Because financially struggling customers are often hot targets for online scams – especially in a down economy like the one we’re in now – the goal of this new service is to help provide this group with critical information as to how they can stay fraud-free.

The landing pages for the credit repair and mortgage foreclosure PSAs will be hosted by the FTC while the landing page for advance fee fraud (aka “lottery scams”) will be hosted by Microsoft. (Perhaps because one common scam of this sort involves a nonexistent “Microsoft Lottery?”)

Since search companies such as Bing are often involved in a cat-and-mouse game to keep fraudulent listings out of the search results, these PSAs will help educate potential victims of what search results they should be wary of. You should start seeing the PSAs appear now in Bing’s sponsored ads sections. Here’s an example.

Do I think that some kind of universal, government-run healthcare fix is the answer to all of our problems? Absolutely not!  One of the things I have learned as I have traveled around the world these past few years is that providing timely, cost-effective, equitable healthcare for an entire population of people is challenging no matter what payment system is in place.  Healthcare is expensive and it doesn't matter whether the payor is government (we pay), employers (we pay) or private citizens (again, we pay); many of the miracles of modern healthcare have become so expensive and so out of the reach for people of ordinary means, there's just not enough money in any system to apply them universally and equally to every citizen.  Therefore, healthcare always has been and always will be rationed in some way.

So, if how we pay for healthcare has flaws no matter what system is in place, we must find better ways and better systems to deliver more affordable and accessible care.  I've taken a few hits for my positive stance on retail clinics, home health, patient self-service, physician-patient e-mail, personal tele-health services, and other modalities to provide health information and medical services in ways besides those that our current "system" provides.  Many of my physician colleagues are on a war path against retail clinics.  They are calling every state legislator and pulling out every tool in their regulatory armamentarium in an attempt squash the movement, but they will ultimately fail.  Prohibition doesn't work.  Retail clinics will thrive or falter based on the quality of services they provide and the value that their customers perceive.  The whole reason this movement has gained a foothold is because medical professionals haven't been listening to their patients.  Patients want healthcare to behave like other industries.  It really doesn't matter who's paying the bill.  We are all paying the bill, and we expect more than we have been getting considering how BIG that bill has become. 

Doing something about this will take more than coming up with new ways to pay for healthcare as it is presently delivered.  We need new care delivery models, staffing models, business models, and a bevy of contemporary information and communication technologies to truly revolutionize American medicine.  Neither Google, nor Microsoft nor any of the other companies mentioned in Lohr's article can be your doctor, nor should they be.  But these companies can and should help us with the technologies that will be needed to change the game.  If not Microsoft or Google, then who?

Bill Crounse, MD     Worldwide Health Director     Microsoft

I've mentioned before on this Blog that I'm a fan of Most-Wired Online and its guest editorials.  Every so often, a Most-Wired edition comes across my desk that especially draws me in.  This week's editorials by Senator Sheldon Whitehouse of Rhode Island on Building a National Health IT Infrastructure and by Lois Taveras and Dadong Wan of Accenture on The Case for Pervasive Healthcare really hit a chord with me.

I suppose we all tend to gravitate to folks who think like us, but I couldn't help but ponder how relevant these editorials are to some of the really big issues we face in American healthcare.

Senator Whitehouse is advocating for a public-private partnership akin to the COMSAT legislation for satellite communications during the Kennedy administration.  The partnership would drive interoperability, privacy and security rules, and EMR data standards for healthcare IT.  As I've hop-scotched around the world and seen for myself, America is woefully behind in the adoption of IT in healthcare (and don't even get me started on even more basic infrastructure failings like roads, bridges, airports, etc.). 

Taveras and Dadong write eloquently about the opportunity to transform healthcare delivery and services with pervasive technology that would help us better care for the elderly, treat people with chronic diseases, and frankly serve just about everyone else far more safely and efficiently than we do today.  Their editorial is a two-parter and I suspect next week's edition will deal with the harsh reality that unless we change reimbursement mechanisms and perverse incentives in American healthcare, these very real solutions will never see the light of day.  

Regular readers of my Blog will immediately understand why I embrace what these guys are saying.  Whether it is my commentaries on the potential for Unified Communications in Healthcare, Remote Physiological Monitoring, the need for a Common User Interface, the value proposition for Commodity Software in Healthcare IT, Failing American Infrastructure, and more; there is a very common theme.  And that theme is interwoven in everything Whitehouse, Taveras and Wan are writing about.

