Clearly there is a focus then on the consumer-side. As I said, HealthVault is often referred to as a Personal Health Record (PHR), however, is there any inclination to offer HealthVault to doctors, too? Perhaps HealthVault could be offered to doctors who cannot afford an electronic health record (EHR). This question comes from someone via Twitter: Is there any strategy to roll out a bare-bones EHR, provider-side product based on HealthVault?
We get that question a lot in the United States because of the dismal numbers around EMR adoption particularly in smaller practices. We are really, really clear about who HealthVault is for — who it is defined for and who we have in mind as our user: This is the consumer. We don’t want to muddy that picture by saying that it is also a tool for physicians, except in the case that it is a tool that consumers can use to convey information to physicians. That said, we do work with partners like Covisint and the American Medical Association and the two of them have collaborated to offer a hosted, light-weight EMR to AMA members that is, incidentally, HealthVault compatible. There are a number of ways we think that HealthVault can play a role both in creating a certain amount of demand on the patient/consumer side for digital medicine and at the same time it can be a more effective tool for physicians. Physicians can now see that their follow-up care instructions are transmitted directly to the user via HealthVault or they can get more accurate information from their patient online before the patient even sets foot in their office.
Some of that information that physicians might be looking at through HealthVault has been transmitted from patients’ medical peripheral devices. Can you highlight some of the ways HealthVault is working with medical device makers to enable patients to port health data from these devices into HealthVault? I noticed that HealthVault only has a few wireless-enabled devices in their directory like those devices offered by MedApps.
It all stems from the idea that whether you are well or ill you really do not spend the majority of your time in your physician’s office. For the most part, 90 percent of your day is spent managing your condition, health or wellness by yourself. Devices can be an important part of that whether it’s a pedometer keeping track of the number of steps you take, or a blood pressure cuff that helps you manage your hypertension, or even a weight scale — something a lot of us use even if we don’t think of ourselves as managing a condition. Right now you are correct in that a lot of these devices are not IP addressable wirelessly connected to the cloud. As a consequence they don’t have a direct relationship with HealthVault.
[However], understanding the home health space, we have built-in the ability to get the data off of these devices and into your HealthVault record so that the physician can use that data, for example. There is a trial we are running with Cleveland Clinic where they are issuing patients managing hypertension and other heart disease a set of devices so that they can manage and monitor their condition at home. The data is being uploaded to HealthVault through HealthVault Connection Center, which is the software that sits on your Windows Vista or Windows 7 PC. The data itself is also being transmitted — with the patient’s permission and full consent — to the clinicians at Cleveland Clinic and they can case manage individual patients. They can say that this patient is normal, he is not gaining weight so we don’t have to worry about him right now or they might see some rapid weight gain and high blood pressures with this patient. So they then can focus their resources on the patient who is at risk before he shows up in acute care some place. There is definitely a role that HealthVault plays in connecting two previously very separate domains of healthcare management.
Wireless is an extremely interesting and obviously developing angle to all this: What happens when you can almost do this telemetry in real-time? The problem is that a lot of the companies playing in the wireless health space have previously thought of themselves as wireless companies. A lot of the wireless companies out there don’t have a ton of domain expertise in the healthcare device space. As those two industries converge and as standards emerge for sensors to be connected to wireless hubs, either personal ones or ones in the home, as they solution architectures sort themselves out, HealthVault will of course be there. You still need a place to sort out all this data to make it useful, available in applications or to transmit it to care givers instead of locking yourself into a vertical, siloed solution.
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