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Walgreens Boots Alliance and Microsoft establish strategic partnership to transform health care delivery

Companies aim to improve health outcomes and lower overall costs with enhanced digital and retail experiences and an R&D commitment to build health care solutions through seven-year agreement

Stefano Pessina, executive vice chairman and chief executive officer of WBA, and Microsoft CEO Satya Nadella
Stefano Pessina, executive vice chairman and chief executive officer of WBA (left), and Microsoft CEO Satya Nadella.

DEERFIELD, Ill., and REDMOND, Wash. — Jan. 15, 2019 Walgreens Boots Alliance Inc. (WBA) and Microsoft Corp. have joined forces to develop new health care delivery models, technology and retail innovations to advance and improve the future of health care. The companies will combine the power of Microsoft Azure, Microsoft’s cloud and AI platform, health care investments, and new retail solutions with WBA’s customer reach, convenient locations, outpatient health care services and industry expertise to make health care delivery more personal, affordable and accessible for people around the world.

Logos for Walgreens Boots Alliance and Microsoft

Current health care systems are a complex combination of public- and private-sector organizations, providers, payors, pharmaceutical companies and other adjacent players. While there has been innovation in pockets of health care, there is both a need and an opportunity to fully integrate the system, ultimately making health care more convenient to people through data-driven insights. This is what brought WBA and Microsoft together. Through this strategic partnership, the companies will deliver innovative platforms that enable next-generation health networks, integrated digital-physical experiences and care management solutions.

“Improving health outcomes while lowering the cost of care is a complex challenge that requires broad collaboration and strong partnership between the health care and tech industries,” said Satya Nadella, CEO, Microsoft. “Together with Walgreens Boots Alliance, we aim to deliver on this promise by putting people at the center of their health and wellness, combining the power of the Azure cloud and AI technology and Microsoft 365 with Walgreens Boots Alliance’s deep expertise and commitment to helping communities around the world lead healthier and happier lives.”

As part of the strategic partnership, the companies have committed to a multiyear research and development (R&D) investment to build health care solutions, improve health outcomes and lower the cost of care. This investment will include funding, subject-matter experts, technology and tools. The companies will also explore the potential to establish joint innovation centers in key markets. Additionally, in 2019 WBA will pilot up to 12 store-in-store “digital health corners” aimed at the merchandising and sale of select health care-related hardware and devices.

“Our strategic partnership with Microsoft demonstrates our strong commitment to creating integrated, next-generation, digitally enabled health care delivery solutions for our customers, transforming our stores into modern neighborhood health destinations and expanding customer offerings,” said Stefano Pessina, executive vice chairman and chief executive officer of WBA. “WBA will work with Microsoft to harness the information that exists between payors and health care providers to leverage, in the interest of patients and with their consent, our extraordinary network of accessible and convenient locations to deliver new innovations, greater value and better health outcomes in health care systems across the world.”

Connected, consumer-centric health care delivery and management platform

The companies will focus on connecting WBA stores and health information systems to people wherever they are through their digital devices. This will allow people to access health care services, such as virtual care — when, where and how they need it.

The integration of information will enable valuable insights based on data science and artificial intelligence (AI) that can allow for fundamental improvements such as supporting the transition of health care data into more community-based locations and sustainable transformation in health care delivery.

Working with patients’ health care providers, the companies will proactively engage their patients to improve medication adherence, reduce emergency room visits and decrease hospital readmissions. Core to this model is data privacy, security and consent, which will be fundamental design principles, underscored by Microsoft’s investments in building a trusted cloud platform.

By better connecting people, providers and the systems in which they work, the industry will be able to provide better quality patient care.

Personalized health care services

WBA and Microsoft will also focus on enabling more personalized health care experiences from preventative self-care to chronic disease management. WBA will pursue lifestyle management solutions in areas such as nutrition and wellness via customers’ delivery method of choice, including digital devices and digital applications or in-store expert advice.

Through a combination of dedicated R&D and external partnerships, a suite of chronic disease management and patient engagement applications are planned for development, alongside a portfolio of connected Internet of Things (IoT) devices for nonacute chronic care management, delivered by Microsoft’s cloud, AI and IoT technologies.

Collaborating with payors, providers and pharmaceutical manufacturers to implement solutions to improve health outcomes at lower cost

Additionally, the companies will work to build a seamless ecosystem of participating organizations to better connect consumers, providers — including Walgreens and Boots pharmacists — pharmaceutical manufacturers and payors. Microsoft and WBA will leverage each other’s market research and identify the right partners to develop solutions.

For example, major health care delivery network participation will provide the opportunity for people to seamlessly engage in WBA health care solutions and acute care providers all within a single platform.

WBA to transition its IT platforms to Microsoft

Through this agreement, Microsoft becomes WBA’s strategic cloud provider, and WBA plans to migrate the majority of the company’s IT infrastructure onto Microsoft Azure. This will include new transformational platforms in retail, pharmacy and business services, new capability in data and analytics, as well as certain legacy applications and systems. The company also plans to roll out Microsoft 365 to more than 380,000 employees and stores globally, empowering them with the tools for increased productivity, advanced security, internal collaboration and customer engagement.

WBA’s transition to Microsoft’s platform will enable WBA to accelerate its speed to market, gain deeper customer understanding and insights, and ultimately provide better and more personalized care, products and services to its customers and communities. In addition, the move to Microsoft Azure accelerates the modernization and cost effectiveness of technology across WBA.

