Category Archives: Healthcare

Introducing HealthCaddy–A Windows Phone 7 App

Do you track your blood glucose, blood pressure, heat rate and, weight readings as part of your health maintenance goals? Then HealthCaddy is your buddy. This Windows Phone 7 App helps you track these important health readings.

The main reading entry screen displays a quick snapshot of four most recent entries. Double-tap the graph to display a full-screen version of the graph which also allows you to view historical readings.

HealthCaddy uses the CTP version of Telerik Windows Phone 7 date and time picker controls. Data is stored to the phone’s isolated storage via the excellent Sterling database engine. And, like discountCalc, HealthCaddy also uses MVVMLight framework to achieve UI and business logic separation.

Here are a few screen shots of the app.

HealthCaddy_ScreenShot1HealthCaddy_ScreenShot2

HealthCaddy_ScreenShot3HealthCaddy_ScreenShot4

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I had to cut out certain features of the app to hit the December 31st 2010 deadline. I intend to implement these ASAP. I am also awaiting the release of version 1 of Telerik controls and the Sterling database engine. These updates will be rolled into the next point release.

I have also setup a UserVoice forum to solicit feature suggestions for future implementations. Post your feature requests here and cast your votes.


Putting Microsoft Tag to meaningful use

I while back my colleague and I were discussing how far the bar code has come and how there are different kinds of bar codes and how a lot of information is being packed into those humble stripes. I had read that in Japan, advertisers put black and white matrix on posters and you can take a picture of the code using your mobile phone and get additional information or coupons for the service. People will figure our ingenious ways to put technology to good use.

I came to know the existence of Microsoft Tag via Glen Gordon. I downloaded Microsoft Tag Reader iPhone app and played with it a little. Toyed around with a few ideas and planned a project that could use it. Then I got busy at work. There is so much stuff to do at work that I find it hard to work on any of the personal projects.

This afternoon @lizasisler tweeted about Microsoft Tag and wondered how it could be used to better Health Care. We exchanged a couple of ideas.

@lizasisler: Saw @MicrosoftTag @ #WPC09 Neat printable interactive barcode technology http://www.microsoft.com/tag/ Thoughts on good #Healthcare uses?

@rsringeri: @lizasisler @MicrosoftTag have med devices display MS Tags that can be snapped with mobile app to upload to @HealthVault.

@lizasisler: @rsringeri Nice! Think there could be great @MicrosoftTag uses in Healthcare – drug/equipment uses/education etc

@rsringeri: @lizasisler agree. Instead of the paper manual in the box, put a MS Tag on the device that takes you to the device’s home page on you iPhone

@lizasisler: @rsringeri What abt using @MicrosoftTag as emergency gateway to @HealthVault information. Click on tag interact with/access HealthVault?

@rsringeri: @lizasisler emgcy access is a great idea. My @HealthVault should have a section where I can put in non-stealable data, get a tag, ….

@rsringeri: @lizasisler … snap tag from mobile device and download vital emgcy data to Healthcare prof’s device. Blood Group, diabetic, allergies

Here are some ideas for meaningful use of Microsoft Tag in Health Care

  • Medical devices like BP and Blood Glucose meters can display, in addition to numbers, an MS Tag with the data encoded. I can then whip out my MS Tag reader app on my iPhone, snap a pic and upload the data to my Health Vault repository. No cables to fumble. No PC to connect the device to. Instead of trying to make the device Internet enabled, just modify the screen to display an MS Tag. And if I happen to use multiple devices to manage my health I don’t have to buy cables for each of these devices and connect them to a computer one after another. Most device manufacturers do not bundle a cable to connect the device to a computer.
  • Instead of including product manuals, instructions with med devices, just put couple of MS Tags on the device. Whip out the Tag reader app again, snap the pic and the iPhone can now play a video demo of the device or load a PDF manual, with click enables links.
  • Enable Health Vault to create an MS Tag that encapsulates data that I decide to make available to emergency medical personnel. I could carry a MS Tag card in my wallet (or a dog tag) that can be used by medical personnel to gather vitals stats like blood group, allergy information in situations where I may be unable to communicate that info.
  • The above idea can be expanded to create a portable medical record I can carry for my visit. Prior to my doc visit, I logon to Health Vault, select a bunch of data points, export that as an MS Tag, save the tag on my iPhone, and assign an expiration date to it. At the doc’s office, the doc or other Health care personnel can “read” the encoded information using a MS Tag Reader. I don’t have to print anything nor do I have to logon to a computer at the doc’s office to make the information available.
  • Put MS Tags on medication bottles. Snap pics of all the medications and an app can figure out and warn about potential drug interactions. Couple that with data from med devices and the app can alert you – hey your blood sugar is high pop this pill from your prescription

