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It’s About the Patient: Peter Neupert on Consumers, Standards, and what HealthVault Needs to Succeed

by Malorye Allison

Peter Neupert is Corporate Vice President, Health Solutions Group, at Microsoft, which is charging into the personal health record field with HealthVault.  After the recent spat of articles and editorials in Health Affairs debating health IT strategy, I was eager to hear Peter’s view on the “standards first?” controversy and how Microsoft sees the emerging consumer health world.

The company is betting that consumers will dive in and start demanding online records as a better and easier way to manage their health care.  “No single silver bullet will transform something as interconnected or complicated as health,” Neupert says.  “We believe consumers will be the primary actors of change because they are the voice that has been least heard.”

“Most incentives are around the needs of payers or providers,” he adds. “When people ask how they can impact things that are costing the most, such as chronic disease, the big gain is clearly around how we influence patients.  To do that, we need to change how we interact with consumers.”

Consumers themselves, he says “Want more information and better access, especially if they have to interact with the health care system frequently.”

But consumers won’t sit and type their health data into online forms themselves, nor will they chase down all their providers and ask them to do it.  For Health Vault to succeed, Microsoft itself needs to bring those providers along, and to add plenty of new layers of function to its offering as well.

“We need to reach the point where patients are saying ‘Aha, this makes my life easier,’” Neupert says.

It will take a lot more to fulfill the whole vision — that beautiful dream of a networked U.S. healthcare system, with networks all over the country seamlessly connecting to deliver optimal care to patients no matter where they have ended up seeking care.

I also asked Neupert where he stands on the recent “standards debate” that erupted in the latest issue of Health Affairs, and whether the U.S. health IT initiative is indeed constrained by an overreliance on technical standards.

He agreed there is too much focus on standards. He thinks we should put the highest priority on getting the content right, and once that’s achieved, standards will naturally follow.  In the meantime, “There is a ton of value we could be getting out of the data today.”

Peter sees today’s emphasis on standards as a straw man.  “The world of software is not like the physical world,” he says:  When building things like railroads, having standards from the start is crucial, or you end up with multiple small networks rather than a seamlessly interconnected whole.  “Software allows for translatable interoperability,” he says.  “If the data isn’t interoperable, it’s because people don’t want it to be.”

Exactly how will that one seamless mega-network arise if groups are working from different platforms at first? The answer, he says, lies in the metadata – the details that describe the data, and how it has been captured.

“Our focus is on metadata-driven translational interoperability – to get data moving better, faster,” Neupert says.

Of course, not everyone is thrilled to see a software giant like Microsoft striding into the personal health record field. Some bloggers are quite alarmed by the prospect, and have pondered what the company’s evil intentions must be or how keeping one’s health records on the web could horribly backfire.  I’m sure we’ll hear plenty more about that too.

In the end, either the whole field will quickly crest, making the early entrants really glad they got that quick start, or, it’s all a straw man and only a minor subset of us will ever be managing our health records online.

By the way, Neupert now has his own blog called “Neupert on Health.”
And you can read those Health Affairs articles here.


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