About Walgreens Boots Alliance

Walgreens Boots Alliance (Nasdaq: WBA) is the first global pharmacy-led, health and wellbeing enterprise and the largest retail pharmacy, health and daily living destination across the U.S. and Europe. Walgreens Boots Alliance and the companies in which it has equity method investments together have a presence in more than 25 countries and employ more than 415,000 people.

The company’s portfolio of retail and business brands includes Walgreens, Duane Reade, Boots and Alliance Healthcare, as well as increasingly global health and beauty product brands, such as No7, Soap & Glory, Liz Earle, Sleek MakeUP and Botanics.

Walgreens Boots Alliance is proud to be a force for good, leveraging many decades of experience and its international scale, to care for people and the planet through numerous social responsibility and sustainability initiatives that have an impact on the health and wellbeing of millions of people.

More company information is available at www.walgreensbootsalliance.com.

About Microsoft

Microsoft (Nasdaq “MSFT” @microsoft) enables digital transformation for the era of an intelligent cloud and an intelligent edge. Its mission is to empower every person and every organization on the planet to achieve more.

All statements in this release that are not historical are forward-looking statements made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. These forward-looking statements are not guarantees of future performance and involve risks, assumptions and uncertainties, including, but not limited to, those related to the timing and effectiveness of collaboration plans, the ability to realize the anticipated benefits of the collaboration, competitive actions in the marketplace, and the ability to achieve anticipated financial and operating results in the amounts and at the times anticipated, as well as those described in Item 1A (Risk Factors) of Walgreens Boots Alliance, Inc.’s Form 10-K for its fiscal year ended August 31, 2018, Microsoft Corporation’s Form 10-K for its fiscal year ended June 30, 2018 and subsequent documents that Walgreens Boots Alliance, Inc. and Microsoft Corporation file or furnish with the Securities and Exchange Commission. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially. These forward-looking statements speak only as of the date they are made. Except to the extent required by law, each of Walgreens Boots Alliance, Inc. and Microsoft Corporation does not undertake, and expressly disclaims, any duty or obligation to update publicly any forward-looking statement after the date of this release, whether as a result of new information, future events, changes in assumptions or otherwise.

For more information, press only:

Microsoft Media Relations, WE Communications for Microsoft, (425) 638-7777
rrt@we-worldwide.com

Walgreens Boots Alliance Media Relations, Jim Cohn, (224) 565-1967, jim.cohn@walgreens.com

Walgreens Boots Alliance Investors: Gerald Gradwell, Jay Spitzer, (847) 315-2922

Note to editors: For more information, news and perspectives from Microsoft, please visit the Microsoft News Center at http://news.microsoft.com. Web links, telephone numbers and titles were correct at time of publication, but may have changed. For additional assistance, journalists and analysts may contact Microsoft’s Rapid Response Team or other appropriate contacts listed at http://news.microsoft.com/microsoft-public-relations-contacts.

 

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Curing diseases and delivering effective treatments with the cloud

Researchers trying to cure some of the world’s least-understood diseases, such as Alzheimer’s and Parkinson’s, are discovering new and exciting opportunities in the cloud. With the ability to instantly access vast amounts of computing power, and without the burden of large initial investments or ongoing costs, cloud technology is making it easier for healthcare organizations to study complex disorders and develop innovative new treatments. This is helping lead to an era of more precise and effective medicine.

Although the healthcare industry has used distributed computing networks to tackle large-scale health challenges before—such as the Folding@Home project, which allows individual PC users to contribute unused computing cycles to study how protein misfolding can lead to disease—there are a number of benefits to using a modern cloud computing solution. Cloud-based artificial intelligence (AI) and machine learning (ML) tools, for example, are helping healthcare organizations become more efficient and medical researchers develop better treatments for diseases.

Here are a few ways the cloud is powering healthcare research that’s leading to new cures, while also making the industry more efficient and secure.

Curing Alzheimer’s and Parkinson’s using the cloud

Together, Alzheimer’s and Parkinson’s afflict over 50 million people worldwide. Although the complexity of these disease processes has made finding cures elusive, the cloud’s ability to effortlessly scale resources and instantly tap into significant amounts of computing power is helping researchers gain a better understanding of these diseases faster.

One example: Researchers have built a comprehensive digital model of the human neurological system at comparatively low cost through quicker, on-demand access to high-performance technology stacks. Biotech startup NeuroInitiative uses virtualized GPUs in the cloud to create a general model of the nervous system, a strategy that has proved 40 times faster than using physical GPUs. “The need for lots of GPUs in a pay-as-you-go, easy-to-use model led us to the cloud from day one,” said Andy Lee, co-founder of NeuroInitiative. “We can spin up a 100,000-core cluster in minutes and stop paying for it after experiments finish.”

Using this technology, researchers have been able to simulate a variety of different treatments for neurological diseases. NeuroInitiative alone has identified more than 25 promising drug targets for Parkinson’s. They’ll be ready for human clinical trials in two to three years—half the time it typically takes for preclinical work.

Speeding up treatments with AI and ML

As more healthcare organizations embrace digital technology, they are dealing with increasing volumes of data, which must be quickly processed and analyzed in order to be meaningful. This is just the sort of work cloud-based AI and ML tools are designed to do. Just like on-premises AI and ML systems, these cloud-based tools can help humans handle routine and time-consuming tasks with unmatched speed and accuracy. Plus, these tools don’t require any special knowledge or equipment to set up, making data processing more cost-effective.