These are just a few ideas I dumped from my brain. What’s yours? With the availability of Microsoft Tag API here, I guess it’s only a matter of time before we see some implementations.

Update:

Check out Vizitag, their blog and follow them on Twitter. Interesting applications of Microsoft Tag and bar codes.


Opening My HealthVault

Given my passion for Health Care IT, it is only natural that I give Microsoft HealthVault a try. I have already downloaded the SDK and am waiting for our product rolls at work to be done to start playing with the SDK and creating my own application.

I plan to chronicle my experience using HealthVault here. And after I have explored it, I’ll move to Google Health and contrast my experiences with that application.

The first thing you do to get into your HealthVault is to navigate to the HealthVault website.

The home page for HealthVault looks like a typical marketing web page. The design is simple, clean, and unobtrusive. I like it. The sign-in option is at the top left corner, but in my opinion should be a bigger font. Very easy to miss and it’s blue on very light blue. Make it a little more prominent, and it will be easy to find. Click it and you are taken to the login screen.

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You are presented with couple of options. You can enter your email address or sign in using OpenID. Ah! This is great. I have setup my open id with myopenid.com and I have set it up so that every time I logon using my open id, I get a call on my cell phone from myopenid.com verifying that I indeed did try authenticating on some website. This is great and especially important on a cloud application that promises to hold all kinds of health information imported from all providers. So I click on the OpenID link, enter my open id. In the screenshot below, I have xxed out my open id, but here is what I get when trying to use open ID

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Communications problem! What? I can’t sign in using my open ID? What kind of communications problem are we talking about here? And this has been going on for quite sometime. I have been trying to login using my openID since I created my account. Yes, I know HealthVault still sports the BETA tag, but implementing an openID authentication scheme should not be that hard. stackoverflow.com does it. Not impressed, yet.

However what impressed me is the responsiveness of the HealthVault team. I tweeted my issue and a few hours later, @HealthVault responded to my tweet and I got an email from a HealthVault team member requesting additional repro information and an assurance that the team will look into it. Great job folks!

Update: I figured out the bug. Here is what is happening. If you type in https://name.myopenid.com and click Sign In, you will redirected to the openID provider’s (myOpenId.com) site where you can authenticate. However, if you type in https://firstname.lastname.myopenid.com, you will receive the error shown in the screen shot above. My guess is, https://firstname.lastname.myopenid.com is being parsed and the extracted provider ID is lastname.myopenid.com and not myopenid.com and therefore results in a communication error because there no provider called lastname.myopenid.com. A simple parsing bug. Hope the HealthVault folks can fix it soon.

So the only alternative, at least for me, is to use Windows Live ID. My issue was, I had a weak password for my Windows Live account because I use it only to view MSDN Live meeting screen casts. The first order of business was to strengthen my Windows Live ID password. Once you successfully login, your home page will look like so

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There a host of tasks that can be completed. I’ll delve into each of the available tabs in future posts and also share my opinion. HealthVault is being billed as a consumer focused and consumer centric application. Let’s see if it truly holds up to the promise. Stay tuned.

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HiMSS Virtual Conference 2009 Day 1

Thanks to Cesar Torres (@HIMSS), I got a VIP invitation to the HiMSS Virtual Conference and Expo. If I were to use one word to describe the experience, it would be – AWESOME.

