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How to Leverage the Microsoft Stack For Healthcare Innovation

Recently, I wrote about the best next moves in healthcare for Amazon, Apple, and Salesforce. A glaring omission in this series, though, is Microsoft.

I hesitated to write this one, in fact. In my 30-year career, I’ve only once been so ticked off at a company that I was willing to spend a weekend trying to figure out how to remove them from my organization. That company was Microsoft.

I’m going to chalk that one up to the Ballmer years and consider it in the past. Satya seems to be running a completely different company, so it’s worth a revisit..

In my last article, I noted the digital hurricane which is approaching healthcare providers. To address the coming storm, the providers will need to be agile in their business and data models. They’ll have to adopt and integrate new tech like AI, IOT, Blockchain, AR/VR, and machine learning into their operations. They also need to build digital channels to connect with and deliver personalized experiences to the emerging consumer in healthcare.

Now you know why healthcare CIOs may look a little stressed. Luckily, Microsoft can play the white knight here. (That’s about as sexy as you can get when talking about Microsoft.)

Let’s take a look at what I mean.

Transformative Technologies

I believe there are five disruptive technologies that will be applied to healthcare today or in the near future.  Briefly, they are:

Cloud: The ability to provision services via the web as needed, to deliver capabilities for an organization that would normally not be available if they had to be built internally. This provides healthcare organization agility. Think AI on demand.

Telemedicine: The ability to deliver medical services digitally across geographic boundaries. This enables new business models to enter healthcare.

Artificial Intelligence: The ability for machines to perform tasks that would normally require human intelligence. This enables healthcare to improve quality and reduce cost.

Augmented Reality: The ability to overlay information and images into reality, to assist in decision-making. This enables healthcare to reduce errors, improve efficiency, and engage consumers.

Internet of Things: The ability to collect information from every device associated with care. This enables healthcare to improve its reach and relevance in the daily health of the population.

Honorable mentions include Alternative Input (voice, gestures) and Blockchain. They’re at the bottom of the list not because they won’t have a dramatic impact, but because their timeline for disruption is less clear.

The Glaring Architecture Mistake of Healthcare

The EHR is the center of the clinical world, but it is not the center of a high-performing technology architecture. There are three reasons for this.

  1. The EHR was not designed to be a platform.
  2. A platform is required for extensibility and innovation.
  3. EHR company practices are designed to protect revenue, not encourage market innovation.

The EHR was designed to run a hospital or physician practice. At the time, it was not even a glimmer in their eye to build a platform for healthcare innovation.

A massive retrofit is underway to make the EHR look like a platform. Of course, though, that’s exactly what it is: a retrofit.  “We are adding API’s.” “We will make it a Comprehensive Medical Record.” “We are adding an app store.”  You get the picture — same low ceilings, just with new paint.

Social determinants of health account for 60% or more of health outcomes. The EHR tracks very few of these measures. In addition, the EHR doesn’t recognize someone until they become a patient, and that’s too late in the process for today’s emerging healthcare business model.

A platform allows for new data to be incorporated and innovation to begin immediately on that data. Today, EHRs are ill-equipped to handle this and the hundreds of other data sources that exist in healthcare.

You can’t out-innovate the market. There will be $4B spent on healthcare startups this year, and the first thing they will have to figure out is how to integrate into the current health technology stack. Many will fail before they even get started, even if their idea and funding are both good.

A platform has real APIs, security, and developer tools to foster external innovation. The lack of extensive APIs, an incomplete development partner platform, and the language that is utilized in EHR agreements all reflect a design to protect interests and hamstring market innovation.

For these reasons, the EHR is a piece of the architecture… but it will not be the center of an innovative health system. This is where Microsoft could enter the picture.

Microsoft’s Platform

“Microsoft Azure is the future of computing. It’s going to completely disrupt organizational IT strategies and the role of the CIO, in a good way.”  Dale Sanders – President of Technology for Health Catalyst 2015


In 100 words or less, as that’s all I have left:

Healthcare IT needs to move into working on higher-value, more strategic tasks for the organization. For this to happen, they need to leave behind those things which can be done more effectively by cloud providers, and move up the stack.

Certain processes are handled in the cloud better than they are onsite. These include cloud computing, storage, disaster recovery, networking, and identity. This is the case for all but a few health systems today.

Move it to the cloud. You already have a contract with Microsoft — just check the box and get going.

You need to start tracking your customers. While I still believe Dynamics is not nearly as robust as Salesforce, the ease of contracting and integration makes this a good place to start.

Now the place where Microsoft can break away: If a health system can move its data out of the EHR and into their cloud platform, and keep it synced, they will have the ability to truly break away.

Azure can integrate IoT data, consumer data, and many additional data sets. They can layer technologies on top to provide elastic search, transactional data stores for applications, and even machine learning and artificial intelligence. This may be the quickest path for many health systems to get the benefit of AI.

The ability to integrate additional data sources with a single identity cannot be minimized in our efforts to unleash the creative energy of the market on healthcare. Microsoft has the stack and offers the quickest path to breakout innovation for most health systems today.

If you know anyone at Microsoft, please forward this along. My hope in writing this is to elevate the capabilities of every health system in the country. The future of healthcare is bright; I would love to see us get there faster. 

Please follow me on Twitter @ThePatientsCIO, connect on LinkedIn, or reach out at [email protected] if you wish to discuss further. Thanks for reading.