However, there’s more to be saved than money. When it comes to the development and distribution of new treatments, fast data analysis can also help combat diseases and save lives. Genomics researchers at the Icahn School of Medicine at Mount Sinai, for example, needed a way to analyze and sequence large sets of genomic data with a limited set of resources. Using cloud-based AI tools from Microsoft Genomics, as well as Azure Data Lake Analytics, they were able to download their data, and then use AI to quickly process and archive it. “The tool can uniformly realign everything and let me do the variant calling for the analysis I want,” said Dr. Robert Klein, head of the Klein Lab at the Icahn School. They are scaling up their research as a result.

Likewise, Intelligent Retinal Imaging Systems (IRIS) wanted to build a platform that could detect diabetic retinopathy, a form of vision loss that can develop rapidly. To help make tests more accessible, they designed a system doctors can use to quickly analyze images of retinas and detect anomalies using ML algorithms. All doctors have to do is send a retinal image to IRIS, which then processes it using Azure Service Bus and Azure Machine Learning Package for Computer Vision. Within 24 hours, doctors receive an enhanced image back with anomalies identified, making it easy for them to give a final diagnosis. “We went from zero to 300,000 patients examined in under five years,” said Jonathan Stevenson, chief strategy and information officer at IRIS. “There is no way we could have done that without Azure.”

Automatically securing healthcare data

Privacy and security have long been concerns in healthcare, and they’ve taken on a much larger significance with the digitization of the industry. Organizations that want to modernize their operations without sacrificing security can use the cloud as an alternative to siloing all their patient records on site.

One of the most effective ways to do this is by choosing a cloud solution that comes with HIPAA and HITRUST compliance. Instead of having to worry about properly storing, accessing, and analyzing sensitive health data, an organization can simply transfer patient information to their cloud, where it will automatically adhere to secure data regulations. Another layer of protection is to use cloud services that emphasize security from the ground up. This includes introducing security elements at every phase, from the initial hardware components to the final transfer of information.

Cloud technology means better treatments are on the way for some of humanity’s most difficult diseases. By giving researchers easy and scalable access to computing resources, cloud technology is helping to reduce the time it takes to test hypotheses, increase the iteration of promising ideas and treatment methods, and develop new cures. It’s also allowing healthcare organizations to modernize without neglecting security. All this is helping to make medicine more effective, accessible, and timely. For doctors, researchers, and patients, the future of healthcare is in the cloud.

To stay up to date on the latest news about Microsoft’s work in the cloud, bookmark this blog and follow us on TwitterFacebook and LinkedIn.

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How Narayana Health uses data analytics and AI to provide affordable, high-quality healthcare

Making healthcare affordable for patients

The ability to visualize data from across the group opened new avenues to ensure patients get the best care possible at the most affordable prices. The team at Narayana Health is now unlocking insights from historic data as well as data generated in real-time to optimize costs from the perspective of both patients and business goals.

Faster lab turn-around times: One team looked at how they could minimize the visits a patient has to make to the hospital by ensuring they get their lab test reports on the same day. Using Power BI, they were able to compare the performance of different labs across the network and identify roadblocks as well as best practices. They implemented changes in the clinical processes at one of the units and noticed a 60 percent improvement and close to 95 percent of lab tests were turned around in less than two hours. In many cases, this meant that a patient could consult a doctor, get tests done, and get diagnosis done by the doctor on the same day.

Monitoring consumables and antibiotic use: A Power BI dashboard provides insights about the consumables used by doctors for different surgeries. Thanks to this, the management team has been able to establish an average of consumables used for any kind of surgery and can quickly identify trends and cases of even slightly higher usage, which can impact the cost incurred to the patient.

Another parameter monitored is the administration of antibiotics by doctors. This is an important aspect of patient care to ensure that the antibiotics usage is within the limits prescribed by the internal policy at the hospital, which in turn is aligned to WHO standard recommendations. With this, they can quickly identify any aberration and rectify it across the group.

Predicting blood requirement: Thanks to data being available in the system in real-time, hospitals are now able to predict blood requirements on any given day. This has led to optimal stocking and reducing wastage of blood, which is a critical and scarce component.

Reducing the time spent by patients in the ICU: Narayana Health runs one of the world’s busiest cardiac programs and the world’s largest pediatric cardiac care facility. A constant challenge at the organization is to optimize throughput to match the demand of patients with the limited manpower, assets, and capacity available. With real-time analytics they can monitor patients in the ICU and are able to identify any outliers, who have a longer than average duration of stay for any given surgery. This also allows them to identify any bottlenecks and reduce the patient wait time and stay at the hospital.

Better prediction of surgery costs: All this data analysis eventually circles back to Narayana Health’s core mission of providing affordable, high-tech healthcare. Before the implementation of data analytics, the quotes were updated periodically. Now, they can formulate a very narrow band of the expected cost of a treatment, based on multi-year data of the relevant procedures and costs.

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Microsoft unveils genomics innovation and new partners at ASHG 2018

The world’s leading geneticists will converge in San Diego October 16-20 for the American Society of Human Genetics (ASHG) Annual Meeting. This year’s event will showcase some amazing new advances in genomics, and Microsoft Genomics will have exciting news and updates to share.

The latest in genome analysis

The strength of any analytical insight will always depend on the strength of the data used to generate it. If you want to perform repeatable genomic analysis that generates durable datasets, you should rely on industry standards that are constantly validated, versioned and properly curated.

With that in mind, Microsoft is deepening its commitment to genomics with the fourth iteration of the open source Genome Analysis Toolkit (GATK4). The toolkit update is designed to optimize performance for researchers as they strengthen data pipelines and power successful genomic analyses, so they can reduce the risk of noise or artifacts within the data set and extract more insight from the genome.

