Widening access to healthcare through technology

The Covid-19 pandemic has revealed fault lines in the healthcare sector as providers face unprecedented pressures on resources. Dr David Rhew, global chief medical officer and vice president of healthcare at Microsoft, explains how cloud-based technology tools are helping

Michele Witthaus
By Michele Witthaus on 01 February 2022
Widening access to healthcare through technology

Communities worldwide have been impacted by the pandemic, resulting in hospitals and health systems becoming overloaded, a situation which is still ongoing in many areas.  

“Healthcare providers see clinicians dropping out and individuals moving on to other professions because of the emotional overload that they’re experiencing and the physical exhaustion,” says Rhew. Microsoft saw an opportunity to help by implementing its advanced research on technologies that lessen the burden of administrative work. “One of the technologies that we’ve been working on is ambient clinical intelligence, which is about taking a conversation with the patient and seamlessly capturing that information, organising it into a clinical progress note, and then integrating that into the electronic health record (EHR). This can save between 50 to 80 per cent of a single clinician’s time. “Based on technology that Microsoft had been developing, a solution was created in partnership with healthcare solutions provider Nuance and was brought to market as a product called Dragon Ambient eXperience (DAX).  

Launched during the pandemic, DAX was originally developed for use during in-person clinic visits. “We reconfigured DAX so that it could be used as part of a virtual care visit. Documentation related to a virtual care encounter could then be seamlessly integrated into the medical record,” says Rhew.  

“DAX falls within a broader set of technologies related to artificial intelligence (AI) and natural language processing (NLP). Through AI and NLP, information that traditionally requires a human to interpret, such as a conversation between a patient and a clinician, a clinical progress note, or a published study, can now be translated into something structured, searchable, and understandable by a computer.” 

Rhew says: “While AI and NLP are often the stars of the show, the process also requires data ingestion, normalisation, and integration and care coordination. The Microsoft Cloud for Healthcare leverages healthcare data interoperability to facilitate data ingestion, applies AI and NLP to perform data analysis, and connects to virtual care platforms and EHRs to enable care coordination. As healthcare data becomes more interoperable, individuals and organisations can benefit from advancements in AI and cloud computing.”  

Microsoft leverages the Fast Healthcare Inter­operability Resources (FHIR) standard, which allows for health records to integrate with different systems of record and be made portable on the patient’s device or technology of choice. This portability of data is made possible through interoperability rules that require the release of information to consumers using open application programming interfaces (APIs) and through the adoption of FHIR interoperability standards. 

During the pandemic, Microsoft and its partners formed VCI, “a voluntary coalition of public and private organisations committed to empowering individuals’ access to a trustworthy and verifiable copy of their vaccination records.” VCI leverages the SMART Health Card framework, which is based on FHIR.  

Also during the pandemic, Microsoft and its partners formed the Vaccine Equity Consortium (VEC).  VEC’s mission is to provide Covid-19 vaccinations and other essential health services to underserved and vulnerable populations.  

A key partner for VEC has been the California Health Medical Reserve Corps (CHMRC). “We needed an experienced organisation that could go into any setting, understand how to deploy health services with limited technology infrastructure, and integrate with the local public health agencies,” explains Rhew. “In working with CHMRC and other VEC partners, we established pop-up sites at schools, churches, parking lots and malls. Community engagement was led by trusted individuals within the communities such as pastors, community leaders, and even beauticians and barbers. The aim was to empower trusted people with the knowledge and resources to have informed conversations with members of the community about Covid-19 and the vaccine, while also providing access to preventive   medical screenings and immunisations that may have been missed during the pandemic. 

And VEC is working: the results from events organised so far in Seattle’s King County, California’s Inner Central Valley, and communities in Georgia and Mississippi, have demonstrated high levels of community engagement, improved Covid-19 vaccination rates, and expanded delivery of other essential health services to underserved communities. 

“While improving Covid-19 vaccination rates was the initial objective, we found that the most effective way to promote engagement was to start with a popular community-led event unrelated to Covid-19, such as an ethnic or holiday celebration, or a return to school or sporting event. We then married the community event with a health fair.” 

