A Special Presentation For:A Special Presentation For:

October 29, 2007Leesburg, Virginia

The Future of Healthcare Delivery The Future of Healthcare Delivery

5 Trends5 TrendsThat Will Shake That Will Shake the the WorldWorld

Bill Crounse, MDBill Crounse, MDWorldwide Health DirectorWorldwide Health DirectorMicrosoft CorporationMicrosoft Corporation

Significant Healthcare Industry ChallengesSignificant Healthcare Industry Challenges

IncreasingIncreasingRegulationRegulation

ss

Aging PopulationAging Population

Expensive TechnologyExpensive Technology

ReducedReducedReimbursementsReimbursements

Labor ShortagesLabor Shortages

Healthcare industry faces Healthcare industry faces myriad of regulationsmyriad of regulations

There is a shortage of trained There is a shortage of trained nurses and pharmacistsnurses and pharmacists

Rising expense of Rising expense of technology is technology is impacting costimpacting cost

Increased utilization of Increased utilization of healthcare serviceshealthcare services

HealthcareHealthcareIndustryIndustry

EMR AdoptionEMR Adoption

JustJust 25%25% among practices with 10 or among practices with 10 or more physiciansmore physicians

JustJust 15%15% among practices with 5 or among practices with 5 or fewer physiciansfewer physicians

The highThe high--tech plumbertech plumber

The Perfect Storm Is BrewingThe Perfect Storm Is Brewing

5 Trends5 Trends

Trend #1Trend #1

Increasing personal responsibility for Increasing personal responsibility for healthcare costshealthcare costs

Government spending constraintsGovernment spending constraints

Health Savings AccountsHealth Savings Accounts

Consumer Directed PlansConsumer Directed Plans

High deductibles & coHigh deductibles & co--payspays

MarketMarket--drivendriven

Comparison of Spending on Health

USA Today 9USA Today 9--1515--20052005Employee Health Plan CostsEmployee Health Plan Costs

$14,000 / year per family$14,000 / year per family

StarbucksStarbucksWill spend more on health insurance for Will spend more on health insurance for their employees than on coffee beans.their employees than on coffee beans.

This isnThis isn’’t sustainable!t sustainable!

Concern About Health CostsPercent of American adults who cite rising cost of healthcare as 1 of top 3 personal concerns: 2006 Roper Report

Healthcare is becomingHealthcare is becoming

consumerconsumer --centriccentric

Trend #2Trend #2

Commoditization of Medical ServicesCommoditization of Medical ServicesFurther expansion of OTC marketFurther expansion of OTC market

Retail medicine: The $40 Retail medicine: The $40 ““officeoffice”” visitvisit

Patient selfPatient self--serviceservice

Continued growth in Continued growth in ““alternativealternative”” carecare

OnOn--line consultations, eline consultations, e--health serviceshealth services

Retail Clinic Price Transparency

Organized Medicine RespondsOrganized Medicine Responds

AAP ISSUES POLICY OPPOSED TO RETAIL-BASED CLINICS

The American Academy of Pediatrics (AAP) has issued a new policy statement opposing the use of Retail-Based Clinics (RBCs) as a source of medical care for infants, children and adolescents. These clinics offer limited, lower-cost services at walk-in facilities that are often located in supermarkets, pharmacies and large retail stores.

Trend #3Trend #3

Commoditizing ProvidersCommoditizing Providers

More More parapara--professionalsprofessionals

Physician shortages Physician shortages

Concierge servicesConcierge services

MachineMachine--aided diagnosis aided diagnosis

The Next Crisis in CareThe Next Crisis in Care

Machine-Aided Diagnosis

Trend #4Trend #4

Information EverywhereInformation EverywhereConsumer empowermentConsumer empowerment

Cost & quality transparencyCost & quality transparency

Intelligent systems & toolsIntelligent systems & tools

Personalized medicinePersonalized medicine

Trends in e-Healthcare Services• On-line appointment scheduling

• Web messaging with physician and support staff

• Access to lab and radiology reports

• Prescription refills

• Reminders and “information therapy”

• Access to personal medical record

• Outcomes & disease management tools

• Ability to manage benefits on-line

Patient SelfPatient Self--ServiceService

CheckCheck--InIn

CoCo--PayPay

Consent FormsConsent Forms

Way FindingWay Finding

Physician Referral TrackingPhysician Referral Tracking

GlucoPhoneGlucoPhoneHealthPiaHealthPia / Verizon Cell Phone / / Verizon Cell Phone / GlucometerGlucometer

HealthGear Sleep Apnea MonitorHealthGear is a real-time wearable system for monitoring, visualizing and analyzing physiological signals. HealthGear consists of a set of non-invasive physiological sensors wirelessly connected via Bluetooth to a cell phone which stores, transmits and analyzes the physiological data, and presents it to the user in an intelligible way.

Trend #5Trend #5

Globalization of Healthcare ServicesGlobalization of Healthcare Services““The Healthcare World is FlatThe Healthcare World is Flat””

If it can be done virtually, it willIf it can be done virtually, it will

The rise of medical tourismThe rise of medical tourism

The Healthcare World is Flat TooThe Healthcare World is Flat Too

Medical TourismMedical Tourism

150,000 Americans sought elective medical care outside the US in 2006

1.5 Million people sought care in other countries in 2006

Launch a Video ConversationLaunch a Video Conversation

Hey Dr. Jordan!

Have time for a video chat?