A growing partner network

To ensure that genomics researchers have access to a broad array of tertiary analysis and orchestrated cloud technology options, Microsoft is working with several new partners:  BizData, Eagle Genomics, Genoox, Gentera Biotechnology, L7 Informatics, Parabricks, Qiagen and Veritas Genetics. They will be with us at ASHG 2018, sharing their insights and demonstrating how their data tools and services will help broaden and deepen what researchers can achieve in genomics. We continue to expand our genomics partner ecosystem, with now more than 20 partners, from wet lab sequencing prep out to interpretation.

“We are very excited to partner with Microsoft Genomics and utilize Whole Genome Sequencing and the Arvados platform to answer the most interesting and difficult questions in genomics.” notes Ward Vandewege, Veritas’ VP of Engineering,  “Running on Microsoft Azure, we can demonstrate the possibilities of genomic analyses at scale by taking advantage of Veritas’ sequencing capabilities and Arvados’ open-source federated platform bringing the analyses to data.”

Anthony Finbow, CEO of Eagle Genomics commented: “We are delighted to partner with Microsoft Healthcare on its Genomics service and look forward to working together to unlock the potential of the microbiome and solve some of the grand challenges of our age. We are seeing strong demand for our knowledge discovery platform amongst enterprise customers in the biotech and pharma, food and personal care industries as they embrace the digital reinvention of Life Sciences R&D. Microsoft Genomics will help tackle the computing and scaling challenges, accelerating the adoption of the technologies and the launch of new products and therapies, heralding a new era in scientific discovery.”

A promising research study at The Icahn School of Medicine at Mount Sinai

Dr. Robert Klein from the Klein Lab at the Icahn School of Medicine at Mount Sinai is leading a team of bioinformaticians and geneticists seeking evidence for how our genes are involved in cancer risks, assisted by new technologies and the cloud to analyze the largest “big data” sets.

The Mount Sinai research team had been successful in gene sequencing, but they were starting to run into a bottleneck. “We weren’t getting enough space on the computer to store the data as we’re downloading it, running it, and working with it,” Dr. Klein said. “The data was just getting too big.”

With the Microsoft Genomics service, Dr. Klein added, “I give it the input data that would come from the sequencers, it can uniformly realign everything and let me do the joint calling for the analysis I want.” Microsoft Genomics enables “a way to try the large re-analysis of whole genome sequencing data.”

A powerful new way to analyze long-read bio data

In what’s likely to be our most exciting development at the event, we plan to demonstrate a completely new method for analyzing long-read genomic data and capturing major structural rearrangements.

Through collaborative research with Stanford University, we’ve developed a powerful new genomics algorithm that runs on an Intel Altera field-programmable gate array (FPGA) infrastructure within Microsoft Azure. It is an entirely new way of utilizing and understanding long-read genetic data, and will also be one of the first public-facing services based on FPGAs—the same board-level architecture that underpins the incredible machine learning capabilities of Microsoft Project Brainwave.

This revolutionary genomics service will make it easier for researchers to build and complete a whole new set of explorations using long-read data in the cloud. We can’t wait to see what the genetics community makes of it and hear how you plan to apply these powerful new capabilities when the service formally launches.

An exciting genomics success

At last year’s ASHG annual meeting, we presented a summary of how Microsoft Genomics was supporting collaborative pediatric cancer research at St. Jude Children’s Research Hospital.

This year, Microsoft and St. Jude are pleased to share early global adoption of the hospital’s global data sharing and research initiative. The St. Jude Cloud is using Microsoft cloud technology to successfully deliver pediatric cancer data to more than 2,000 clinicians and researchers among 300 organizations in 28 countries. St. Jude is using collaborative research in the cloud to make the genome more actionable, and it’s taking powerful steps forward in the understanding and treatment of pediatric cancer.

What the future holds

At ASHG, you can hear a poster presentation from Microsoft data scientist Erdal Cosgun, Ph.D. on research he conducted with his intern Min Oh. They explored the consistency of the quality scores with machine learning for next-generation sequencing experiments. He will present a machine learning approach for estimating quality scores of variant calls derived from BWA+GATK best practice powered by the Microsoft Genomics service.

You can also try out our Public Preview of Microsoft Genomics service GATK4. Between now and December 31, 2018, bring your Azure account and 20 whole genome samples to run with Microsoft Genomic Service at no cost. Let us know if you need to open a free trial Azure account and we can help you get started.

Stop by Microsoft Genomics at ASHG 2018 and find out more how we’re making deep genomic analysis easier and more accessible.

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CAE’s training simulators make us safer – from the hospitals to the heavens

The birth was seconds away. The mother rested on her back while a medical student sat at the foot of the bed, blue surgical gloves on her hands – a scene common to delivery rooms everywhere. Except the mom was a manikin, her fetus was a manikin and the student wore Microsoft HoloLens.

Using the device, the student looked at the mother’s abdomen and saw a hologram of the fetus inside the womb before it rotated and descended the birth canal. Then, her mixed-reality training session got tricky.

Suddenly, the baby’s shoulders became stuck inside the mother, a risky complication – but an emergency purposely triggered by a classroom instructor. The student had to act fast. She placed her hands on the tiny manikin and gently freed the shoulders, safely completing another digital delivery.

CAE LucinaAR – the first human-patient simulator augmented with HoloLens – simultaneously delivered another digital lesson. The technology comes from CAE, a Canadian company that offers virtual-to-live training solutions to assess human performance, improving overall safety from health care to civil aviation to defense operations.

