Microsoft delves under the Surface for the healthcare enterprise

Apple may have started the mobile healthcare revolution when it launched the iPad, and its devices still remain the product of choice for doctors in particular, but Microsoft is now snapping at its heels with the recent launch of the Surface tablet, which Microsoft is promoting as an enterprise-level device for healthcare users.

Microsoft's senior director for worldwide health, Bill Crounse, was in Australia recently for one of his regular trips and was proudly wielding his Surface tablet, a lightweight and well-received device that he believes is one of the bevy of new technologies that, in his words, are going to be revolutionary as much evolutionary in clinical medicine.

While Apple is still the king of consumer devices, Dr Crounse believes the fact that Microsoft dominates enterprise IT, with its software, unified communications and cloud offerings like Office 365, is one reason that the Surface – and the new Surface Pro, launched recently in the US but not yet available in Australia – will be a major player in the healthcare setting.

“What is important is not just Microsoft but what all of the OEMs are doing in this whole new generation of very mobile, very robust devices is that I think they really begin to meet the needs of clinical end-users, but they also meet the needs of enterprise IT,” Dr Crounse said.

“This era of bring your own device has been marvellous in terms of pushing technology forward because it is a consumer-driven sort of thing, and clinicians are consumers. They've been coming in with these devices, presenting them to IT and saying 'make it work, make it network'.

“It is very hard for the CIO sometimes to say no to that and so they've been trying to take these devices and trying to make them work, but what they are finding is many of things out there in the market were never intended for the enterprise, particularly in healthcare where you have to be concerned about data security and privacy and loss of devices and encryption.

“So we are finally having this new generation of devices that can both delight the end user, who has become accustomed to a certain standard in the kind of devices they want to use, be they smartphones or tablets, and the needs of IT being able to ensure they are encrypted by default, that they can be managed as they come into the enterprise.”

Dr Crounse said one of the big strategies for Microsoft these days is its concentration on what it calls “the flexible work style”, which rather than a one-size-fits-all view now takes into account that end-users are choosing to use a number of different devices and platforms.

“This new generation of devices, touch for Windows 8, apps, cloud – [that] is all about enabling this flexible work style,” he said.

Of particular interest to the Australian telehealth sector is Microsoft's plans for the integration of its Lync unified communications platform with Skype, which Microsoft purchased in 2011. Microsoft recently announced that the “federation” of the two products would begin in June.

Dr Crounse could not divulge any more information, but he did say that “anyone who looks at it will realise there is going to be further integration” between the two.

Microsoft is also promoting Lync as an enterprise-grade platform, as opposed to the consumer-grade Skype, and Dr Crounse believes UC will also help revolutionise the healthcare sector, particularly in large networks like hospitals.

“Not only Lync but Skype as well are becoming fairly predominant platforms for what I call 'commodity' telemedicine and telehealth services,” Dr Crounse said. “It varies country by country and place by place but part of what we are seeing here in Australia is some amazing progress at an institutional level, with people understanding and mapping out where are their patients coming from and how far are they travelling.

“How can we leverage this technology to better serve that population, not only the clinicians who want to get out of trains, planes and automobiles and work more efficiently, but also patients who are being asked to travel three hours across town for a snippet of information or reassurance, when in fact this technology can be applied?

“What's important at government levels is greater recognition that these telehealth services are not just about extreme distances or remote areas. The need is every bit as great within a metropolitan area – it can take three hours to get across Sydney in traffic, so why are we asking the frail, the elderly and the disabled to get in cars, with a huge carbon footprint, or huge expense in a taxi, not to mention discomfort and unpleasantness?”

At a healthcare enterprise level, Microsoft is marketing Lync not just for physician to patient communication, but for care team collaboration within single healthcare facilities or groups of facilities. And while Lync is a video conferencing solution, Dr Crounse sees functionality such as instant messaging and presence notifications as equally important.