Wake up, America! If you think our foreign competitors don't see HUGE opportunities to beat us in healthcare because of our failings in IT and our screwed up system, think again.  We are at a crossroads here.  American healthcare as an industry is at risk of collapsing just like that freeway bridge in Minneapolis.  

Bill Crounse, MD   Worldwide Health Director      Microsoft

If your company ever comes to Redmond for a health industry briefing at our Executive Briefing Center, or you happen to attend one of the many keynotes I give at industry conferences throughout the year, you'll more than likely see what is known as our Health Future Vision video. 

This is the third such health industry video we have produced here at Microsoft.  It has been my pleasure to work closely with Ian Sands and his Industry Innovations Group (IIG) to bring these videos to life.  What's particularly interesting is how accurate the videos have been in predicting future industry trends and how technology will influence the way we work.  Perhaps that's because IIG does so much internal and external research before producing one of these videos.  We also base them on technology that is either currently available but not widely implemented, or on technology that is being actively pursued in the labs at Microsoft Research.  In any event, everything you see in the video is based on technology that is available now, or is very likely to be available within a 7 to 12 year time frame.

Our newest Future Vision Video also captures the essence of healthcare industry trends that I've been following and writing about for the last few years.  This includes the rising tide of consumerism in healthcare, the retail movement, commoditization of services, information everywhere, and globalization.

In the video, we follow a young pre-diabetic patient as she ventures out on a run. During her run, various physiologic functions are being monitored and data is being sent in real time to her personal health record. 

A case manager, who has been given permission by the patient to see her data, becomes aware that she may qualify for a new clinical trial.  When the young woman returns home she enters into a virtual consultation with her case manager who directs her to check with her personal physician about possible enrollment in the study.  She immediately schedules a "virtual conference" with her personal physician.

The scene switches to the young woman's endocrinologist as he beings to make rounds in a hospital.  He uses a very light-weight Tablet computer to gather information on his patients, locate needed equipment, and conduct his patient visits. 

 

We see him performing a retinal exam on one of his diabetic inpatients and sharing results with the patient. 

He later enters a special room where he conducts a "virtual visit" with the young woman we saw at the beginning of the video.  The physician, his patient, and a clinical researcher collaborate on details of the proposed clinical trial.

The doctor instructs his patient to visit a nearby retail setting, where as the video comes to a close, we see her using her "digital wallet" and a kiosk to get necessary tests and medication for the clinical trial.

I think the video accurately reflects the kind of consumer-directed, quality and price transparent, knowledge-driven healthcare delivery system we'd all like to see.  And while this is just a video, it certainly captures the essence for how information technology will help transform medical practice to better connect people and data, facilitate improved collaboration, and better inform everyone involved.

Bill Crounse, MD   Worldwide Health Director    Microsoft Corporation

Prior to founding MedStory, Dr. Rappaport was the co-founder, president and chief scientist for Neuron Data, a world leader in artificial intelligence and other business-critical software components. That Dr. Rappaport’s roots are embedded in the science of artificial intelligence made all the more sense as we discussed his vision for MedStory.

Dr. Rappaport likened the healthcare industry today to that of American manufacturing in the 80’s. All of us old enough to remember will recall that the American automobile companies and other manufacturers were getting clobbered by much more nimble competitors overseas (particularly the Japanese) who started using computers and technology to optimize the supply chain and their manufacturing processes. American manufacturers have now narrowed the gap. Productivity has improved and they are turning out higher quality products, but we continue to pay a price for falling behind in the 80’s. According to Dr. Rappaport, American healthcare is now where manufacturing was in the 80’s, and the time for change is upon us.

Realizing that healthcare is an industry that is driven by information, Dr. Rappaport turned his attention to improving how both consumers and clinicians alike will find the information they need. It is not enough, he says, to provide links to information. Search engines must become intelligent enough to understand a user’s “intent”. “We need a web that knows versus one that just links”, said Dr. Rappaport. “We are moving the center of gravity of search to return an understanding of what the user wants. Our core objective is to provide meaningful information that is also actionable.”

Asked why he decided to team up with Microsoft, Dr. Rappaport said it was the opportunity to engage with customers and partners all around the world who are now coming forward to help us innovate and use this technology. “Even in parts of the world where populations are medically underserved, providing relevant and timely information, will make a difference”, he said.

