DIGITAL TRANSFORMATION IN HE ALTH

The Microsoft Cloud empowers organizations of

all sizes to re-envision the way they bring together
people, data, and processes that better engage
A New
patients and customers, empower care teams Model for
and employees, optimize clinical and operational
effectiveness, and digitally transform health. Healthcare

by Dr. Simon Kos,

Chief Medical Officer
Microsoft Coporation
 DIGITAL TRANSFORMATION IN HE ALTH 3

As a society, we need to continually

assess whether models invented
in the past still fit the needs of
today and can accommodate
the demands of tomorrow. The
industrial revolution, for example,
brought huge efficiencies to
manufacturing and dictated the
management and work practices
of an era: people laboring daily
in a centralized space during set
periods of time, filling rigidly-
defined roles in dedicated teams
to produce physical goods.
Ultimately, that way of doing things gave way to virtual
spaces, fluid roles, ad-hoc teams, and anytime work
that produces and consumes information. To thrive
in the digital age, we needed a new model.

The modern hospital system was the result of a

similar revolution that brought scale, organization,
and science to the practice of caring for the infirm.
 DIGITAL TRANSFORMATION IN HE ALTH 4

It was a great model to deal with infectious disease consult with a stroke professional via telecare to
and battlefield trauma, but our needs have changed. authorize urgent medical imaging, bypassing an
The overwhelming challenges of our modern health- Emergency Room assessment. By reducing the
care system include caring for our aging population, time from stroke to this essential diagnostic test
managing the rise in unhealthy lifestyles and chronic and approval to administer TPA, Brighton and Sussex
diseases, and ensuring continuity for patients as care University Hospital is not only saving costs and lives,
delivery becomes more specialized and fragmented. but also reducing disability. With the help of telehealth
Demand for health services has become overwhelm- technology, we have created a new model for
ing and cost pressures have intensified. Moreover, stroke care.
consumer expectations against the backdrop of a
society that has fundamentally changed through New models abound, as does clear evidence of
technology are higher than ever before. superior results:
We need a new model. • Virtual health allows us to increase access to care
for those isolated by age, mobility, or even just the
A case in point is how we manage acute stroke. When
constraints of their busy lifestyles.
treatment for survivors was limited to physical and
occupational therapy, the model of paramedic transfer • Remote monitoring can increase the fidelity of
to the Emergency Room for assessment, subsequent physiological data collected and decrease the
transfer to an inpatient ward for stabilization, followed latency to care team intervention.
by discharge and long-term rehabilitation made sense.
• Predictive analytics can drive down avoidable
The introduction of thrombolytic therapy, however,
readmissions or boost the detection of fraud in
meant we could dramatically reduce or even eliminate
medical claims.
the impact of occlusive stroke, if only we could
administer a medication like TPA within four hours. • Precision medicine allows us to tailor therapy
Meeting this narrow window of time required a according to individual patient genetic profiles,
redesigned process. improving efficacy.
In the UK, paramedics are empowered to screen for
stroke when they first encounter a patient. They can

• Population health upends our reactive “sick care”
model by getting in front of lifestyle risk factors,
improving wellness, and better managing chronic
disease before a crisis manifests.
• Patient engagement strategies improve patient
literacy and lift treatment compliance.
Collectively, these new approaches represent the future
of our healthcare system, and signal nothing short of a
healthcare revolution.
The common enabling factor across these innovative
models is cloud technology. As data volumes rise,
processing loads increase, and high order functions
like machine learning and artificial intelligence become
hallmarks of the system, cloud computing provides
unequaled solutions that are scalable, secure, and
affordable.
New models in healthcare: productivity in the cloud
Advocate Health Care, one of the largest hospital systems in Illinois
with 37,000 associates, radically changed its operations by moving
to Microsoft Office 365—the same service that billions of business
people, students, and consumers use every day. This investment in
commodity software helped Advocate save almost $54 million
USD over three years from gains in information worker
productivity alone. These savings in time and expense go into
improving care.
DIGITAL TRANSFORMATION IN HE ALTH 5
An outstanding example is work at the University of
Washington that applies the power and scale of cloud-
based machine learning to create a predictive model
for patients with heart failure. They use data collected
from the patient to feed a data model that continually
adapts based on incoming data from broader sources.
The algorithm helps clinicians risk stratify inpatients and
optimize a discharge time to minimize readmissions.
Not long ago, this kind of capability was inconceivable
monitoring of children with hypoplastic left heart
without a supercomputer, something inaccessible and
syndrome. By collecting information digitally—rather
unaffordable for the vast majority of health
than using a paper diary—and transmitting it to the care
organizations. Today, the power of a supercomputer is
available—on demand—at a commoditized price team in real time, they were able to maintain constant
point and compliant with stringent regulations around contact with families and intervene before deteriorations
data protections. became life-threatening. The result was a dramatic
reduction in mortality for interstage children, redefining
New models in healthcare: reducing fraud and waste the standard of care for this condition.
Reducing fraud and waste is essential for expanding the capacity Ordinarily, making a solution like this available to other
of an overburdened healthcare system. The Canadian company health organizations would be a complicated prospect.
CGI ProperPay has created a predictive analytics engine that can Because the application was written and deployed on the
detect potentially fraudulent claims. It then facilitates workflow to cloud, however, dissemination is no longer the limiting
help staff research and audit those claims, and if necessary, halt or
factor. Now the only thing that gates the pace of
recover payments. They have helped clients, such as the Medicare
adoption is how quickly the next site can adapt their
and Medicaid systems in the US, recover billions of dollars.
process and retrain their staff. This solution is going
national in the US, and its appeal has been global. And
The cloud totally changes our ability to scale and because the app is based on Windows and Azure, two
distribute health solutions. Children’s Mercy Hospital in widely used platforms, it can easily serve as a template
Kansas City, Missouri, knew they had a breakthrough for similar solutions to monitor larger patient populations,
when they introduced CHAMP, an application for home such as those suffering from heart failure or diabetes.