A medical student practices delivering a baby with the use of a virtual-to-live patient simulator and Hololens.
A medical student practices delivering a baby with CAE LucinaAR and HoloLens.

“CAE operates in three sectors where the stakes are high, where there’s no room for error and where the people need to be properly trained to be ready for unlikely situations that could lead to catastrophes,” says Dr. Robert Amyot, president of CAE Healthcare, one of CAE’s three business segments.

“On-the-job training is dangerous and costly,” adds Amyot, a cardiologist by trade. “So, we train pilots to make flying safer. We train the forces in our defense and security division to make them more prepared for their missions. And we train clinicians and health care providers to improve patient safety.”

By going digital, each of those training regimens is becoming more precise at pegging and addressing human vulnerabilities, says Marc Parent, the CEO at CAE.

In the realm of aviation, CAE guides pilots to prep for potential airborne adversities by using individualized simulations built with artificial intelligence and the Internet of Things (IoT).

A new pilot trains on a CAE flight simulator.
A new pilot trains on a CAE flight simulator.

“Although it’s the safest mode of transportation in the world, pilots have long been assessed in a subjective way,” Parent says. “But now, by leveraging the data that our simulators are giving us – powered by the cloud – we can give them an objective assessment in real time. That’s invaluable.

“When the pilots go into our simulator, we are able to give them personalized insights into their skills, into how they perform different operational practices. This raises their level,” Parent says. “And practice makes perfect.”

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Microsoft, Amazon, Google, IBM, Oracle and Salesforce issue joint statement for healthcare interoperability

Photo credit: ITI
Pictured, L-R: Dean Garfield (ITI) – Alec Chalmers (Amazon) – Mark Dudman (IBM) – Peter Lee (Microsoft) –– Greg Moore (Google)

Interoperability is an overlapping set of technical and policy challenges, from data access to common data models to information exchange to workflow integration – and these challenges often pose a barrier to healthcare innovation. Microsoft has been engaged for many years on developing best practices for interoperability across industries. Today, as health IT community leaders get together at the CMS Blue Button 2.0 Developer Conference here in Washington, DC, we’re pleased to announce that Microsoft has joined with Amazon, Google, IBM, Oracle, and Salesforce in support of healthcare interoperability with the following statement:

We are jointly committed to removing barriers for the adoption of technologies for healthcare interoperability, particularly those that are enabled through the cloud and AI. We share the common quest to unlock the potential in healthcare data, to deliver better outcomes at lower costs.

In engaging in this dialogue, we start from these foundational assumptions:

  • The frictionless exchange of healthcare data, with appropriate permissions and controls, will lead to better patient care, higher user satisfaction, and lower costs across the entire health ecosystem. 
  • Healthcare data interoperability, to be successful, must account for the needs of all global stakeholders, empowering patients, healthcare providers, payers, app developers, device and pharmaceuticals manufacturers, employers, researchers, citizen scientists, and many others who will develop, test, refine, and scale the deployment of new tools and services. 
  • Open standards, open specifications, and open source tools are essential to facilitate frictionless data exchange. This requires a variety of technical strategies and ongoing collaboration for the industry to converge and embrace emerging standards for healthcare data interoperability, such as HL7 FHIR and the Argonaut Project. 
  • We understand that achieving frictionless health data exchange is an ongoing process, and we commit to actively engaging among open source and open standards communities for the development of healthcare standards, and conformity assessment to foster agility to account for the accelerated pace of innovation. 

Together, we believe that a robust industry dialogue about healthcare interoperability needs will advance this cause, and hence are pleased to issue this joint statement.

While I’m new here at Microsoft, I’ve been focused over the past decade on lowering the barriers to innovation in healthcare, working closely with open source and standards development communities. I’m happy that my first blog post here at Microsoft aligns so well with my charter to collaborate on open cloud architecture with the healthcare community.

Electronic Health Records (EHRs) are approaching universal adoption in US hospitals and ambulatory practices, thanks in part to the Centers for Medicare and Medicaid Services (CMS) Electronic Health Record (EHR) Incentive Programs. The 21st Century Cures Act will make digital health data even more accessible with the call for open APIs.

In the context of US healthcare, many health record systems have focused on consistent representation for a key set of data elements defined by the Meaningful Use Common Clinical Data Set. As support for this common data set grows, it becomes easier to plug new tools into clinical workflows, analyze clinical histories, collect new data, and coordinate care. Many of these technical capabilities have been available within small, tight-knit health systems for a long time – but developing these capabilities has required complex, custom engineering and ongoing maintenance and support. Driving toward open architecture makes adoption faster, easier and cheaper.

As a medical student, I used to practice what I called “rogue interop” – connecting to services where I could, and cobbling together the data platform I wanted. It all worked, but it was a nightmare to maintain. Later when I joined the research faculty at Boston Children’s Hospital and started work on the SMART Health IT Platform, we wanted to build a robust platform to isolate app developers from the underlying details of an EHR system, so we started by designing new, open APIs from scratch and bridging to the underlying vendor system.

This work caught the attention of Health Level Seven (HL7), the healthcare standards development organization responsible for several generations of health data standards. When HL7 convened a “Fresh Look Task Force” to invite perspectives about newer, API-based approaches to data exchange, I was pleased to participate, sharing my experience from SMART.

This task force (among many influences) ultimately inspired the creation of Fast Healthcare Interoperability Resources (FHIR) – a more open, agile approach to the development of healthcare standards. I got involved with the FHIR community early when I wrote the first open-source FHIR server. Five years later, it’s been inspiring to see so many vendors, including Microsoft, supporting the emerging FHIR standard.

