Microsoft has been getting its share of bad press lately after poor quarterly results and more details on a planned reorganization.  Many are saying that Microsoft can’t sustain its dominance with Windows and Office as PC sales stall.  It is interesting to speculate as to what healthcare might look like post-Microsoft, given the dominance of PC applications in healthcare. Or, will Microsoft be successful in transforming itself, and all this speculation be for naught?

This seems like déjà vu, as years ago IBM and the mainframe dominated.  Most hospital applications were mainframe-based with terminals for user interaction.  Then came the PC and Microsoft’s emergence as the predominant operating system, and the world transitioned to virtualized servers for applications and PC’s for user interaction. 

In imaging, high-end graphics and processing requirements initially pushed workstation applications to industrial hardware such as UNIX-based workstations.  Some novelties also existed such as the Apple McIntosh-based graphics workstations of the Loral PACS, again due to their graphics processing capabilities.  As mainstream PC’s evolved, their wide availability and cost advantage eventually won over most image display applications.

Today most legacy PACS exist on dated Windows XP platforms, which means an impending dilemma for both legacy implementations, and new PACS from vendors.  When Windows XP is eventually sunset, facilities will need to update software.  Many facilities are contemplating moving to Windows 7, but not to Windows 8.  Vendors face similar issues – move directly to Windows 8 or support yet another superseded operating system.  And Microsoft has now let the cat out of the bag about Windows 8.1, to fix many of the criticisms of Windows 8.

The advent of MHealth has also entered the fray, with most mobile applications existing today on either Apple iPad or Android platforms.  Unfortunately, these represent new challenges to IT organizations, as both are additional security concerns to support.  In terms of imaging, both represent viable applications for simple image viewing, but neither has the horsepower to support image interpretation applications such as in radiology and cardiology. 

Vendors could always turn to alternative operating systems such as Linux or UNIX, but widespread availability of hardware platforms for these applications is secondary to Windows-based platforms.  A promising trend these days is the so-called “zero-footprint” viewers that rely on server-based rendering applications that merely require a high-resolution viewer application on the viewing end.  Unfortunately, to date, no one has extended this to full-scale reading stations.

Given such options, does this mean that Microsoft will be pushed out of healthcare applications, especially imaging?  I think the jury is still out, and it will probably be dependent on where Microsoft heads in reorganization.  If they continue down the current path of creating a unified operating system environment from desktop to tablet to phone, perhaps Microsoft has a fighting chance. 

I just ditched my Lenovo laptop and Android tablet in favor of a new Lenovo product known as the ThinkPad Helix.  It has the form factor of an Ultrabook, with a removable keyboard dock that turns it into a full-scale tablet.  It runs Windows 8 Pro, so it is directly compatible with any desktop application.  It has lightened my load considerably, and has all the capability of a full-scale laptop.  Now instead of taking notes on an Android tablet device using one of the Office applications, and having to transfer/convert it to a Microsoft Office Word document, I can take notes directly in Word.  I can also grab the tablet portion while touring a facility and take pictures or make sketches.  (For all those Apple users, there is the same issue between an iPad and a MacBook as they are different operating systems as well!)

Microsoft has only begun to dent the phone market with the Windows 8 Phone.  If my carrier offered a Windows-based phone, I would jump ship from Android and have one uniform computing platform!  This is what I think might save Microsoft, if they can pull it off.  It seems that such a unified product base would be very attractive to healthcare IT, and to users as well.  So, the big question is … does Microsoft have the time and resources to really succeed?  Or, can someone like Google or Apple expand to offer a competitive environment ahead of them?  Only time will tell.  What is for certain is that industries such as healthcare will have to follow whatever direction the consumer market takes, as that is where the dollars are!