the physician, to the pharmacist, to the medical records department at the hospital. Vigano stresses that the user retains control over who has access to information.
“The patient is definitely in charge,”
he says.

New Technologies and New Scenarios for Healthcare

Microsoft is currently collaborating with the medical and technology industries to bring to life scenarios that could change the way patients and providers see healthcare.

Chronic Diseases and Healthy Hearts: PC-based programming devices will allow physicians to interrogate and program a pacemaker or other implanted device from a remote clinical location. Developed as the focal point of a new patient management business, Medtronic.com will offer an Internet-based program that gives patients direct connectivity to specialty care teams of physicians anywhere in the world, at any time. Using the convergence of biomedical and information technologies to provide new computer-based systems to help physicians manage people with chronic cardiovascular disease, MyHeartOnline.com is being built and should be operational within 12 months.

“We believe we can serve these people and their physicians well by connecting them via the Internet to improve the quality of patients’ lives while reducing the cost of their care,”
says William W. George, Medtronic’s chairman and chief executive officer.

Three fundamental findings, according to George, support Medtronic.com strategies. George predicts that healthcare will be transformed by the increase in patient and consumer use of the Internet to explore treatment alternatives and assume major decision-making roles. Second, since chronic disease accounts for 79 percent of healthcare spending, its management is a critical need. Finally — echoing a major driving force behind the development of the .NET platform — technological advances are resulting in the convergence of medical and information technologies, enabling a direct link between physicians and patients.

“Microsoft technology will provide the underlying operating system for the new Medtronic.com clinical system and, subsequently, Microsoft will provide a broad range of technologies for the Medtronic.com remote system that will connect physicians electronically with patients in their homes and remote locations worldwide.”

Virtual Visits: DrGoodwell.com, a service in development to establish communication between physicians and patients through the Internet for preventative health and wellness counseling, to treat minor illnesses and injuries and to address behavioral health issues, is, in the words of one of the founders,
“a true .NET model.”

Bill Crounse, MD, vice president for medical technology at the Overlake Venture Center in Bellevue, Wash., is also the senior vice president and chief medical officer for DrGoodwell.com, which will provide
“virtual clinic”
medical services to employees in high-tech industries. According to Crounse, DrGoodwell.com focuses on employees in the high-tech field because the infrastructure is already in place.

DrGoodwell.com, according to Crounse, is about connecting real people with real doctors.
“Sixty of my colleagues and I formed a medical editorial board, not to diagnose patients but to redirect them to the appropriate place,”
says Crounse.
“DrGoodwell.com is the result of exploring how we can facilitate communications between the patient and doctor to improve the care process.”

DrGoodwell.com offers secure email, appointment scheduling and a
“virtual visit environment”
along with tools for exchanging information via the Internet. Patients can schedule appointments and then go online and actually visit with their doctor. DrGoodwell.com is also working toward eliminating the
“islands of information”
by transforming the way information is captured, stored and transmitted.
“Although the electronic medical record as a concept has been around for decades, it’s always broken down because even if you have the perfect record in your own setting, if it wasn’t accessible across town or in another state it was of no use,”
says Crounse.
“What I’m seeing emerge in .NET is the potential to aggregate, store and make available information from anywhere.”

Crounse says that DrGoodwell.com addresses an issue that affects the healthcare industry at nearly all points: cost.
“The healthcare industry is looking for lower costs but highly effective solutions that will deliver real value in the healthcare-economic chain,”
he says.
“Healthcare is very much an industry that’s struggling. Our hospitals are not flushed with cash and our providers are very much feeling the pinch. We don’t have millions of dollars in excess capital to drive the changes and adopt some of the technologies that are available in other industries. As a physician and information technologist, I’m pleased to see solutions emerging that are of the .NET flavor — low cost, pay as you go, pay for what you need.”

. According to Crounse, .NET captures the essence of the healthcare industry.
“The healthcare business is really about information at every level,”
he says.
“It’s about gathering, interpreting, acting on information and disseminating information. That’s why more efficient ways of doing all that are needed, and .NET certainly offers that potential.”

Acute Care and Telemedicine: “With Microsoft tools, we are enabling patients, wherever they are, to access expertise,”
says Joseph Kvedar, M.D., director of telemedicine at Partners HealthCare System.
“Telemedicine is a new distribution channel for our medical knowledge. For cost reasons, we’ve built centers of excellence for procedures like CT or MRI scans. We’ve also created academic centers with very specialized expertise. If you live in Boston, for instance, you’re fortunate to have some of the world’s best physicians taking care of you.”

With telemedicine, however, you can have some of the world’s best physicians whether you’re in Boston or Boise. Partners HealthCare System, a group of teaching hospitals associated with Harvard Medical School, makes Boston-based medical expertise and resources broadly available on the Internet. The telemedicine solution supports remote consultation, education and triage, and home-based healthcare. Providers and patients worldwide feed information through the Web, email, streaming media — including live video via NetMeeting — and multiple point-of-care devices to specialists, who provide advice in real time.

“Telemedicine raises the standard of care everywhere by sharing the standards at our academic centers with colleagues everywhere,”
says Kvedar.
“We thus improve care and extend care to many more people.”

Empowering People Through Software

The global implications of healthcare, according to Vigano, make it an ideal focus for the .NET platform — an area in which people are truly empowered by software. The partnerships between Microsoft and healthcare providers, according to Vigano, offer great examples of how Microsoft technology empowers healthcare organizations with solutions and tools to increase the quality of care and reduce costs.

“Healthcare is very global in nature, but also very personal and local,”
he says.
“You have to solve problems and provide value to multiple constituencies. Working with partners throughout the industry, with the .NET platform we’re well on our way to doing that.”

Vigano says he believes that .NET for Healthcare is helping to bridge the gap between patients and healthcare that has been widened by the managed care environment.
“Your doctor has, on the average, seven minutes to meet with you and figure out how you’re doing,”
he says.
“.NET for Healthcare is committed to helping you and your physician use those seven minutes in a smarter way — to be a more informed patient, and therefore a healthier, happier person.”

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