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Originally published Monday, March 17, 2008 at 12:00 AM

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Brier Dudley

Microsoft's future vision

Imagine calling up your health data any time, any place. Microsoft already is hard at work to make that happen, along with other projects aimed at rebuilding society's infrastructure.

Seattle Times staff columnist

A few years from now, when you drive into a McDonald's parking lot, your dashboard computer will start beeping.

The computer is synced to your phone, and both devices have geographic location services. They know where you are and, based on your credit-card activity, they guess you're about to order another burger and supersized fries.

But because you've subscribed to Microsoft Personal Trainer 2015, a premium feature of the online health-management system you've been using since 2012, technology intervenes. The services are gathering information on your behalf, using a new software platform that began taking shape in 2008.

When your car stops moving, the phone projects your image on the windshield, similar to the way R2D2 played the holographic image of Princess Leia in "Star Wars."

On the windshield, you're looking chubbier than you do in the rear-view mirror, because the image shows what you'll look like if you keep eating this way.

Superimposed on the image is your current weight, the cholesterol reading from your last checkup and — highlighted in red — a notation that you haven't used your Web-connected treadmill for over a month.

The image flickers and zooms ahead two years, showing how you'll appear after gaining an extra 30 pounds and being diagnosed with diabetes. With the ka-ching sound of a slot machine, it starts calculating what will happen to your health and life-insurance premiums. Somewhere in the background, it sends an update to your physician.

The image on your windshield is more than virtual. It's reality, based on the medical imagery, health records and genetic profiling accumulated in your online medical-record repository.

All of those images are stitched together using Photosynth technology Microsoft acquired in 2006 when it purchased a Seattle imaging startup. The images and other records are stored and distributed by HealthVault, the health-information platform the company launched in October 2007.

HealthVault plugs into Amalga, the health-care-information platform Microsoft plans to launch this summer after testing by top-tier hospitals across the country.

The McDonald's scenario is a bit facetious, but that's how I visualize the direction Microsoft is heading with its software-plus-services strategy.

Why Yahoo?

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It also sheds light on why Microsoft is willing to spend nearly all of its cash on Yahoo — to give its Web search and online services like HealthVault the scale needed to attain critical mass — and why it's confident enough to keep hiring thousands of developers and building all those new buildings in Redmond and Bellevue.

Looking far ahead, this is no longer about protecting the Windows-Office desktop franchises.

The company's long-range goal is to rebuild society's infrastructure, to paraphrase Craig Mundie, Microsoft's chief research and strategy officer and Bill Gates' successor as the company's visionary.

The platform isn't on any particular computer, phone or Web site. It's more the webbing that ties them all together and the tools you'll use to manage your personal data.

Google and others are going after the same thing, and the building blocks are falling into place. It's starting with search, with systems that draw on personal medical information to tailor searches for information about health-related topics.

Just Wednesday, Aetna announced a program that lets its insurance customers tap their medical records to focus Web searches done on a special medical search engine powered by San Francisco-based HealthLine Networks.

Comfort factor

The biggest challenge may be getting people used to the new tools and comfortable with the information sharing.

"We'll have the technical capability in a relatively short time," Mundie said. "Like other things, we've learned that when you're changing the infrastructure of society, it doesn't happen overnight. You have to get the thing started and stick with it until it tips over and everybody realizes it's the way."

Within a few years, consumers will probably collect and store their medical records to help them make better decisions about their care and have more control over their personal information.

Doctors and hospitals will use better systems for accessing and using all of this data.

Once these foundations are in place and dramatically more powerful computers appear, it's not so far-fetched to think of ways this information will be used and displayed, keeping you informed of your health status as if you're a character in a video game.

The first step is developing better tools to manage and use the medical data that's already being collected.

At Microsoft, that's the task of Peter Neupert, vice president of the health-solutions group, who reports to Mundie.

Neupert joined Microsoft in 1987 but left in 1998 to become chief executive of Bellevue-based drugstore.com.

Before returning to Microsoft, he served as co-chairman of a presidential committee that examined ways information technology could improve health care. Among its recommendations were making disparate health-care systems work together.

Its advice also led President Bush to establish an objective that everyone should have an electronic health-care record by 2014.

Neupert sees health care as "fundamentally an information-management problem," where Microsoft can help by building systems that "make it easy to synthesize vast amounts of data that people are collecting in various environments."

He compares health care to the travel industry in around 1998, before it was revolutionized by online services that gave consumers more options and involvement in their travel planning.

Consumer impetus

The privacy implications are spooky, but Neupert said Microsoft's research has found people want their health-care providers to get into the Internet age, starting with online lab results and the ability to communicate with physicians.

"I think you'll see a progression — if we, online, deliver real value where value is better convenience, better safety, better results, make my life easier, they'll start to use it," he said.

Regulations about sharing medical information could be a challenge, and Microsoft will undoubtedly try to have a say in how those regulations evolve, but Neupert said the company designed its systems "to be operable and legal and successful in the current regulatory environment."

The "connected health environment" that Neupert describes gets more interesting when you think of how it could modernize the health-care payment system.

Today doctors are paid when patients are in their offices, but what if they were able to remotely keep tabs on the health of their patients and intervene (and get paid) when necessary?

"With the infrastructure, I think you can change the economics, and then it's a question of who gets the benefit," Neupert said.

Fertile ground

For Microsoft, the benefit will come from selling its Amalga enterprise software to hospitals and its tool kit to software developers and firms building services that run on its health-care platform.

HealthVault is free to consumers and doctors, and supported by advertising.

So when you're sitting there in McDonald's, perplexed about the messages flashing on your windshield, the system will display an advertisement for an organic juice bar across the street.

You can drive there, leave the phone in the glove box, walk back to McDonald's and pay cash for that burger.

Later, after your heart attack, paramedics will swipe your medical card through a reader to call up your HealthVault and see if you're allergic to any medications.

The hospital will be using Amalga to line up your bed and a defibrillator, and pull your records into a dossier for the emergency-room crew.

It will also sync up with your insurance company so the treatment is covered, as long as they don't notice the ketchup stains on your shirt and the receipt in your pocket.

Brier Dudley's column appears Mondays. Reach him at 206-515-5687 or bdudley@seattletimes.com.

Copyright © 2008 The Seattle Times Company

About Brier Dudley
Brier Dudley offers a critical look at technology and business issues affecting the Northwest.
bdudley@seattletimes.com | 206-515-5687

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