Microsoft's Innovative Health Information Plan
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Microsoft is making a big push into the management of individuals’ health information with a new online offering called HealthVault. The Wall Street Journal even ran a long article by Bill Gates (subscription required) on the topic, which the newspaper probably should have labeled an advertorial. Gates argued that individuals should be managing their own health information -- less than surprising, since that’s the assumption behind HealthVault. MSFT wants individuals to establish their own privacy-protected websites containing health information that they’ve either put in themselves, or permitted health care institutions to transfer to their sites.
The good news is that this very important issue is getting attention from Microsoft and other prominent vendors like Google and Intel. We won’t ever make much progress on health care in the US unless we have a means of capturing and sharing, within well-defined limits, health information. We don’t even have a common health care identifier, much less an electronic medical record, in this country, and we haven’t made much progress toward one. Other countries and large organizations that have made progress toward a common electronic medical record are using the resulting data to fight disease. Both Australia and the U.K., for example, have an electronic medical record standard in place and are moving toward full implementation.
The Veterans Health Administration in this country has an electronic medical record called VistA (Veterans Health Information Systems & Technology Architecture). Not only does it create some of the most efficient care in this country; it also improves effectiveness. A 2005 article in Washington Monthly describes how well: “electronic medical records collectively form a powerful database that enables researchers to look back and see which procedures work best without having to assemble and rifle through innumerable paper records. This database also makes it possible to discover emerging disease vectors quickly and effectively. For example, when a veterans hospital in Kansas City noticed an outbreak of a rare form of pneumonia among its patients, its computer system quickly spotted the problem: All the patients had been treated with what turned out to be the same bad batch of nasal spray.”
OK, but politics and lobbying and governmental incompetence have kept anything useful from happening on a nationwide basis in the U.S. I still think a governmental solution makes the most sense. What can we do to bring it about? Vote for a candidate who argues not only for national health insurance, but also an electronic medical record.
If you don’t think that will work, then you should probably use and advocate the Microsoft approach. It has some problems, particularly the reluctance of most individuals to take action in establishing their own online medical record. But it’s undoubtedly better than the nothing that we have today.
What do you think? Is Microsoft's approach on target or do you favor a government-led solution?
MORE ON HEALTH CARE AND DATA MANAGEMENT:
Redefining Health Care: Creating Value-Based Competition on Results (Hardcover)
Competing on Analytics: The New Science of Winning (Hardcover)
Curing U.S. Health Care, 3rd Edition (HBR Article Collection)
The Dark Side of Customer Analytics (HBR Case and Commentary)
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Tom Davenport holds the President’s Chair in Information Technology and Management at Babson College, where he also leads the 
Comments
The hubris of large companies "solving" healthcare continues. If you look at history, Lockheed, American Express, AllTel, even GE have all failed miserably in this area and I don't see the outlook for Google or Microsoft as much better. Companies focused on this problem, like Cerner and Epic have been at it for 20+ years and continue to build a base of hundreds of hospitals and health providers using health records but the going is very slow. I suggest you read the commentary from an expert on this industry for further information, Mr HIS Talk at http://histalk2.com/.
- Posted by John Harris
October 15, 2007 10:53 AM
Dear Prof. Davenport,
In this imperfect world, technology is a double-edged sword. Used judiciously, it can provide the platform for a better quality of life. By the same yardstick, in the wrong hands, it has the potential to wreak havoc on an already stretched system.
While the basic idea of an electronic database of health records is a laudable one, several concerns need to be addressed before the idea can become operational:
1. Security issues - what is to prevent someone hacking into the records and using the information for undesirable purposes?
2. What is to prevent employers from seeking access to health records before offering employment to anyone?
3. How can we ensure that such health records do not spawn a new generation of OTC drugs and a trend towards self-medication?
4. This is too sensitive a matter to be left to the corporations whose ultimate objective is a healthy top line and an equally healthy bottom line, or governments that are already over-zealous
to lay their hands on private information.
The solution, if at all, lies in entrusting the task to an independent entity comprised of individuals of unimpeachable integrity.
Warm Regards
- Posted by B V Krishnamurthy
October 16, 2007 5:16 AM
Microsoft's approach is on target, but the association of that name will delay adoption of the product.
Looking at the Healthvault web site, it promises not to commercially use my health information unless I clearly tell them that they can. A simple statement - but its very easy to see a Microsoft lawyer holding that use of HV establishes such agreement, and, anyway, if they don't sell it to anyone else, it's not really 'commercial'.
But the concept is excellent.
- Posted by bill reith
October 16, 2007 11:37 AM
Seems the wrong question or comparison to me. The government is apparently woefully ill-equipped to solve the problems associated with healthcare information - or any other major problem within the territorial borders of the U.S.
Volition to solve these problems by government will likely only come from partisan advantage in pursuit of office, not for accomplishment of the goal of social betterment.
The thing about innovation, there's always someone standing up to say "that won't work" - if this is the solution (not just 'another' solution) it will prevail regardless of the fair weather pundits that poo-poo anyone that wants to stand up and take a risk to resolve an issue. Microsoft is a corporate giant, but they succeed more than they fail. Given the opportunity, perhaps this could become the lesser of evils and a far better value for the taxpayer than another lame-duck governement program filled with general service vampires.
We have such a surplus of brainpower - pity we can't solve our own problems collectively.
- Posted by Steve Charwell
October 16, 2007 3:56 PM