Tartle Best Data Marketplace
Tartle Best Data Marketplace
Tartle Best Data Marketplace
Tartle Best Data Marketplace
Tartle Best Data Marketplace
Tartle Best Data Marketplace
June 9, 2021

Microsoft Cloud Healthcare

Microsoft Cloud Healthcare

Microsoft Cloud Healthcare

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BY: TARTLE

Healthcare on F.H.I.R.

You may have heard of this thing called the COVID-19 pandemic. Now, if you haven’t heard this next part, you may want to sit down – it has put unusual and significant strains on healthcare systems worldwide. There are of course a lot of reasons for that. One is just the challenges of dealing with a brand new virus. Another is that some places (such as the Lombardi region of Italy) have been hit hard enough to strain available resources, while other places wound up laying off staff. Finally, due to various travel and workplace restrictions, more and more work – even in the medical field – is being done remotely, forcing people to learn new ways to work in a short amount of time. One of the results of this is that there have been increased calls for making healthcare data more universally readable and transmissible.

As it turns out, such a system already exists, F.H.I.R. or Fast Healthcare Interoperability Resources. This system is designed to make it easier for researchers and doctors to more easily share information with each other around the world. The goal is to develop better treatments faster and get them to where they are needed in order to save lives. The problem is, until recently, hospitals, universities and governments have been slow to adopt it. Why would that be?

Adopting a new system, especially a universal one based in the cloud, means there will need to be training so staff understands the new system. Liability and security are also significant concerns since all that healthcare data would be stored on a remote server rather than onsite. That same issue also brings up concerns of privacy, of protecting the identities of patients. 

Due to COVID, there have been a number of companies that are trying to address this problem and encourage the adoption of F.H.I.R. One of them of course is Microsoft and its Microsoft Cloud for Healthcare. They are trying encourage adoption of this universal system and manage all the computing aspects of healthcare, from the sharing of patient data to the “how was your visit” surveys. For the right (and as anyone with experience here knows, a very large) price Microsoft will fully integrate your data with the cloud and make it sharable worldwide. 

As good as that is, there are limitations to that approach. One is that such things are always designed with a “one size fits all” mentality. Data is presented in certain ways and the interface is whatever it is designed to be. There will be a number of features that certain users will never even be aware of. Sure, there is always some degree of customization available but all of that bogs down the system. Finally, patient engagement is severely lacking in this approach. 

Think of it this way, if someone takes a bunch of x-ray images from the Microsoft cloud and uses them to find a way to more quickly identify bone cancer, that’s great. But wouldn’t it be even better if the doctors could directly and quickly use that information to treat their patients rather than waiting months for the information to circle back in a meaningful format? 

TARTLE of course has a better way. First, when your healthcare data is uploaded into our system, it is already converted into the F.H.I.R. format. Already, it is in a format designed to be used everywhere. We also convert it into a format that easily readable by you, the patient. You don’t have to worry about sifting through a mess of code, it’ll be nice, clean and accessible. Finally, let’s look again at the bone cancer example above. If you have chosen to share your data with TARTLE you are more likely to get treatment quickly. If those researchers are using data acquired through TARTLE and they determine that you have bone cancer, then you and your doctor can be contacted directly with whatever treatment recommendations the researchers have. A process that could take months can be shortened to the length of an email. 

Better treatments delivered faster around the world, all with total transparency and security, as well as a financial incentive, for you, the individual. That’s the future TARTLE is building.

What’s your data worth? Sign up and join the TARTLE Marketplace with this link here.

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For those who are hard of hearing – the episode transcript can be read below:

TRANSCRIPT

Speaker 1 (00:07):

Welcome to TARTLE Cast with your hosts Alexander McCaig and Jason Rigby, where humanity steps into the future and source data defines the path.

Alexander McCaig (00:26):

Help, I'm on fire. You'll understand [crosstalk 00:00:29]

Jason Rigby (00:28):

I'm on fire.

Alexander McCaig (00:29):

You'll understand that in a minute. I'm on F-H-I-R. I'm on FHIR. What's our current event today we want to talk about?

Jason Rigby (00:37):

I want to talk about Microsoft Cloud for Healthcare, and they put this on their blog, unlocking the power of health data for better care. And one of the things that they are worried about and of course, if there's a problem, Microsoft wants to be able to solve it, is healthcare providers have faced unprecedented workloads, institutionally and individually. And it's not just here in the United States, you're looking around the world, especially with the pandemic response and how it's creating these seismic shifts in how care is being provided. And not just short term care, with hospitals being overloaded or [worried 00:00:01:11], but they're looking at the long term care and how care is going to be shifted when you bring data involved into it, what it's going to look like.