I have been to many conferences, mainly hosted by Microsoft, but this is my first time attending a Virtual Conference. And it was completely beyond expectations. This is what the main screen looks like. You can mouse over various venues and click to enter, say the Exhibit Hall, which hosted a few familiar and a few not so familiar vendors.

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Although I did not get a chance to attend any live presentation during the day because of work, I did “wander” around a few vendor booths and register for giveaways. These vendor booths are just like the physical booths at real conferences. You have the vendor staff on hand to answer any questions, you can browse the available literature, or participate in an open chat. Just like in the physical world, when you “walk-up-to” a booth someone will greet you. I was surprised not to see Microsoft or Google. Both are trying to market their consumer Health Records Management systems. Microsoft, probably, is getting ready for the Connected Health Conference. Next year?

The navigation links at the top guide you to the various sections and you can wander around to check out the action. Another neat feature is the Tote Bag. This is a one-stop collection of all “conference goodies”, articles, information brochures, white papers, podcasts and a host of things. All these can be downloaded.

The lounge is an interesting place. You can strike up conversations via the chat and expand your network. You can look up who is online using the Who’s Here link. Click on a name and you can drill down into additional information. Cool feature – Send VCard.

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Overall, I am very impressed by the sophistication of the event. I wish there were more vendors. Can’t wait for day 2. I hope I can find some time to attend a few live sessions I am interested in.


Accelerating EHR – Part 2

I am a fan of John Halamka, Mr.Healthcare CTO and hope to be able to become like him. In his recent blog post, Mr. Halamka talks about cloud computing and how cheap computers deriving their power from the cloud can help cut costs in the healthcare industry. In my previous blog post on Accelerating the adoption of EHRs (Electronic Health Records), I was kind of alluding to leveraging the power of “the cloud app” to speed up the adoption of EHRs. I wondered why a 3rd party vendor cannot build an interface to either Google Health or Microsoft HealthVault and give away such an application to primary care facilities. As was pointed out in the comment, McKesson’s Relay Health division, in fact, has been closely working with Microsoft in developing such an interface which will allow easy import of health records into HealthVault. This is a great first step. However what I proposed is something different.

Consider the diagram below. I have drawn it on a real napkin to emphasize the fact that this is a rough, grossly simplified draft of my understanding of the healthcare setup based on my interactions with various touch points.

HealthVaultBlogPost The typical “actors” here are, the individual, the primary care doc’s office, the dentist’s office, the big insurance companies and of course the Internet which connects everything. HealthVault is the new kid on the block.

You visit a doc for the first time and you have to fill out couple of sheets of paperwork with the same set of standard questions. If you move to a new practice, you do this all over again. Just remember not to write your SSN. The doc’s office does not need SSN. They are not paying you social security. All the information you handed over goes into a “system”. Each primary care facility or practice may have a proprietary system which hopefully is developed to a set of standards. I know we have HIPPA and other regulations pertaining to medical records, but my point is that, your information is fragmented among various systems.

The current set of solutions provided by Microsoft HealthVault or Google Health involve the following steps:

1. You, the individual, have to create an account (free) on HealthVault.

2. You have to fill in the standard set of questions and submit your information to the system. DISCLAIMER: I have not created an account on either system so I don’t know the exact set of questions/forms you need to answer or fill out.

3. You will have to authorize the pulling (or downloading) of your health records from various providers. Your insurance company, your primary care facility, and any other healthcare providers that you may have interfaced with.

And step 3 is where I see a problem and unless we redesign the workflow we will never be able to achieve the goal of EHRs for the majority of the population. The very fact that you the individual has to create an account on HealthVault or Google Health assumes that you have access to a computer and are fairly competent in the use of one. That is a whole lot less number of people than there are in the country. Of all the computer savvy folks only those who want to take control of their data will be able to pull information into HealthVault.

Although this is a great first step, I think, we should turn the idea around and sell HealthVault as a free data repository solution to primary healthcare centers where most of the data collection happens. The folks at these primary healthcare centers, have no choice but to maintain the data collected in some form. So why not just store all that information in HealthVault? Granted the health records are *your* records and *you* should be responsible for them, but currently you have no control or easy access to this data anyway. Shifting the responsibility of moving the data into the cloud from individuals to those who already are engaged in the activity will greatly accelerate the move toward EHRs. Imagine the cost savings. The various providers will not have to maintain proprietary systems. They can better deploy such funds toward developing competitive advantages and providing better services to beneficiaries. And your records will be in a central repository.