Another goal for VEC has been to ensure that individuals continue to receive health services after the community event. This requires identifying eligibility for insurance coverage, connecting individuals to local healthcare providers, and empowering local non-profits and community health workers with the digital tools and resources needed to help them provide continued support. 

“Our goal is not to replace existing work but to augment or extend the capabilities so that healthcare providers and public health can reach the folks that are unreachable.” 

It is a model that is reproducible, and Microsoft and its partners have created a playbook that it offers free to anyone that’s interested, says Rhew. “We encourage communities to take the lessons learned, the best practices and the tools that we’ve developed and apply them in their own settings.” 

He adds: “We have established a coalition of national non-profits that have local chapters and that are already connected to vulnerable populations within underserved communities – organisations like Easter Seals, United Way, and American Heart Association. To complement these, we have established a network of healthcare providers that can deliver services at the local level. On the technology side, Microsoft, Accenture, and other technology partners have been able to provide the technology infrastructure required to support pop-up events and enable secure and reliable transfer of healthcare data to the appropriate healthcare and public health data systems.” 

Rhew is passionate about the changes that have been set in motion by these interventions. “One thing the pandemic has shown is that we have a broken public health infrastructure,” he said. “We are helping provide the resources and support for people to work together.  

“Our goal is not to replace existing work, but to augment or extend the capabilities so that healthcare providers and public health can reach the folks that are unreachable or have not been reached. That’s super exciting, because by enabling improved communication and coordination of care between non-profits who work directly with the community, local healthcare providers and public health, we have demonstrated through VEC that we can improve the lives and outcomes for the vulnerable and the underserved, and in the process are validating a new model of care that addresses health disparities at the community-level.”  

Partner perspectives 
We asked a selection of Microsoft partners how they are using the firm’s cloud technologies to help healthcare providers maintain and improve the health of the communities they serve. Below are extracts from their responses, which you can read in full from page 142 of the digital edition of the Winter 21/22 issue of Technology Record.    

Terry Myerson, CEO of Truveta, said: “The Truveta Platform, built on Microsoft Azure, enables researchers to find cures faster, empowers every clinician to be an expert and helps families make the most informed decisions about their care.” 

Kimberley Totten, operations director at Akari, said: “Working with NNUH, we were able to maximise Microsoft Teams interactions following a rigorous change management programme, which ensured consultants were able to continuously deliver excellence during an uncertain time.” 

Steve Witt Public Sector Director at Nintex, said: “Over the past 18 months, Nintex has worked even more closely with various public health departments to implement mission critical solutions designed to keep communities and citizens safe.”  

Suresh Krishnan, chief technology officer of healthcare at Quisitive, said: “Quisitive’s MazikCare solutions are built on the Microsoft Cloud for Healthcare, which brings together proven industry solutions on a scalable, secure platform.” 

Jennifer MacGregor, senior vice president of global solutions management at Allscripts, said: “As the Covid-19 pandemic spread across the globe, the Allscripts Sunrise Platform of Health, powered by Microsoft Azure, provided the tools and technology organisations needed to easily transform and optimise efficiencies across the enterprise and beyond.” 

Mick McNeil, vice president of business development for lead Microsoft business unit at Logicalis, said: “Using our Cloud Readiness Assessment, we designed, deployed and migrated a healthcare provider from at-risk servers to the Microsoft-audited Logicalis Production Ready Cloud.” 

Sankar Konduru, head of consulting solutions and innovation for Microsoft Biz Apps and Power Platform Practice at Infosys, said: “We are partnering with government agencies across various levels to incorporate technology solutions that support their vision and strategy, keep them engaged with citizens and provide tools for employee productivity and security, even during times of crisis.” 

Julie Duncan, senior account manager of healthcare for Experian Data Quality, UK&I, said: “Accurate and comprehensive contact data underpins sound decision-making at every level in our health services and contributes to the improvement of patient healthcare, organisational efficiency, reputation, governance and government budgets.” 

This article was originally published in the Winter 21/22 issue of Technology Record. To get future issues delivered directly to your inbox, sign up for a free subscription.

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