Jason Rigby (01:22):

Now you can do a Zoom. Or you went... In previous episodes, you talked about all the data points when you went just to see a doctor.

Alexander McCaig (01:31):

When I went in to a provider. Yeah.

Jason Rigby (01:32):

And the guy that wrote this blog, he works at Microsoft. He's also a physician. And he had talked about seeing firsthand the challenges of not having the right data at the right time in the right format to make informed, shared decision with his patients.

Alexander McCaig (01:46):

Okay. And so when they talk about format, there's a thing called FHIR. It's a healthcare format codex that [crosstalk 00:01:55]

Jason Rigby (01:54):

Fast Healthcare Interoperability Resources.

Alexander McCaig (01:57):

Right. So what they're trying to do is they're trying to institute a format that healthcare systems all over the United States and all over the world can adopt. So that when information, health care information, which is important, because the faster you can figure something out, there's a high probability that somebody lives.

Jason Rigby (02:10):

Yes.

Alexander McCaig (02:11):

So if we can transmit this information and just ingest it in systems, and they can all read the same sort of format, that's a big plus. So everyone's been trying to push this FHIR system, it's called HL7 format. So what they're saying is that Microsoft is using their online platform to almost, because of its efficiencies of Azure, their cloud processing, that if they can continue to push the FHIR standard, that there will be tangible benefits that will come back to the hospital, the doctor, and the patient.

Jason Rigby (02:45):

Right.

Alexander McCaig (02:45):

That's essentially what they're speaking to.

Jason Rigby (02:48):

And their business model is to establish trusted partners and then create those solutions, but the trusted partners is the huge?

Alexander McCaig (02:54):

The thing is this is not creating a solution.

Jason Rigby (02:58):

Right.

Alexander McCaig (02:59):

FHIR was already instituted. People just don't want to adopt it because it's a hassle. And also they're not incentivized to adopt it across disparate systems, but with TARTLE, it's a little different. Your healthcare information in TARTLE is in FHIR HL7 format, okay. And it spoke to this article about having the ability for the patient to be also to read it.

Jason Rigby (03:20):

Yes.

Alexander McCaig (03:20):

So when you pull down your healthcare data in TARTLE, we keep it in the system in that beautiful format that's easy for other people to understand. We hope that the world will adopt because there's efficiencies to it. But you as the person have to be able to read that.

Jason Rigby (03:35):

Yes.

Alexander McCaig (03:35):

But you don't want to go through and read all this XML text and that is a mess. This isn't even readable [crosstalk 00:03:41]

Jason Rigby (03:41):

The problem that they're facing, we'll talk about it later, when you're talking about unreadability is describe notes that physicians are putting in there, because a lot of physicians are getting scribes and then having them, and then they're just typing really fast and machine learning can't understand that.

Alexander McCaig (03:55):

Yeah. So here's how this is going to work. So as it's ingested into TARTLES's marketplace, okay, you have your record there, we're going to put this sort of document reading lens. So to you, you're going to see this nice clean, separated document with all of its categories, even the doctor's notes, they're going to be there. You have the entirety of your healthcare record, right? But on the backend, when someone goes to purchase it, if you choose to sell it, they're purchasing it in the FHIR HL7 format. So now people all over the globe, even here in the United States are incentivized to adopt the FHIR system more so than partnering with Microsoft, which is probably costs gobs of money, right?

Jason Rigby (04:40):

Yeah. And they've even changed the name, it's Microsoft Cloud for Healthcare.

Alexander McCaig (04:43):

Yeah, right. So like, "We're doing this just for healthcare."

Jason Rigby (04:46):

Right.

Alexander McCaig (04:47):

Well, TARTLE is doing it for humanity, okay? So, and what happens is now that an individual can become financially empowered by controlling their healthcare data, they can share it in this readily adoptable format that is trying to be pushed. Now there's an incentive for healthcare networks, researchers, biopharma, all these people to actually start to be like, "You know what? It's time we transition." The availability of information sits here in the TARTLE marketplace with all 240 million Americans, if they want to, to sell their healthcare information. And it's going to be in this format. I think it now makes time for, sense for us to do this because now we can get access to that data.