5 Trends Summary5 Trends Summary

Increasing personal responsibilityIncreasing personal responsibility

““RetailizationRetailization””

Commoditization of providersCommoditization of providers

Information everywhereInformation everywhere

Globalization of healthcareGlobalization of healthcare

Health Future VisionHealth Future Vision

Remote Monitoring

Virtual Visit with Case Manager

Hospital Rounding

Medication Management

Locating Equipment

In-Patient Visit

Virtual Consultation

Retail Clinic Services

49Microsoft CorporationConfidential and Privileged 49

50Microsoft CorporationConfidential and Privileged

HealthVault is a way for individuals to collect, store, and share their health information

It is a shared data platform that allows multiple applications to work with a person’s health data to improve health management and outcomes

HealthVault is NOT a PHR

PHR

PHR Jr.

Fitness

Wellness

BMI

Chronic Condition

HealthVault Account

51Microsoft CorporationConfidential and Privileged

Design Principles of HealthVault

Free for Users and Developers

Inclusive of Industry

Standards

Privacy and Security Focused

HealthVault Connection Center

53Microsoft CorporationConfidential and Privileged

HealthVault Search

55Microsoft CorporationConfidential and Privileged 55Microsoft CorporationConfidential and Privileged

SAVETool that allows users to save and organize articles from various searches in one place (accessed via user name/password).

SAVETool that allows users to save and organize articles from various searches in one place (accessed via user name/password).

ACTAdvertising is served up based on the relevancy of the search, plus a desired call to action in the ad.

ACTAdvertising is served up based on the relevancy of the search, plus a desired call to action in the ad.

DISCOVERQuick links to refine results without doing a new search

DISCOVERQuick links to refine results without doing a new search

LEARNArticles from leading industry resources that are related to the user’s query

LEARNArticles from leading industry resources that are related to the user’s query

www.mscui.net

Commodity HIS SolutionsCommodity HIS Solutions

Hospital de São Sebastião

Labs Cardiology Procedure Documentation

Medication Administration

Hemodynamics CPOEPharmacy Dictation Medication Dispensing

PACS

Mobile Data ICU/Critical Care

Advanced Analytics

Contract Management

Claims Management

Revenue Management

Bed Management

Financial/ERP Enterprise Scheduling

Business Decision Support

Inventory

Registration Staff/Nurse Scheduling

Outcomes Management

Transcription

Electronic Medical Record

OR Management

Emergency Department

Image Distribution

Purchasing Access Management

Lots of different systems that don’t talk to each o therLegacy systems from 30 years ago attempting to comm unicate with newer systems that have been just installedA multitude of vendors

Nursing Workflow/

Documentation

Charting Clinical Notes

Pathology

Document Imaging

Medical Records Coding

Orders

Call Management

Physician Practice

Imaging

RIS

Labs Cardiology Procedure Documentation

Medication Administration

Hemodynamics CPOEPharmacy Dictation Medication Dispensing

PACS

Mobile Data ICU/Critical Care

Advanced Analytics

Contract Management

Claims Management

Revenue Management

Bed Management

Financial/ERP Enterprise Scheduling

Business Decision Support

Inventory

Registration Staff/Nurse Scheduling

Outcomes Management

Transcription

VIEWERS

Electronic Medical Record

OR Management

Emergency Department

Image Distribution

Purchasing Access Management

Azyxxi focuses on the key issue in medicine – instant access to dataAzyxxi adds a layer of extra value and intelligence to existing clinical and non-clinical systems by aggregating and unifying disparate data for comp rehensive management and analysisIt does not replace the EMR and other interactive s ystems because we currently do not support writing capabilities required for complex workflows and processes

Nursing Workflow/

Documentation

Charting Clinical Notes

Pathology

Document Imaging

Medical Records Coding

Orders

Call Management

Physician Practice

Imaging

RIS

FUNCTIONSDATA CORE

Azyxxi Client ViewerNavigation and function buttons

Filter

Sort

Timeframe

Data Scope

Info

Input

Forms

Details and values displayed in colmns

Name

Age/Sex

Date/Time In

Chief Complaint

Vital Signs

Past Medical History

Lab Results

Radiology Results

Medications Ordered

X-Ray Images

Dictations

CT Scan Images

A

B

C

D

E

F

G

1

2

3

4

5

6

7

8

9

10

11

12

Displays current patient count

Displays title of view

Details and values displayed in columns

Patients displayed in rows

Navigation and function buttons

A B

C D E F G

1 2 3 4 5 6 7 8 9 10 11 12

5 Trends Summary5 Trends Summary

Increasing personal responsibilityIncreasing personal responsibility

““RetailizationRetailization””

Commoditization of providersCommoditization of providers

Information everywhereInformation everywhere

Globalization of healthcareGlobalization of healthcare

5 Trends Impact5 Trends Impact�� Rising consumerism, and responseRising consumerism, and response

�� Cost and quality transparencyCost and quality transparency

�� New service locations, delivery modelsNew service locations, delivery models

�� Leaner operationsLeaner operations

�� Enabling technologiesEnabling technologies

�� KnowledgeKnowledge--driven insight to informationdriven insight to information

�� Advanced communication, collaborationAdvanced communication, collaboration

�� Global competition, eGlobal competition, e--health, selfhealth, self--serviceservice

Will Will You You Be Ready?Be Ready?

ResourcesResources

www.microsoft.com/healthcarewww.microsoft.com/healthcare

http://blogs/msdn.com/healthbloghttp://blogs/msdn.com/healthblog

www.mscui.netwww.mscui.net

www.azyxxi.comwww.azyxxi.com

www.live.health.comwww.live.health.com

www.healthvault.comwww.healthvault.com

© 2007 MICROSOFT CORPORATION. ALL RIGHTS RESERVED.THIS PRESENTATION IS FOR INFORMATIONAL PURPOSES ONL Y. MICROSOFT MAKES NO WARRANTIES, EXPRESS OR IMPLIE D, IN THIS SUMMARY.