I joined Microsoft because it is among the largest contributors to open standards and open source. We actively contribute innovative technology to standards efforts in many industries, and we implement thousands of standards in our products that are formulated by a broad diversity of standards bodies. Just over the past year we’ve seen deep commitments to cross-cloud consumer data portability through the Data Transfer Project, an interoperable ecosystem for AI models through the Open Neural Network Exchange (ONNX), and the world’s leading software development platform through the acquisition of GitHub.

We at Microsoft are taking a collaborative approach to building open tools that will help the healthcare community, including cloud-hosted APIs and services for AI and machine learning. Microsoft understands that true interoperability in healthcare requires end-to end solutions, rather than independent pieces, which may not work together.

Most recently, we’ve added support for FHIR to the Dynamics Business Application Platform through the Dynamics 365 Healthcare Accelerator, and developed an open source Azure Security and Compliance Blueprint for Health Data and AI for deploying a FHIR-enabled, HIPAA/HITRUST in Azure. These solutions are results of Microsoft teams working closely with our partners to ensure all components of our product portfolio work together to serve the unique needs of healthcare scenarios.

Transforming healthcare means working together with organizations across the ecosystem. Today’s joint interoperability statement reflects the feedback from our healthcare customers and partners, and together we will lay a technical foundation to support value-based care. We expect that the assumptions from our joint statement will continue to evolve and be refined based on this open dialog with the industry.

Please join the conversation. You can find me on Twitter @JoshCMandel. If you want to participate, comment or learn more about FHIR, you can reach our FHIR Community chat at https://chat.fhir.org.

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The power and promise of digital healthcare in the Middle East and Africa

Mirembe, 24, lives in a rural village in north-east Uganda, where access to healthcare is limited. Mirembe is pregnant and walks, cradling her swollen belly and fanning herself from the heat, 15 kilometres to the closest clinic to check on her unborn child.

Hundreds of expectant mothers, elderly men and women, and sickly children line the corridors of the clinic patiently awaiting medical attention. Midwives and nurses are few, and they wearily dart from patient to patient doing what they can to help. Mirembe will wait six hours to be attended to.

When she’s finally seen, she’s told the clinic doesn’t have an ultrasound machine. If she wants to have an ultrasound, she must travel to the Mulago Hospital in Kampala, Uganda’s largest public hospital, where she must pay 20,000 Ugandan shillings, equivalent to about US$5, for a prenatal visit. In this part of the world, that is a significant amount of money.

According to the World Health Organisation (WHO), about 830 women die from pregnancy or childbirth-related complications around the world every day. It’s estimated that in 2015, roughly 303 000 women died during and after pregnancy and childbirth. Many of these deaths were in low-resource locations like Uganda, and most could have been prevented.

However, technology is helping to eliminate some of the challenges of distance and lack of trained medical staff. Mirembe can now hear her unborn child’s heartbeat from the comfort of her own home through an innovative app call WinSenga, which reassures her that both she and her baby are healthy.

WinSenga is a mobile tool, supported by Microsoft technologies, which helps mothers with prenatal care. The idea was conceived when the Microsoft Imagine Cup competition inspired then-university students Okello and Aaron Tushabe to use their computer science skills to tackle some of Africa’s biggest problems. They were motivated by the plight of mothers like Mirembe who live outside the reach of modern medical care.

The handheld device scans the womb of a pregnant woman and reports foetal weight, position, breathing patterns, gestational age, and heart rate. The app makes use of a trumpet-shaped device and a microphone which transmits the data to a smart phone. The mobile application plays the part of the nurse’s ear and recommends a course of action. The analysis and recommendations are uploaded to the cloud and can be accessed by a doctor anywhere.

man touching a smart tablet

This is just one example of how Africa, a continent that bears one-quarter of the global disease burden but only has two percent of the world’s doctors, could outperform developed nations’ healthcare systems by leapfrogging over inefficiencies and legacy infrastructure.

In fact, digital healthcare in the Middle East and Africa (MEA) region is booming with the proliferation of disruptive solutions underpinned by 21st century innovations like cloud, mobile, Internet of Things (IoT) and Artificial Intelligence (AI).

Let’s talk telemedicine

One trend revolutionising the delivery of healthcare in MEA is telemedicine, which is the use of telecommunication and IT to provide clinical healthcare over long distances. Given the region’s high rate of mobile penetration, telemedicine is growing rapidly. In fact, the telemedicine market in MEA was estimated at $2.19 billion in 2015 and is projected to reach $3.67 billion in 2020.

Forward-thinking countries like Botswana are making swift progress when it comes to the implementation of sustainable telemedicine projects.  Microsoft and the Botswana Innovation Hub launched Africa’s first telemedicine service over TV white spaces in 2017. Through this initiative, clinics in outlying areas of Botswana can now access specialised care remotely using TV white spaces, which are unused broadcasting frequencies in the wireless spectrum.

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Q&A: How genomic data can boost patient-centered care

Simon kos headshotGenomic data provides the foundation for the delivery of personalized medicine, although cost-effective and secure management of this data is challenging. BC Platforms, a Microsoft partner and world leader in genomic data management and analysis solutions, created GeneVision for Precision Medicine, Built on Microsoft Cloud technology. GeneVision is an end-to-end genomic data management and analysis solution empowering physicians with clear, actionable insights, facilitating evidence-based treatment decisions.

We interviewed Simon Kos, Chief Medical Officer and Senior Director of Worldwide Health at Microsoft, to learn more about how digital transformation is enabling the delivery of personalized medicine at scale.

