I came into this review with very high hopes, hopes that Microsoft, with its vast resources and market clout, would make a major splash in the rapidly evolving consumer health IT (HIT) market. I was thinking BIG. Big grand schemes, a monster of a Personal Health Record (PHR) solution that would provide all a consumer would ever wish for and solve all the ills that exist today in this very young market. Yes, I was quite Pollyannaish.
HealthVault didn’t even come close to what I imagined.
HealthVault is NOT an application. HealthVault is NOT a PHR. Instead, HealthVault is a Personal Health Platform (PHP), a platform upon which other applications may reside. And that distinction has created a lot of confusion for most in the media and even knowledgeable people in the HIT market (myself included). We all had assumed that Microsoft was announcing a long anticipated PHR and getting the jump on its major competitor, Google.
I received an in-depth briefing from Microsoft last week on exactly what is and is not HealthVault, what their strategy is and how that is reflected in the product. I have also spent some significant time on the HealthVault site and several partner sites that are listed on HealthVault. Here are my impressions.
One of the most powerful features of HealthVault is that as a platform, it allows for an ecosystem of consumer-centric applications to be made available wherein the consumer can pick and chose which applications are best suited to their specific needs for their personal health. It is nearly unlimited as to the possibilities of what types of personal health applications may be found in the future on HealthVault. Today, there are 16 partners up and running and Microsoft claims that there are over 40 total who have signed-up to participate in HealthVault.
As an ecosystem of applications all residing on the same platform HealthVault can, theoretically, insure a level of interoperability and data sharing across the applications, For example, a consumer may use the ActiveHealth PHR solution while their physician uses Allscripts EMR. Since both Allscripts and ActiveHealth are a part of HealthVault, a doctor could easily provide a patient their medical record to their ActiveHealth PHR through HealthVault. Of course there are a host of privacy issues that must be addressed, but it can be done.
Where this really gets interesting though, and what I believe is the most brilliant aspect of Microsoft’s HealthVault strategy, is when one starts coupling home-care medical devices to HealthVault thus enabling telemedicine. During the briefing, Microsoft gave a pretty slick example that combined the use of a blood pressure monitor with the American Heart Association’s (AHA) tracking and charting software and a physician’s EMR to show how a consumer could take scheduled, periodic blood pressure readings, have them automatically recorded (Bluetooth) into their computer and fed directly into their HealthVault, then charted into the AHA application and lastly, on a predefined schedule, automatically push that data into the patient’s electronic medical record (EMR) at their physician’s office for subsequent review and follow-up by their physician. Quite an impressive demo and ultimately, this may be the Trojan horse that gets medical practices to really begin adopting EMR software to better manage chronic care patients.
Microsoft has also made a very savvy move by focusing on the platform, rather than the application(s). In doing so, Microsoft has been able to elevate itself above the market fray, leaving that to others to battle it out in the trenches. This market is still extremely immature and no one is quite sure how the market will develop and coalesce in the coming years and which applications will experience broad acceptance in the market. By choosing to focus on the infrastructure, via a platform play, Microsoft is taking a path with much greater potential for success than just going out and trying to create another PHR, or some other consumer-centric, health application.
But the trick here for Microsoft will be to get those ISVs (independent software vendors) to configure their applications for HealthVault and insure that these ISVs comply with the main operating tenants of HealthVault for not only interoperability, but also privacy and security. Also, since HealthVault will enable a consumer to consolidate all of their personal health information into one central repository that they have complete control of, who ultimately has control of the consumer relationship? This is one of the BIG issues today in this market. Providers want it, employers want it, payers (insurance companies) want it, Microsoft wants it, other ISVs want it, but who gets the relationship in the end?
For example, one of HealthVault’s partners is ActiveHealth, a division of Aetna who is responsible for Aetna’s own PHR, ActivePHR, which is purportedly used by some 800,000 Aetna customers today. One of the nice features of ActivePHR is that Aetna automatically updates a customer’s PHR with claims data. Of course, should a customer decide to leave Aetna, they would also leave their ActivePHR behind as this PHR is tethered to their Aetna policy. Now the question becomes: If I am using ActivePHR and set-up a HealthVault account, can I then move all my data in ActivePHR, including Aetna claims data, to my HealthVault account? This is not just a question for tethered PHR’s such as ActiveHealth’s, but pertains to virtually any application and a consumer’s data that may reside both within HealthVault and on an ISV partner’s site. Who ultimately has control of the data and therefore how truly “portable” is a consumer’s HealthVault account and the data contained therein?
