This week, I spoke with Steve Shihadeh, vice president, Microsoft Health Solutions Group, about the software solutions offered to 
help hospitals view information and communicate for better patient medical care. This is a good opportunity to take a look at what can be accomplished and what the Amalga software systems from Microsoft have to offer, particularly with the economic stimulus bill recently being signed into law by President Obama.
Aggregating data with Amalga has the ability to integrate database information from dozens of different types of systems and bring the information to the computer screen in a user friendly format. In other words, aggregation presents a common ground where data can be merged and viewed quickly by health care individuals to deliver quality patient care. For example, this enables hospital “A” (with the appropriate security permissions) to access and view information that hospital “B” already has on file and vice versa, even if the two facilities are using two different systems of medical records documentation. A recent KLAS report indicated that Amalga is a major advancement in healthcare in defining, storing, accessing and viewing healthcare data. The press release from KLAS, whose focus is healthcare technology, can be read here.
The Microsoft Health Solutions group consists of over 500 individuals and the group was created in the year 2005.
The Interview:
First, I asked Steve about the real value and advantages of aggregating hospital data; is there any value in creating an entire new data base with comprehensive patient data?
To create an entirely new database that includes all data in one program would not only be almost prohibitive cost wise, but also time wise. Our system in the US is highly fragmented by comparison to the UK, which operates under a completely different business model, and we also have a much larger population here. We already have useful and good patient data that has been gathered over the last number of years from various systems, so the key approach here is to enable this existing data to exchange and communicate rather than to start from scratch by creating an entirely new system. This would be a major upheaval to “rip” out old systems and replace with “new” software across the US.
It is also advantageous to make better use of the software that a healthcare organization already has, as opposed to starting with something new by using communication “standards” such as HL7 and Continuity of Care Data formats. Recent testimonies from the US Senate demonstrate that Microsoft and other healthcare institutions as well as government agencies all concur.
What exactly does Amalga do? Is it a hospital records system or does the product lend itself to hospital aggregation of medical records only? 
There are two different parts to the Amalga system, and right now in the US the big emphasis is on aggregation services. For a hospital that is already established with an electronic system, the aggregation solution is desired and it uses current systems and data to communicate. The Amalga Hospital Information System is a complete “in house” solution for facilities that may not have a software system and rely on old paper methodologies, and the focus here is on countries outside of the US.
A client listing for Amalga and the services being utilized can be viewed here.
Within the US, St. Joseph Health System in Orange, California is using Amalga throughout their 14 hospitals. El Camino, in northern California, is another hospital that is working with Amalga. This solution makes sense for these organizations when you stop and think about the various numbers of systems in place, and how a physician currently has to sign on to access each one without a common interface that aggregates all the data together.
How does Amalga impact the emergency room? In other words, is this an area where patient care though better software can become a reality? I recently posted about the Wisconsin Health Information Exchange. Could you elaborate a little more on the value Amalga is offering here?
Emergency Rooms are the first point of entry for many patients and the value of the project has been recognized recently by Humana’s partnership with the WHIE. It really shows a great effort in creating better healthcare through information technologies. For instance, some of the hospitals in the network are somewhat competitive with services offered, but they have all realized the importance of having aggregated patient data in the long run to create better patient care. A patient’s tests recently performed at another hospital could be securely accessed by any hospital in the network, thus this saves repetitive tests, reduces medication errors, etc. as all the patient information is available.
Humana, an insurance carrier, is working with the unified intelligence system to advise patients of the most appropriate service that fits their needs. This is a way of directing patients to less costly facilities outside of the ER, such as a clinic or physician’s office, because the condition is not as severe.
What roles can or does Amalga play with research area? In addition to better patient care, does any of the collected data have use in other areas such as clinical trials?
The Moffitt Cancer Center in Tampa, Florida is one example of a hospital that is working with Amalga to collect patient data. Moffitt will deploy Microsoft Amalga to aggregate clinical, bio-specimen, research data and clinical images to allow the R&D staff to create scenarios to better ascertain possible treatment results ahead of time, again based on patient charts and outcomes already on file. The information can be queried and studied with one common information data base with Amalga, versus having to access many levels of data with several software programs. The goals here are to develop personalized cancer care and create clinical trials around evidence based information.
I understand Microsoft HealthVault is also part of the overall process, could you tell me a bit about HealthVault and how consumers can benefit? I keep a link on this site for anyone to visit the HealthVault site and just recently created a section for Personal Health Records on the blog. I recently set my 84 year old mother up with her account and have had quite a few questions of late, especially from seniors who are curious as to how this will help benefit the healthcare they receive.
HealthVault is an integrated solution on the patient or consumer side of Microsoft healthcare. The HealthVault group is working to bring
additional vendors and participants into the program, and HealthVault will continue to grow as more hospitals and vendors incorporate this program. HealthVault is working together with Scripps and Navigenics on a project that allows individuals to sign up for the pilot program and have their entire human genome sequenced. The results of the 20 year study will all be contained in HealthVault, and every participant in the program now has a HealthVault account established as part of the process.
“Co-sponsors of the study include Navigenics Inc. of Redwood Shores, Calif.; Affymetrix of Santa Clara, Calif.; and Microsoft Corp. of Redmond, Wash. Study participants age 18 and older can receive a scan of their genome and a detailed analysis of their genetic risk for more than 20 health conditions that may be changed by lifestyle, including diabetes, obesity, heart attack and some forms of cancer.”
I used this as an example of how vendors and programs are some of the key efforts in helping expand the HealthVault program. HealthVault uses health care industry communication standards to store and receive data, and as a part of the entire Amalga solution process, patients will have the ability to have credible medical data stored in their own personal health record and be able to share the information with physicians and other healthcare facilities.
Anyone can open a free HealthVault account at any time. With more medical devices connecting to the system, adding information is simplified because it is using a device that connects to a computer and automates the process, without having to type information. Aggregated patient data from Amalga will be able to populate the personal health records of Microsoft HealthVault.
Thank you Steve for taking a few minutes of your time today to help explain Amalga and how an aggregated data approach is the key to truly getting health records and information to communicate for all of us, as we are all somebody’s patient along the line. I learned a bit more about Amalga as well today!
Related Reading:
Sage resulted from the realization that the needs and potentials of clinical and molecular data to inform drug development are greater than the resources or capacity of any one company or institute. Sage is a legacy of successful proof of principle work accomplished at Rosetta Inpharmatics, a subsidiary of Merck & Co., Inc. in Seattle. Core human and intellectual property resources from this effort are seeding Sage’s growth.
genomics research to find out why. If this is known up front, it would save that population the risk of taking a drug that is not going to work for them. Thus far the FDA will not give approval for a drug to be used based on an individual’s genomes. This group is hoping to change some of this and work to create solutions for personalized medicine. 
collaboration with GC RRITS Sdn Bhd (GCR), a Malaysian company providing integrated information technology solutions to the healthcare industry. 