I know I have grossly simplified the processes but we have to start somewhere and let this, the shifting the responsibility of moving data into HealthVault, be the first step toward a giant leap in Healthcare reform. Just ping me if I can help in any way 😉


Accelerating the adoption of Electronic Health Records (EHR)

I picked up the book “The Future of Medicine Megatrends in Healthcare” by Stephen C. Schimpff from our local library, by chance. I can read too much into the coincidence given my interest in Healthcare in general and Healthcare IT in particular or just enjoy the fact that I relish reading anything and everything Healthcare. Let’s move on.

Healthcare as a system is a complex beast and most times players forget about the most important actor in this system. The patient. The human whose “issue” needs to be resolved. We have providers, insurers, benefits, plans, employers, lawyers, and law makers (and breakers). Most of these are working toward covering their behind. And in this complex dance, often times the beneficiary is forgotten or relegated to the back. This post is not about that.

Recently the Federal Health Architecture released the Connect system, an open-source scalable solution to help organizations tie Health IT Systems to NHIN (National Health Information Network). One of the key pushes of the current US administration is digitizing medical records so we can realize the dream of electronic health records (EHRs). Also, a while back, both  Google (Google Health)  and Microsoft (Health Vault) released their versions of consumer grade one stop Health records management system. I am not sure if this has hit widespread adoption. We are skeptical and are concerned about security and privacy issues.

And here is where, I think, a third independent player, say, McKesson, can come in and help move the adoption of electronic health records. How you ask. Where is the data collection happening? I would say, most, about 70% of the information, is collected at the primary care facilities that people go to for their routine illnesses and wellness checkups. So, instead of relying on the patient or people to put their data in the “cloud” (either Goggle Health or Microsoft Health Vault), McKesson can work with the primary care facilities and, give them a system that interfaces with both Google Health and Microsoft Health Vault and stores the data in both clouds. A double entry system. I said give. Yes give, like give away, free. Google Health and Microsoft Health Vault, I am sure, have API’s (Application Programming Interfaces) that lend themselves amenable to creating applications that encapsulate workflows of a typical primary care facility. So, McKesson can put together a high performance team to develop a software system, preferably a web application that can be installed on a single server. With McKesson’s reach in the Healthcare space (McKesson is *everywhere* in Healthcare), they can influence large numbers of these primary healthcare facilities to adopt their system. Throw in some free data migration consulting work too. What do the facilities have to lose? If a company like McKesson is giving your facility a complete system, why wouldn’t you take it?

What is McKesson gaining from all this? Remember McKesson is everywhere in Healthcare. They then make their big budget systems (say, Horizon HMS – Hospital Management System) consume the data from Google Health and Microsoft Health Vault clouds. Which could then be a leverage in the sale of such systems to the hospitals. Hey hospital, this many primary care facilities and doctor’s offices in your community use our other system which seamlessly interfaces with the HMS so you can concentrate on taking care of the patients and not worry about data import tasks. I say that is a big win.

I know I am making this sound simple. But, we have to start somewhere. Like the Micofinance movement to help alleviate poverty, an open source, free, patient healthcare records management system can drive the push toward electronic health records, lowering the healthcare costs significantly. Digitizing health records is a big first step and I think giving away free systems that leverage Google and Microsoft’s clouds is the way to go. Currently you and I don’t have any control over what software system, if any, a doctor’s office uses. We don’t even know if they have proper data security policies. I don’t think any doctor’s office will let you logon to system to check your records. If the Google and Microsoft clouds are used, we would have a ready made system in place for patients to check their records. What I am proposing is we shift the responsibility of feeding the system from the patient to the folks at the doc’s office who are already doing the work, except on numerous proprietary systems that may or may not talk to each other.

Anyone listening? Well, maybe I should get started on the project. Hey where are the API docs?