The HealthVault (HV) beta was launched October 4, 2007. Between the confusion surrounding the launch and work, I've tried to gather some thoughts and get some questions answered.

The launch was a classic Microsoft launch: big, dramatic, expensive, and well executed, right down to the goody bags (you had to be there to get one, so I missed out). Typical with such events, naysayers were out in force, and there was a bit of confusion. You can also find some good information on the big picture of HV from Vince Kuraitis and Enoch Choi.

Perhaps the most confusion around HV is whether or not it is a personal health record (PHR). Many of the "news stories" that recycled the HV press release referred to HV as a PHR. A few, Vince and Enoch among them, noted that HV is in fact not a PHR. From what I and others can see, there is very little in the way of a user interface that would allow patients to maintain and manage a PHR.

According to one Microsoft executive I talked with, HV is a "platform" that's intended to be used by other applications, and is not a PHR. He reported that Microsoft's taken a more consumer focused approach, surrounding them with their information so they can share their health data with whom they wish. So, the absence of a robust PHR user interface is apparently a conscience
decision on Microsoft's part. Nor would it be to awfully difficult to
provide one should they move in that direction.

The published API, data interoperability via numerous standards, data storage, security, authentication, and the patient's ability to control their data creates a veritable Swiss Army knife for health data. Microsoft has tried to create a new kind of platform that's ideal for health information. They certainly have some ideas about how it can be used (and currently monetized - by ad revenue), but my contact acknowledged that they expect partners and consumers to take the platform in unforeseen directions. As a beta product, there are many unknowns beyond the mid term horizon.

Device Connectivity
Microsoft sees devices for health and fitness and chronic disease management as a big piece of HV. Medical devices are integrated into HV via the Connection Center (CC). The HV CC includes a device driver (specified by Microsoft and developed by the device vendor) that integrates a remote monitoring device into a Windows PC, and the CC application that runs on the PC and integrates with the HV web site. Microsoft has an SDK for creating a serial device driver for connecting these devices to Windows PCs, along with the HV CC sync program that allows consumers to capture, review and share data via HV. There do not seem to be any data editing capabilities in HV CC - more on this in an upcoming post.

My contact used the digital camera analogy when describing what this might mean for remote monitoring devices. In the early days, digital cameras came with their own proprietary software that allowed you to connect your camera to a computer and download pictures. As the technology matured, cameras adopted the USB standard and now plug and play with PCs.

This ubiquitous connectivity sounds great, but Microsoft is not anything like the USB Implementers Forum. While their device to PC SDK is open, the software on the PC is not. In fact, one wonders how HV will play out against another medical device group, the Continua Health Alliance.

Remote monitoring systems have 4 components: the medical device, a gateway device for aggregating data from multiple devices and moving that data over a network to an application, the application that manages the patient data (which usually runs on a server on the Internet), and some sort of integration with EMR/billing system(s). Continua is working to provide multi vendor plug and play interoperability between each of these components. Microsoft is not a member of Continua and is providing an open, but proprietary means to link devices with server applications - turning the Windows PC into a virtual gateway.

The HV CC turns your Windows PC into a remote monitoring gateway. The application can aggregate data from multiple devices and push that data into your HV account. To then get the data into the remote monitoring application it is transferred (automatically?) from HV to a compatible application.

Most remote monitoring gateway devices pull data from remote monitoring devices and push it directly into the target application. In fact the data may not be "ready" for third party applications until it is processed by the target application - more on this issue in an upcoming post. Certainly Internet-based remote monitoring server applications can leverage HV to provide interoperable data between other applications like physician EMRs.

Will vendors implement both Continua and HV connectivity? The fact that Continua validated interoperable products won't be available until the end of 2008 is an issue than you might think. Any vendor starting development now will take at least that long to finish their product. So they must make the decision whether to base their new product on Continua, HV, or both. (Hint: this is not a "o brainer" question.)

Closing Thoughts
Regardless of those that claim Microsoft "won round one" against Google, there is no first mover advantage in any of this. In fact, follow on solutions will likely benefit greatly from Microsoft's very public experience. Other big vendors or efforts mentioned in the press include Google, Cisco, and Dossia (which includes Intel, Wal-Mart and other big employers). I talked about non health care companies entering the health care market before. This is not an easy transition; it will take longer and cost a whole lot more that most anticipate.

Check back throughout the week; I'll have some follow on posts on adoption, network effect and other topics.

Pictured right is Bill Gates, from a PhotoShop contest on Gizmodo, that tickled my fancy.