“We are talking about creating vast federated networks with directories and presence so that if I'm a physician and I need help with something, I can go to a global directory and I can see who's online and is available, what their speciality is, IM them, voice call them, web conference with them – it can be a single party or multi-party conference.

“It's really changing the way that we work and moving away from the really synchronous paper, phone and fax world to a world that is much more nimble. The value of both Lync and Skype is in the reliability of the platform and the ease of use. You can't underestimate the ease of use, whether we are talking about consumers or clinicians. And with things like integrating scheduling, it just makes it easy.”

Many hospitals have invested vast sums in buying video conferencing equipment, particularly for clinician education and broadcasting live surgical procedures, but Dr Crounse believes that is actually “the telemedicine of old”.

“They are point to point. They are big, bulky, expensive to use – that is telemedicine of old. The sort of telemedicine we are talking about here is unified communications for the masses. Big television screens are all very good, but it doesn't scale.

“With this device [the Surface] and a little bandwidth, I can be a global telemedicine provider and that's the difference. I'm forecasting some fairly fundamental changes in lesser skilled people, armed with smart technology, being able to scale healthcare services in ways that we haven't seen before.”

Microsoft Health Australia's health industry solutions manager Simon Kos used the example of the co-director of the Children's Hospital Westmead endocrinology department, Professor Geoff Ambler, who is using a range of technologies to better connect with patients.

“He is using Lync on his PC, connecting in through a Polycom gateway, accessing the NSW Health Tandberg network and now he has virtualised his paediatric diabetes clinic out to Orange and Bathurst,” Dr Kos said.

“What he has found is that not only is it easy for him, as he's not doing a 16-hour day of travel, but he can actually engage the local care team in a way that he never did. There's good knowledge transfer, clinical education by peer to peer, and the kids love talking to the doctor on telly.”

Microsoft is also working to encourage app developers to combine a number of technologies in new apps to assist clinical workflow, including how to use Lync on the Surface to improve communications within hospitals, but also to create gateways into electronic medical records and health information systems like those developed by Cerner and Epic.

Dr Crounse said Microsoft had long been working with the big EMR vendors, but its main advantage was Microsoft's dominance of the software market. “To a lesser or greater degree there is some Microsoft in all of their solutions,” he said. “Back-end or front-end – somewhere in there, there is some of our stuff.”

While many vendors have already moved into developing apps for the iPad and iPhone that allow clinicians to access an EMR or receive results, Dr Crounse believes that Microsoft will be able to do a lot more due to its presence in every aspect of the enterprise.

“I understand that iOS for consumer devices – there's no question that there has been a lot of traction there,” he said. “The issue has always been how those devices plug and play in the enterprise environment. Microsoft's footprint is very clearly in the enterprise.

“When we look at these kinds of devices, we ask is there a trusted platform module (TPM) chip in here, can this device be managed remotely, does it integrate and plug and play very nicely with the enterprise applications?

“It can be a two-sided discussion – there is the IT viewpoint and the clinical viewpoint, and in defence of the clinicians, up until fairly recently there really hasn't been an alternative to what the experience has been on the iPhone or the iPad.

“They are brilliant, lovely devices, but they are lacking in some of the things you need, like data security, data input options, digital inking – things that doctors really want in devices. It is also about the experience of going from smartphone to tablet to laptop to desktop to the big screen in the living room. That's what we are delivering.”

Posted in Australian eHealth


0 # Data 2013-02-21 21:06
"and its devices still remain the product of choice for doctors in particular"

I'm yet see any doctors walking around with iPad on the ward anywhere, care to give examples?
0 # Pugsley 2013-02-22 15:14
Agree Ipads do not work with our inpatient software and unable to run citrix receiver applications making them virtually useless in all our clinical settings across the hospital.
0 # Kate McDonald 2013-02-24 10:23
Quoting Pugsley:
Agree Ipads do not work with our inpatient software and unable to run citrix receiver applications making them virtually useless in all our clinical settings across the hospital.

Citrix Receiver works on most devices, including iPads, iPhones and Android devices. Accessing your inpatient software is another matter.

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