Giving Healthcare a Digital “Touch”

CHICAGO – April 6, 2009 – Talking with a doctor is rarely easy. Patients might feel intimidated by the white coats and jargon, may forget the names of their medication, can misinterpret a diagnosis.

To make the patient-doctor consultation more comfortable, collaborative and productive is the goal of an application developed by Texas Health Resources, which operates 13 hospitals in the Dallas-Fort Worth area, and Microsoft partner Infusion Development. Using Microsoft Surface, Microsoft Corp.’s first surface computer, the solution uses digital health records and images – along with video and diagrams – to make the doctor-patient consultation more productive, more understandable and less apt to result in mistakes.

Texas Health Resources’ prototype is one of four Microsoft Surface applications for healthcare that Microsoft and its partners are demonstrating this week at the Healthcare Information and Management Systems Society (HIMSS) 2009 conference in Chicago. Other partner demonstrations include an application designed to help patient scheduling and improve overall hospital efficiency, especially when experiencing a rush of patients such as in the aftermath of a natural disaster or construction accident; a tool for assisting children who need rehabilitation; and an application aimed at improving patients’ check-in experience at clinics or hospitals.

Infusion Development’s application allows a physician and patient to collaborate over digital health records, radiology images, prescriptions and other health records. Graphical images of the human body and videos help a physician explain and diagnosis.

Together, these demonstrations showcase how the innovative Microsoft Surface natural user interface (NUI) can provide healthcare providers with solutions to solve difficult hospital-management or patient-care problems.

“From the first time I saw Microsoft Surface, I thought it was just made for healthcare,” says Dr. Bill Crounse, worldwide health senior director for Microsoft. “It doesn’t feel like you’re using a computer – it’s much more intuitive and easy to use, for both patients and doctors.”

Touch or multi-touch computing is not new. Microsoft Surface takes massive multi-touch and amplifies it like a stadium loudspeaker. Inside a Surface unit, five infrared cameras peer up at the screen while an adjacent projector bathes the tabletop with infrared light. Once fingers or hands touch the tabletop, the infrared cameras “see” the reflection and tell a Windows Vista-based computer running Surface what those hands or fingers are doing, and how the application should respond with the corresponding content.

This vision-based technology allows Microsoft Surface to respond dozens of different touches. So several people can individually or collaboratively work on a single Microsoft Surface. While doing so, they can open documents or images, zoom them to larger or smaller sizes, rotate them, copy them from one user to another or close them – all with a tap or the flick of a finger. Microsoft Surface’s vision system also allows it to identify objects placed atop it, so it can communicate with a smart phone or tagged card that might contain digital records.

From the time of the first Microsoft Surface deployment in summer 2008, healthcare was seen as a key market. “We thought Microsoft Surface offered real value to emergency departments, in-patient and ambulatory care, and children’s hospital environments,” says Randy Fusco, chief technology officer for Microsoft’s Health & Life Sciences Provider Industry in the U.S. “Patients have a choice where they receive care, and healthcare systems are looking for innovative ways to differentiate themselves around patient experience. Microsoft Surface can help healthcare providers do that.”

So the Microsoft Surface team worked closely with partners and healthcare providers to develop four innovative applications that address different scenarios within healthcare.

MEDHOST’s emergency department dashboard, built on Microsoft Surface, gives physicians and nurses at-a-glance updates about how many patients are arriving, the severity of their medical emergency, what radiology or laboratory orders are pending, the number of beds available, and much more.

One is the need for collaboration among medical peers, or with patients, so the right decisions are made at the right time. The ability of Microsoft Surface to recognize dozens of different touches from people working all around the unit makes it a natural collaboration tool. In some cases that collaboration is 1:1 – such as Texas Health Resources’ doctor-patient application. But in other cases collaboration may need to take place among multiple caregivers.

Take a sudden medical emergency that sends dozens of patients to the emergency room. To create a digital “traffic cop” that manages the flow of patients throughout the hospital, Microsoft Gold Partner MEDHOST has developed what it calls the Operational Visibility Engine. Using Microsoft Surface and powered by Windows Presentation Foundation, the Operational Visibility Engine delivers a graphical image of the hospital layout, tracks digital records of incoming patients, and maps them to specific floors or beds. Says Patricia Daiker, an ER nurse who now is vice president of marketing for MEDHOST, “In my experience, when there is a disaster you have a handful of patients about whom you need to make very quick decisions related to their treatment and finding a bed for them. With this application a doctor or nurse can look at all the patients coming in and decide how best to handle them, rather than dealing with them one at a time in typical triage.”