David Turcotte: What led to your transition from a clinical provider to a leader within the healthcare technology industry?
Simon Kos:
It wasn’t intentional. In critical care medicine, having the right information on hand to make patient decisions, and being able to team effectively with other clinicians is essential. I felt that the technology we were using didn’t help, and I saw that as a risk to good quality care. This insight led to an interest, and the hobby eventually became a career as I got more exposure to all the incredible solutions out there that really do improve healthcare.

Given your unique perspective within the healthcare technology industry, how do you see digital transformation progressing in healthcare?

Digitization efforts have been underway for more than thirty years. As an industry, healthcare is moving slower than others. It’s heavily regulated, complex, and there is a large legacy of niche systems. However, the shift is occurring, and it needs to happen. We have a fundamental sustainability issue, with healthcare expenditure climbing around the world, and our model of healthcare needs to change emphasis from treating sick people in hospitals to preventing chronic disease in the community setting. Each day I see new clinical models that can only be achieved by leveraging technology, enabling us to treat patients more effectively at lower cost.

How are you and other healthcare leaders managing the shift from fee-for-service to a value-based care model?

My role in the shift to value-based care is building capability within the Microsoft Partner Network—which is over 12,000 companies in health worldwide—and bringing visibility to those that support value-based care. For healthcare leaders more directly involved in either the provision or reimbursement side, the challenge is more commercial. Delivering the same kind of care won’t be as profitable, but adapting business processes comes with its own set of risks. I think the stories of organizations that have successfully transitioned to value-based care, the processes they use, and the technology they leverage, will be important for those who desire more clarity before progressing with their own journeys

What role does precision medicine play in delivering value-based care?

Right now, precision medicine seems to be narrowly confined to genetic profiling in oncology to determine which chemotherapy agents to use. That’s important since these drugs are expensive, and with cancer it’s imperative to start on a therapy that will work as soon as possible. However, I think the promise of precision medicine is so much broader than this. In understanding an individual’s risk profile through multi-omic analysis (i.e. genomics), we can finally get ahead of disease before it manifests, empower people with more targeted education, screen more diligently, and when patients do get unwell, intervene more effectively. Shifting some of the care burden to the patient, preventing disease, intervening early, and getting therapy right the first time, will drive the return on investment that makes value-based care economically viable.

As genomics continues to become more democratized, how will we continue to see it affect precision medicine?

It’s already scaling out beyond oncology. I expect to see genomics have increasing impact in areas like autoimmune disease, rare disease, and chronic disease. In doing so, I think precision medicine will cease to be something that primary care and specialists refer a patient on to a clinical geneticist or oncologist, instead they will integrate it into their model of care. I also see a role for the patients themselves to get more directly involved. As we continue to understand more about the human genome, the value of having your genome sequenced will increase. I see a day when knowing your genome is as common as knowing your blood type.

What role can technology play in closing the gap between genomics researchers and providers?

I think technology can federate genomics research. Research collaboration would tremendously increase the data researchers have to work with, which will accelerate breakthroughs. The more we understand about the genome, the more relevant it becomes to all providers. I also think machine learning has a role to play. Project Hanover aims to take the grunt work out of aggregating research literature. Finally, I think genomics needs to make its way into the electronic medical records that providers use, ideally with the automated clinical decision support that help them use it effectively.

What challenges are healthcare leaders facing when implementing a long-term, scalable genomics strategy?

On the technical side, compute and storage of genomic information are key considerations. The cloud is quickly becoming the only viable way to solve for this. Using the cloud requires a well-considered security and privacy approach. On the research side, there’s still so much we have to learn about the genome. As we learn more it will open new avenues of care. Finally, on the business side, we have resourcing and reimbursement. The talent pool of genomics today is insufficient for a world where precision medicine is mainstream. These specialized resources are costly, and even with the cost of sequencing coming down, staffing a genomics business is expensive. And then there’s the reality of reimbursement – right now only certain conditions qualify for NGS. So, I think any genomics business needs to start with what will be reimbursed but be ready to expand as the landscape evolves.

How do genomic solutions like BC Platforms’ GeneVision for Precision Medicine have the potential to transform a provider’s approach to patient care?

Providers are busy, and more demands are being placed on them to see more patients, see them faster, but also to personalize their care and deliver excellent outcomes. BC Platforms’ GeneVision allows insights to be surfaced from the system level raw data and delivered to the clinician to assist them in meeting these demands. The clinical reports that can be leveraged through GeneVision enable providers to make critical decisions about therapies and treatment within the context of their existing workflows.

In addition to report generation, GeneVision optimizes usage of stored genomic data so that when it is produced, it can be repeatedly re-utilized by merging it with clinical data as many times as a patient enters the health care system. GeneVision makes this possible through BC Platforms’ unique architecture, the dynamic storage capabilities of Microsoft Azure cloud technology, and Microsoft Genomics services. Together, these capabilities make genomic solutions like GeneVision a key factor in delivering patient-centered care at scale.

What will it take for genomics to become a part of routine patient care?

The initial barrier was cost. I think we are past that, with NGS dipping below $1000 and continuing to fall. Research into the genome is the current challenge. Genomics will eventually touch all aspects of medicine, but given the previous cost constraints we are the most advanced in oncology today. A key benefit of GeneVision is that it supports both whole genome sequencing and genotyping, which is currently the more cost-effective method to generate and store genomic data.  Although the cost of whole genome sequencing is coming down, this flexibility is essential to enabling rapid proliferation of genomics applications in healthcare. The future challenge will be educating the clinical provider workforce and introducing new models of care that leverage genomics. I think the reimbursement restrictions will melt away organically, as it becomes clearly more effective to take a precision approach to patient care.