Jason Rigby (05:25):

Yes. And one of the things that their hopes for that is to enhance patient engagement, empower health team collaboration, and improve clinical and operational insights. So I want to talk about enhanced patient engagement with TARTLE, because I think this is really important, how you would be able to engage?

Alexander McCaig (05:43):

So what they want to do is they want to set up easily programmed kind of surveys, or you touch a tablet when you're in the doctor's office, "How did the visit make you feel?" It's sort of like a net promoter score and the system will process it quickly and it will take that customer engagement, whatever it might be, and it will give those ratings back to the hospital. And the hospital will be like, "Oh, look, we're doing fantastic. The room was cleaned. The person felt good about their visit. They are albeit, sick and dying, but they feel pretty good. So then we can apply our customer survey statistics against what our financial information is saying. Can we request more money?" Well, I don't know. Do people like coming to your hospital? Are you actually saving their lives?

Alexander McCaig (06:29):

And what Microsoft wants to do is they want to be able to process all that thing in-house on one server. So there's so many people that attack the healthcare industry, they're coming in there, "I got the next best idea." Because there's so much money, there's so much availability in it, right? There's so many resources. They're like, "Well also you need my healthcare system to come in." Talk about patients and how they feel and follow up with them, yada, yada, yada. Well, Microsoft is saying, "We can do all this in-house on our cloud servers for our Microsoft for Health program."

Jason Rigby (06:56):

Yeah. And one of the things is with the reason that they're saying the word Microsoft Cloud for Healthcare, is they want to shift from on premises computing to the cloud in healthcare.

Alexander McCaig (07:05):

Yeah, because there's certain efficiencies with that, but then for the people that are at the hospitals, they're used to having things in house. So you still owning their own servers because the liability sits a little differently. Rather than saying, "Okay, we're going to pass off all the management liability over to Microsoft," they can take care of it. And so somebody, whoever is the chief of security and information at the hospital would have to make that decision. Is it worth us to actually make a transition from in-house servers to a fully uptime, 99.99% operability with Microsoft cloud?

Jason Rigby (07:38):

Because what people don't realize is a lot of it, whether it's this hospital brand or that corporation or that one, they each have their own separate systems. And they're not communicating with each other. If you go to, like here in Albuquerque, if you go to Lovelace and then you go to Presbyterian, they can't read that information.

Alexander McCaig (07:56):

They don't talk to one another.

Jason Rigby (07:57):

No.

Alexander McCaig (07:57):

They're 500 feet apart.

Jason Rigby (07:59):

Yes.

Alexander McCaig (07:59):

And so Microsoft thinks that, well, if we can pull one individual in, then we can say, "Okay, guess what? We already have one healthcare system. I know they're in your network, so if we pull you in too, look at the efficiencies between you two speaking to one another." That's all they're really saying is they're taking disparate sources and bringing them together and creating a pipe that essentially is a new telephone system for them to talk.

Jason Rigby (08:21):

Yeah, and one of the things that they implemented, which I thought was interesting was they call it the Microsoft Health Bot, and you're laughing, bro. And so it was an AI powered virtual health assistant. During COVID it got 600 [crosstalk 00:08:37].

Alexander McCaig (08:35):

Oh, sorry. That's glass on the mic.

Jason Rigby (08:37):

Oh, yeah. Glass on the mic with your kombucha.

Alexander McCaig (08:41):

Yeah.

Jason Rigby (08:42):

They got 600 million messages and deployed 2300 COVID-19 bots in 25 countries. And it ended up, that bot ended up serving 50 million users. So in what it was able to do, especially with the US Center for Disease Control, was to communicate up-to-date guidance, prioritize care for the most urgent patients, and then receive real-time data on people's interaction with the bot.

Alexander McCaig (09:04):

Sure.

Jason Rigby (09:04):

And so that bot, we look at that and they're considering this to be something revolutionary in healthcare.

Alexander McCaig (09:11):

It's not, it was a chat bot.

Jason Rigby (09:12):

But that real-time data with TARTLE, that's what I want you to talk about because that ability to be able to go directly to the customer or patient or whatever.

Alexander McCaig (09:21):

They had to go through the hassle of redesigning this bot and then pushing out to subsystems. And then educating the people in that health network to tell their patients that this bot is available.

Jason Rigby (09:31):

Right.

Alexander McCaig (09:32):

It was like, I don't know, 20 degrees of separation from the guy that actually wrote the code for the chat bot. So why don't we just skip that, cut to the chase? Why don't we go to TARTLE? We asked the people what their IoT data is. We asked them for their healthcare information. We asked them for their genome record, and then we ask them for their behaviors. Have you traveled? Where have you gone? And you can do it right to that person directly, instantly, no redesigning, nothing.