It is still early in the evolution of HealthVault. In fact so early, that Microsoft readily admitted to me that this announcement was more to get potential partners excited about the opportunity that HealthVault may present to them rather than an announcement for the consumer. It may also have been Microsoft’s intent to get a press release out quickly and get a jump on their competition down in Silicon Valley. What is apparent though is that the HealthVault platform today is far from ready for the general consumer.
I’ll go into much greater detail on that in my next post where I’ll talk about my own experiences with the HealthVault platform.
Well, I think the boys and girls in Redmond have made themselves a nice chicken-and-egg situation here. And you got the main point – why should I as a provider or payer relinquish control of the data to HealthVault? And until they do, why will we the patients/consumers care?
I think MSFT is missing the boat on this one. Platforms have succeeded in the mass market (Amazon, eBay) and vertical (Salesforce) spaces by first providing compelling features and then allowing others to hook into the platform, increasing its already obvious value. I don’t see how HealthVault is going to generate that initial, obvious value. It’s almost as though they said “PHRs? Yeah, we don’t know either…why don’t you guys figure it out. But just give us some money while you do.”
Your words are very well chosen:
“As an ecosystem of applications all residing on the same platform HealthVault can, theoretically, insure a level of interoperability and data sharing across the applications”
“Theoretically” is the operative word. My read here is that this describes what HV is STRIVING for for the future, rather than something that is doable today. I hope Microsoft will provide some clarity here about intent and timing.
I also am unclear about the level of INTEROPERABILITY and TRANSPORTABILITY that ActiveHealth and other application partners will strive for. It’s entirely possible that this will not be consistent across different partners, i.e., that different partners will want different levels of interoperabilty and transportabilty? Will Microsoft attempt to enforce any consistency here? If I’m an application partner, do I have the option of pulling data FROM HV but not necessarily putting back data INTO HV?
There are many details still to discern. Great post.
Two kinds of comments from the people I talk to: Positive and Negative
1. Healthvault is a big joke — a company like Microsoft should not rush out with a product or service in such poor quality. It is half baked and not really usable at this time. The feeling for this announcement is only for Microsoft marketing purpose and shows the immaturity and weakness of Microsoft plan in dealing with consumer health care issue.
2. Healthvault brought a great vision — whatever you see in this beta release is the beginning of a grand vision. It is a great leadership played by Microsoft to bring in many software and hardware companies together to serve the goal: consumer empowerment. With the resource (including talent) that Microsoft possesses and gaining idea from public comments, they are going to create another great opportunity in health care domain.
OPHRAH Health
James, Vince and OPHRAH,
First, thanks for commenting on this post. Now as for my response(s):
James, you are correct in that HealthVault today really does not provide inherent value in and of itself as compared to Salesforce.com, Amazon, etc., thus they are completely reliant on their partners and at this stage, it isn’t all that impressive. In my follow-up post to this one, took a hard look at HV and came to the conclusion that today, it is not ready for the consumer.
Vince, I to wonder about how portable one’s personal health data will be. For example, if you are an Aetna customer using ActiveHealth’s ActivePHR, will you be able to transfer all your data, including claims data provided by Aetna out to your HealthVault? Really unclear at this point in time and something I’ll need to follow-up on with Microsoft.
OPHRAH, Have heard similar comments as well, but what I really want to know is what are YOUR impressions of HealthVault?
Well, we for one will be modifying our software to work with Health Vault. It is true that most efforts to connect an EMR system to Health Vault will be time consuming and expensive. EMR systems are proprietary with each with minimal market share and do not want systems that allow a doctor to easily switch to a competitor. Our software, however, does not require permission from the EMR vendor and can connect to a new system in just a few days. Hopefully we can piggy back on the long coat tails of Microsoft. Check us out at EMRyStick.com.
Paul, your solution is NOT an EMR solution, it is a PHR solution. Quite a difference between these two wherein the former is used in a clinical setting and the latter by a consumer. Also, there are some major EMR players with significant market share (eg, Cerner, Allscripts, Epic, Eclipsys, Meditech, GE, Siemens, etc.) but do agree with you that no one has significant traction and thus market share in the nascent PHR market. Heck, sometimes its difficult to just get agreement on what a PHR is!