New models in healthcare: mobile health
For some people, getting fast, low-cost access to doctors is a big
barrier. Startup companies like MDLive in the US and Doctor2U in
Asia are creating new avenues to care with mobile platforms that
take advantage of communications platforms in the cloud. They
provide mobile apps that let people find available doctors and
schedule virtual appointments with them, which take place via voice
or video. This type of a service is a boon to people in rural areas.
The cloud also affords an opportunity to bootstrap the
progress of innovation and research. In digitizing the
DIGITAL TRANSFORMATION IN HE ALTH
world’s health data and storing it in an accessible
format, we can progress beyond small scale, limited-
geography, point-in-time studies to a future where
each data element captured expands our collective
wisdom and refines a living, breathing computer
model. Ethical secondary use of patient information,
appropriately de-identified and encrypted to preserve
privacy, can increase our understanding of rare diseases,
calibrate real-time drift of common chronic diseases, and
decrease the time to develop new pharmaceuticals.
6
New models in healthcare: machine reading
Cochrane is a not-for-profit organization that creates, publishes
and maintains systematic reviews of health care interventions,
with more than 37,000 contributors working in 130 countries. The
Cochrane Transform Project is using AI and machine learning to
text mine thousands of reports to automatically select ones to
include in systematic reviews. This saves weeks of monotonous
work, freeing up the expert reviewers to spend their time and
energy on high-level analysis.
The imperative to transform our entire healthcare
model to a more affordable, accessible, proactive,
patient-centered system is an urgent one. Cloud
technology provides platforms with new capabilities
that remove traditional constraints around cost,
compute power, storage, interoperability, maintenance,
flexibility, and agility. Leading health organizations
recognized the opportunity early, and have harnessed
cloud computing to create exemplars of new health
models. As fast followers also stand up cloud
solutions, the momentum is undeniable. Cloud
computing is not in itself the reason for change, but
it’s enabling change at an unprecedented, global
scale. It’s helping us design and deliver the next model
of healthcare for a future that is already here.
To explore more stories about innovation in health,
please visit Microsoft’s health industry site.

Benefits of cloud computing
Trust. Security is a big concern when it comes to cloud adoption.
Health data needs to be protected. The industry experts who
manage cloud data centers take physical, technical, and
operational measures to achieve and maintain security and privacy
so your organization can meet the compliance requirements of
regulators. They deploy the latest security patches as soon as
they’re available, so you get them automatically.
Speed. Traditionally, getting access to new or better tools, more
storage space, or more computing power has involved a lot of
waiting. This happens when IT has to get budget, purchase
hardware and/or software, and set it up before they can give you
what you need. With the cloud, it takes minutes instead of days,
weeks, or months, to get more storage space, compute cycles, or
updated software.
DIGITAL TRANSFORMATION IN HE ALTH
Scale. The cloud provides an almost infinite set of computing
resources, which is necessary for storing or processing massive
amounts of data. When you need more resources, you can scale
up instantly and automatically. When you need fewer resources,
you scale down instantly and automatically. In other words, you
get exactly what you need, when you need it—no more, no less.
Economics. Few organizations have the resources to set up
or manage very-largescale data centers. The cloud model, like a
utility, is pay-as-you-go. This way you never have to worry about
having fewer resources than you need, and your organization
never has to worry about paying for more than you’re using.
Choosing a cloud offering
Health organizations need cloud services that are not only
powerful, but also secure and compliant. Here is a short
checklist to consider when evaluating cloud offerings:
• Is it Enterprise-ready? Do the services it offers scale to large
organizations with many users or customers?
• Does it offer more than infrastructure, such as platforms
that support core functions for productivity,
communications, relationship management, and analytics,
so you can easily tailor solutions to meet your needs?
• Does it work with on-premises environments and with
technologies from multiple cloud providers and device
manufacturers?
• Does it have certifications to show it complies with
health security and privacy regulations in the countries
where you operate, so you can safely store and process
personal health information?
microsoft.com/health

© 2017 Microsoft Corporation. All rights reserved. This document is provided This document does not provide you with any legal rights to any intellectual

“as-is.” Information and views expressed in this document, including URL and property in any Microsoft product. You may copy and use this document for

other Internet Web site references, may change without notice. You bear the risk your internal, reference purposes. Microsoft and Windows are either registered

of using it. Some examples are for illustration only and are fictitious. No real trademarks of Microsoft Corporation in the United States and/or other countries.

association is intended or inferred.