When Microsoft talks, people usually listen. That was certainly the case when Steve Ballmer, Microsoft CEO, addressed a packed house for the inaugural keynote at HIMSS07 in New Orleans. Ballmer's speech came after the company's Azyxxi acquisition last year and on the heels of its purchase of medical search engine Medstory. In addition, just before the show, Microsoft announced the release of its Connected Health Framework (CHF) Architecture and Design Blueprint, a free download of code and instructions intended to help CIOs leverage Web services and a services-oriented architecture (SOA) model to integrate disparate applications. In an exclusive interview immediately following his speech, Ballmer sat down with Healthcare Informatics Editor-in-Chief Anthony Guerra and Editorial Director Charlene Marietti to learn more about the company's healthcare strategy.
How can Microsoft help providers and consumers aggregate healthcare-related content?
We're trying to do two important things. Number one, we're going to try to pull together people's information, because I still don't think there's going to be just one EMR. For the provider, that's essentially what Azyxxi does. It will talk to a variety of EMR systems. And, number two, regarding how does the consumer get to play, the consumer needs to do something similar to what the doctor needs to do. The doctor needs to pull from a bunch of EMRs and then look at this information in one way.
The consumer needs to pull a bunch of stuff from a variety of different sources, and then mix it together with content and other things on the Internet that are relevant to what they have pulled together. Because if you just pull together information, it may or may not be that valuable to the average consumer. So while Azyxxi is definitely a product that is targeted today at the provider, the feeds that it has, we also think, can translate well to the consumer side.
Why was this the right year to come to HIMSS?
We feel like we have a real strategy on the provider and institutional side, and we understand what we're trying to do on the consumer side. So we feel it made sense for us to say, "OK, we're very serious about health, not just providing doctors with a word processor, but also very interested in the business of health, and we're very committed to it," and it seemed like a good time to come out and speak on that topic.
Is it the trend of consumer-driven healthcare, with high-deductible plans and health savings accounts that prompted you to move more aggressively into the market?
Absolutely. When we talk about a consumer strategy for us, we have to start with the notion of empowerment for the consumer, empowerment based on the fact that there's so much technology that consumers expect to be empowered. There's so much data, there's so much more to sift through.
You don't care about productivity unless there's some valuable asset tied up in it. Well, my health is a valuable asset, and my money is a valuable asset. There are many healthcare decisions that we make that are life and death. There are many more decisions that have to do with wellness, fitness, etc. And unless there's this aspect of consumerism, we would not get these trends that make things valuable to the consumer audience.
Regarding the personal health record, how many are there going to be and who will own them: the consumer, the employer, the payer or the provider?
I don't think there's going to be only one. There may be one standard format, but the notion that there's really just one record, I think, is always in the future. And so the consumer will implicitly, if not explicitly, trust multiple people. The consumer does today and doesn't think about it. I obviously trust our (company) payer, but a few years ago I would have had no idea what our payer knows about my personal health, but I would trust them. I obviously think I would trust Microsoft to pay me. I trust my doctor as they have one of the most trusted brands of any profession. As these things become more electronic, this issue will become more vivid. I think the only place a patient will get a truly integrated view will be their own view of their own record — assembled from information which gets pulled from multiple sources. Just like my financial information today, if I want to see a unified view I have to pull from Fidelity, Wells Fargo, etc, etc.
Your Connecting for Health Framework features a SOA. I think we've seen that model more rapidly embraced in industries like financial services than healthcare. How do you predict adoption will proceed?
It's one of these things where if you don't get started, you don't make progress, so I think we have to get started to make progress. The technology industry's plumbing is now far enough advanced that this is a sane discussion to have. When you take a look at what's happened with XML Web service standards, we have security, we have messaging. We have enough of the infrastructure ready that you can intelligently do a reference architecture based upon SOA that makes some sense. So now is the time. Getting from here to there is not going to happen overnight, but we have to get out there and get going.
This is such a fragmented industry. It's amazing to me how fragmented this industry is. It should not have developed this way. In other industries, the lines of business processes have been turned over, but this one is so customized still that there's a lot of work to do.