What future applications of genomics in healthcare are you most excited about?

I’m really excited about the evolution of CRISPR and gene editing. Finding that you have a genetic variant that increases your risk of certain diseases can be helpful of course—it allows you to be aware, to screen, and take preventative steps. The ability to go a step further though and remediate that variant I think is incredibly powerful. At the same time, gene editing opens all sorts of other ethical issues, and I don’t yet think we have a mature approach to considering how we tackle that challenge.


BC Platforms GeneVision for Precision Medicine, Built on Microsoft Cloud technology, is available now on AppSource. Learn how GeneVision equips physicians with the tools they need to improve and accelerate patient outcomes by trying the demo today.

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New team assembled to unlock the innovation potential in healthcare data

Peter Lee, Joshua Mandel and Jim Weinstein
From left, Peter Lee, Joshua Mandel and Jim Weinstein of Microsoft Healthcare. Photo: Dan DeLong for Microsoft

It’s an exciting time to be working shoulder-to-shoulder with our healthcare partners and customers, who represent some of the brightest minds in this important industry. We have been approaching the complexities of the healthcare industry with a growth mindset, and for the past two years our team has worked across Microsoft to accelerate healthcare innovation through artificial intelligence and cloud computing, with our initiative Healthcare NExT (New Experiences and Technologies). We shared some updates earlier this year on our work in cloud architectures, empowering clinicians and care teams, and precision medicine, and I’ve been thrilled to see the progress and reaction across the industry.

Today we are building on that progress. I’m very pleased to welcome two prominent experts in the science, technology and practice of value-based healthcare to the team. Jim Weinstein and Josh Mandel will be joining Microsoft Healthcare – which integrates Healthcare NExT and its research-driven efforts – with an added focus of creating strategic partnerships, and driving the cross-company strategy for healthcare and life sciences.

Jim Weinstein, Vice President, Microsoft Healthcare, Head of Innovation and Health Equity

Jim Weinstein will work closely with organizations on the front lines of healthcare delivery as we aim to support health systems, empower clinicians and enable the systems of care as they move to the cloud. He will be my partner in developing the strategic vision for Microsoft Healthcare, and will provide leadership that is grounded in decades of health industry experience. A widely respected visionary, author, surgeon and leader in the future of healthcare delivery who has advised three administrations on healthcare policy, Jim most recently served as CEO and president of Dartmouth-Hitchcock and the Dartmouth-Hitchcock Health system, and is the past director of the Dartmouth Institute, home of the Dartmouth Atlas of Health Care. Jim is also the co-founder and inaugural executive director of the national High Value Healthcare Collaborative, which brings together some of the nation’s top healthcare systems to share data, develop insights and advance the causes of better healthcare outcomes. He recently chaired the “Communities in Action, Pathways to Health Equity” report for the National Academy of Medicine. His book “Unraveled” looks at the broken healthcare system and how it might be repaired with patient-based clinical insights.

Joshua Mandel, Chief Architect, Microsoft Healthcare

Joshua Mandel will work closely with customers, partners and the open standards community to lay the groundwork for an open cloud architecture to unlock the value of healthcare for the entire health ecosystem. As a tireless evangelist for the importance of open standards, Josh will continue his work to help systems across the industry become more agile and interoperable. Josh’s impressive background as a physician and brilliant software architect has set him apart as a leader in the development of next-generation standards for healthcare data interoperability.  In his most recent role, Josh led the health IT ecosystem work at Verily (Google Life Sciences). He is a member of the research faculty at the Boston Children’s Hospital Computational Health Informatics Program where he served as lead architect for SMART Health IT, and is a visiting scientist at the Harvard Medical School Department of Biomedical Informatics. Josh earned his bachelor of science degree in electrical engineering and computer science from Massachusetts Institute of Technology, and his M.D. from Tufts University of Medicine.

Jim and Josh join us at an exciting time, as healthcare processes undergo a digital transformation. This transformation has created a wealth of healthcare data that has potential to help identify diseases earlier, create and improve treatments and improve the lives of patients across the globe. Unfortunately, even with advances in data protection and governance, healthcare data is not easily accessible by the researchers and doctors who need it to help us all realize the potential. And so, for a variety of regulatory, technological and political reasons, we see what is called the “health data funnel,” which holds back the case of scalable innovation in healthcare.

At Microsoft, we’re confident that many aspects of the IT foundations for healthcare will move from on-premise doctors’ offices and clinics to live in the cloud. We ask the questions: Can we take advantage of this huge sea change in healthcare to unlock the innovation potential in healthcare data? Can we work as a community to ensure that we don’t simply re-create the same data silos that we have today?

We think that together, we can solve these problems. We are taking concrete steps with an initial “blueprint” intended to standardize the process for the compliant, privacy-preserving movement of a patient’s personal health information to the cloud and the automated tracking of its exposure to machine learning and data science, for example to support external audit. This is a small first step, but progress toward an open architecture that ultimately will benefit doctors, nurses and clinicians in how they interact with patients, and also allow more time for patients to spend face-to-face with their care providers. It also opens up research opportunities for this data to be shared, and to be done under the same compliance and regulatory standards which protect your health data today; all with the goal of leading to advancements in medical science.

We have our work cut out for us but know that we have the right team in place. We’re looking forward to sharing more later this year about what we’re doing to help unlock the power of healthcare data and create opportunities for the entire health ecosystem.

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