Another powerful aspect of Microsoft Surface is object recognition. Much like a RFID or bar code, Microsoft Surface can recognize tagged physical objects placed on the display. A potential example of this technology can be seen in MEDHOST’s application, which provides a hands-on solution to provide real-time information to caregivers and decision-makers in times of a crisis. Texas Health Resources also looked to incorporate object recognition with its Microsoft Surface application. So imagine, in the future, a doctor or patient being able to see their medical information collaboratively by placing a tagged personal patient card on Microsoft Surface.

Chicago-based Allscripts, a Microsoft partner and one of the largest suppliers of electronic health records (EHR) software for physicians’ office and clinics, and Springfield Clinic developed a suite of applications for Microsoft Surface. The applications can provide an interactive overview of the clinic or hospital when a patient arrives, or provide a personalized interactive care plan. With the personalized interactive care plan, the physician’s notes can be incorporated in the EHR and made available for the patient to review, all with a flick of the finger, in outpatient settings.

The goal is to ensure that patients learn more, understand their diagnosis better, and have a sense that the physician is using the best technology available. “It’s pretty well known that when a patient is better educated during their visit with a doctor, they have a better experience and better satisfaction,” says Steve Schwartz, senior vice president for Allscripts. “We think our app really creates a ‘wow’ factor for patients, and also helps them make more of the visit by really collaborating with their doctor, rather than just being talked at.”

A third aspect of Microsoft Surface that software developers in healthcare find intriguing is the ability to have direct interaction with the content (e.g., use fingers to move or write/draw on it). This can be beneficial for solutions geared toward children who require rehabilitation for physical or cognitive problems. One of the challenges faced by physicians working to rehabilitate these youngsters is accurately tracking how a child’s motor skills are faring from one week to the next. Children, meanwhile, may find traditional rehab exercises less than engaging in a video-game world.

To help children in rehabilitation, Vectorform created an application for Microsoft Surface that lets rehabilitation specialists design their own tests for patients. A youngster’s ability to complete the test can be recorded and used to track progress.

So Vectorform – a global design and gaming specialist and a Microsoft partner – teamed with the Cook Children’s Health System in Fort Worth, Texas, on an application that gives rehabilitation specialists a powerful new way to work with children.

Typically, says Tim McKendrick, a senior project manager with Vectorform, rehab specialists ask children to perform tasks such as tracing a line through a maze the specialist might draw on a piece of paper. Often the test is timed, and repeated daily or weekly to monitor a child’s progress. “We computerize that,” says McKendrick. “The caregiver can create their own tests on Microsoft Surface using its drawing capability, set their own parameters for success, and easily repeat the test and track the child’s progress.” The tests can incorporate a variety of game-like motifs, such as animals or balloons, so the child can find it more engaging.

The excellent graphics capabilities on Microsoft Surface and its ability to recognize and react to a wide variety of touches helped make the application possible, McKendrick says. And it allows the patient and caregiver to really collaborate on tests and gauge progress, as both can work on a Surface unit at the same time.

Among the Microsoft partners who have developed applications for Microsoft Surface, the device gets high marks for its flexibility and the relative ease with which applications can be devised. Says Eric Rock, chief technology officer for MEDHOST, which developed the ER applications, “I give a lot of credit to the SDK (software development kit) at Microsoft. The Surface SDK is phenomenal and really opens up new opportunities for navigating and using the Surface interface.” Developers also like the fact Microsoft Surface uses software they already use, such as Windows Vista and Windows Presentation Foundation.

Still, Rock notes, it’s a challenge for developers to work with Microsoft Surface simply because it is such a change from the usual PC interface. “Microsoft Surface forces developers to forget the keyboard and mouse,” he says. “They need a completely different mindset.”

Another hurdle in healthcare, an industry that has largely resisted digital technology due to costs and implementation challenges, is that a Microsoft Surface unit runs $12,000 – before an application is developed for it. And it’s a fairly large piece of equipment, a factor in cramped waiting rooms or offices.

But the opportunities Microsoft Surface presents developers in the medical world are proving to be difficult to resist. As emphasized by Vectorform’s McKendrick, “Touch technology is here to stay, and Microsoft Surface offers many advantages because of its optical system and its ability to recognize multiple users and tagged objects. It allows a very patient-focused experience, and has seemingly limitless flexibility.”

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