I, for one, very much agree. I’m thrilled to have Dr. Rappaport and his distinguished colleagues join us on our mission to improve the quality and safety of patient care, and the satisfaction of those giving and receiving that care.

Bill Crounse, MD    Worldwide HealthDirector   Microsoft Corporation

Speaking with me in New York were customer representatives from Memorial Sloan-Kettering Cancer Center and Atlantic Health. Pat Skarulis, Sloan-Kettering's VP and CIO, and Dr. Rich Mansour from Microsoft partner Eclipsys, provided a compelling presentation on MSKCC's IT environment. Virtually 100 percent of physician orders are done electronically. Sloan-Kettering is filmless and chartless. Their unified patient record reduces errors, reduces turnaround time, increases security and compliance, and eliminates lost "charts". They have also developed custom electronic order sets for all chemotherapy regimens, vastly improving workflow and increasing chemotherapy safety.

Jacque Brodt-Suggs, Director of Application Support at Atlantic Health, and a representative from Microsoft partner Quilogy, presented information on Atlantic's balanced scorecard application. After looking at scorecard applications on the market they decided that none of them really met Atlantic's criteria for customization and ease-of-use. Furthermore, when they learned from Microsoft that they already owned most of what they would need to leverage a portal solution offered by Quilogy, the decision was a no-brainer. According to Ms. Brodt-Suggs, the solution simplifies data collected and interfaced from 90 disparate systems, creates consistent definitions for performance measurement, and gives care teams first time access to metrics that help them understand how their work can support Atlantic's strategic goals. Oh, and did I mention this solution saved them a ton of money?

What both customers had in common was technology from Microsoft. That's the part of the story I really want to share. That's what gets me so excited. That's why I keep getting on airplanes to spread the word, and sometimes staying on top floors of hotels......... even when I know better.

If you would like more information, please visit our Microsoft Healthcare web site.

See you at HIMSS in New Orleans!

Bill Crounse, MD Healthcare Industry Director Microsoft

Also, a few weeks ago I shared information on this Blog about a hospital in Spain, Torrevieja Salud. There was so much interest in the topic of using commodity components to build truly robust yet much lower cost solutions for hospitals and health systems, especially outside of the U.S., that I decided to host one of my House Calls audio-casts on this subject. The program was conducted in both Spanish and English with appropriate translation as required. While this makes it a little more difficult to listen to compared to other programs we have done, I think you'll enjoy the program and the important lessons we can learn from Spain.

Torrevieja Salud Hospital: A lesson from Spain
This program is also available in MP3 for download.

A fully functional, contemporary hospital information system was built using readily available, lower-cost, commodity software. Does it sound impossible? That's what was done at the newly opened Torrevieja Salud Hospital in the Valencia region of Spain. How did they do it? How long did it take? And what did it cost? The answers may surprise you.

Panel guests

Luis Barcia, general manager of Torrevieja Salud Hospital, has since 2003 been responsible for the hospital's ongoing operations. Barcia has also worked as an administrator for the Valencia Oncology Institute Foundation (IVO), and the director for the Hospital de la Ribera. He is a lawyer with Master's degrees in international commerce and healthcare management.

María Martinez, chief radiologist of Torrevieja Salud Hospital, has a medical and surgical doctorate degree from the Universidad de Murcia. She has also worked as a radiologist at the Virgen de la Arrixaca Hospital. She has twice been a finalist for the prestigious Spanish Healthcare "Profesor Barea" awards. Her work spans from lectures and presentations to numerous articles in prestigious Spanish healthcare publications.

Miguel Ortiz, chief information officer at Torrevieja Salud Hospital, is responsible for the hospital's information technology (IT) strategy and making it work flawlessly. Ortiz's prior work experience includes being the director of IT for the Hospital de la Ribera, the sub-director of Alzira, and an Accenture Coritel project manager. He graduated from the Universidad Politéctnica de Valencia and has a Master's degree in healthcare management.

Felipe Pascual, medical director of emergency services at Torrevieja Salud Hospital, specializes in emergency room (ER) care and is the lead trainer for the Spanish Triage Group (GET-Manchester). He is also one of the main trainers for the Spanish Society of Urgencies and Emergencies “SEMES”. In addition, his experience includes work in primary care, work as a clinical director, and giving lectures throughout Europe about ER management.

Bill Crounse, MD        Healthcare Industry Director                Microsoft