Microsoft’s Bill Crounse Says the U.S Needs to Catch Up

Bill Crounse, worldwide health director for Microsoft, sees himself as an evangelist, promoting the use of information technology as a way to improve patient quality and safety. He combines his medical field expertise as former vice president and chief medical officer for Overlake Hospital Medical Center in Bellevue, Wash., with his knowledge of technology, gained while working with Microsoft industry partners and healthcare organizations. He is also founder of DoctorGoodwell.Net (now Goodwell Technologies), a company that works to improve connectivity between physicians and their patients. Digital Healthcare & Productivity recently spoke with Crounse about the growing consumer movement in healthcare and the application of information technology in medicine and e-health initiatives.

DHP: You’re responsible for providing worldwide thought leadership, vision, and strategy for Microsoft in the healthcare provider industry. What do see as the technological solutions to our overburdened and fragmented healthcare system?

CROUNSE:  What we’re lacking in healthcare are the standards and architecture for building services that exist in other industries such as banking or travel. We need this common language to develop the kind of platform that will enable the transaction services that are so lacking in healthcare. At this year’s Healthcare Information and Management System Society conference (HIMSS), Microsoft, for example, introduced the Connected Health Framework Architecture, a model for providers seeking to deploy service-orientated architecture (SOA) solutions to improve interoperability, clinical collaboration, and decision-making tools.

We had 60,000 downloads within a few days. A lot of work that our Health Solutions Group is doing is working on that platform and related tools and technologies that future partners can use to develop Web services around the provision of health information and medical services. Sutter Health in Northern California, for example, built a solution based on the Framework’s architecture grid. (Editor’s note: Sutter implemented an early detection and treatment program to treat severe sepsis in intensive care patients by using an electronic forms-based solution.) The Connected Health Framework is both the blueprint and source code to help developers write world-class Web services for healthcare.

DHP: You’re a physician; as you talk to healthcare professionals and they ask you what they should looking for applications in the healthcare industry, what do you say?

CROUNSE: I tell my colleagues that if it’s not mobile, it’s not a good solution for healthcare. Healthcare workers almost by definition are extremely mobile. One of the reasons it’s taken so long to get applications that work well in healthcare is the lack of mobility, and it’s only in the last three or four years that we’ve cracked the code with broadband and integrated wireless so we can meet the needs of clinicians in a workforce environment.

Unified communications are also key. We want the ways we communicate and collaborate to be seamless across all devices, whether it is a smart phone, pocket PC, notebook or desktop computer. Voice over Internet Protocol (VoIP) is going to change the landscape of the way we communicate and make it much more device independent.

DHP: And email? You’ve blogged about the growing trend in physician-patient messaging and e-mail.

CROUNSE: Looking at the consumer side of business, almost everyone likes to communicate with doctors using a host of capabilities, be it phone, e-mail, or instant messaging. Health Maintenance Organizations like Group Health in Seattle have embraced the idea of using e-mail because it allows them to provide service to a population without having an impact on their physical facility.

The provision of e-health is absolutely strategic for their organization and has been a huge win not only for Group Health but also for their patients and the quality of care they are providing. But before e-mail can happen on a wide scale, we need to think seriously about reimbursement because we have a system which currently only rewards physicians for a physical visit. It doesn’t make sense to meet demand by building more clinic or hospitals when an awful lot of healthcare can be delivered more efficiently and to the greater satisfaction of consumers by using technologies like email.

DHP: When it comes to routine healthcare, many consumers want faster service and more convenience. How has the market responded?

CROUNSE: I actually applaud the retail health movement, although it causes trepidation for many providers. There is legitimate cause for concern about fragmentation of care, but the issues of quality are non-starters. What I’m seeing in these facilities is every bit as much attention to quality of care as in a traditional healthcare setting. They have a brand to protect, as well as usual concerns about malpractice and medical errors. Customers like the convenience, and these facilities are very focused on customer relations management, something that is lacking in the traditional healthcare setting.

DHP: In your frequent travels, you’ve seen the globalization of healthcare services. The healthcare world is flat with the rise of medical tourism and telemedicine.

CROUNSE: Other markets — South Korea, Thailand, Singapore — are looking at healthcare as an exportable commodity. Telemedicine is really taking off in other parts of the world where healthcare access is an issue. Not in the U.S.  We’re also behind in the way mobile devices are used. In fact, all around the world in healthcare, I’m seeing faster adoption of information technology than here in the U.S.  We lag behind much of the industrialized world in healthcare IT and that gap will widen if we are not careful.

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