Jason Rigby (09:59):

Right.

Alexander McCaig (09:59):

No chat bot had to be written and you can buy all this information in bulk from any country across the globe, in any locale. What's simpler?

Jason Rigby (10:08):

I know. Yeah, exactly.

Alexander McCaig (10:08):

I'm going to write my chat bot in my Azure cloud. I'm not trying to bash Microsoft, but I'm just talking about simplicity of approach. If you're trying to solve a problem, go to the source. Don't create a new tool that you can sell and then resell again and then get people to adopt after you've made your money.

Jason Rigby (10:25):

Yeah, exactly. Yeah. I mean, that's basically what's happening. So there was recently released in open source, the medical imaging server for DICOM, they call it D-I-C-O-M. And so it's ingesting medical imaging data in the cloud, and one of the things that it's working alongside, they want it to work alongside Azure APIs and also for FHIR. But whenever you look at something like this, this medical imaging server for DICOM, and it's open source, and you're seeing AIs being built and open source and stuff like that, that gives the ability for us and anybody that's a programmer to be able to take this information, disseminate it, and then build upon it.

Alexander McCaig (11:08):

Yeah, that's... Listen, that's the thing that's amazing.

Jason Rigby (11:11):

Yes.

Alexander McCaig (11:11):

I love hearing about this open source stuff because there's not a profit incentive first.

Jason Rigby (11:15):

Right.

Alexander McCaig (11:16):

And the fact that somebody can come in with fresh eyes and put in a new type of algorithm that analyzes all this imagery differently, can probably find something that otherwise the medical industry didn't even know to look for, right? Because you always need that outside perspective, especially when people are coming in to analyze certain things or program some sort of machine learning algorithm. It can't just be the specialists. They're not well-rounded enough because when you overspecialize, you breed in certain weaknesses, so you have to get other sets of eyes. And that's the beauty of that sort of open source system that they have in place. That's why Microsoft bought GitHub, this massive open source community with all this code, obviously they wouldn't want to get their hands on it, right?

Jason Rigby (12:01):

Yeah. No. And then also, any of these incubators or test beds or... But because I always like to simplify things, you know that Alex, so I think it's very important. So now we have a problem. We have people buying canine dogs and they're having to be Belgian Malinois now and not German Shepherds because the over breeding of German Shepherds [crosstalk 00:12:21].

Alexander McCaig (12:22):

It's weakened the hips in the back and all other stuff.

Jason Rigby (12:23):

Yeah. And now it's sad because you... We go to the dog park and you can see German Shepherds, their back legs, and they're so crouched down low in they're being able to walk. And that is so specialized in trying to create something that nature begins to go against.

Alexander McCaig (12:40):

Yeah. It breaks down at that point. So this is weaknesses, they come and play. And what's interesting about the DICOM is that's information that has been allowed to be shared.

Jason Rigby (12:49):

Yes.

Alexander McCaig (12:50):

Okay. Those people can go to TARTLE and purchase all the imagery they want, as much as their imagination could ever dream up. And then they can take that and analyze it. And it's a whole new bed. And with that comes all the identifiable markers that are truly important. So not only have I identified a bunch of sick people's x-rays, right? Or CT scans or MRIs, whatever they might be, I actually know the persons that's sick now. I can actually go to them directly and give them instantaneous help rather than just saying, "I took an aggregate of photos from all the healthcare systems and I brought them all together and I analyzed them anonymously, and now we can figure out how tumors grow better." It's like, well, that's all well and good, but let's talk to the person directly to keep them alive. That's a function of going to the source.

Jason Rigby (13:36):

So one of the problems that they're facing is healthcare data and the way that it's formed. One is you have unstructured text, such as doctor's notes. You have medical publications, you have electronic health records, you have clinical trial protocols, and then you have medical encounter transcripts. And there's more than that, but those are... So it's like, so now we're receiving all these data points from all these different, and we have all this text, all these different types of forms, and trying to make sense of it all, if you see.

Alexander McCaig (14:06):

This is where I see the future headed. So FHIR tries to take all those different pieces of the medical system where data is being collected at all those points, and put it in a nice record format. Text is a very difficult thing to go through, but I can say probably with almost a hundred percent assurity right now that the future will be a function of transcription of audio. There'll be microphones in all the rooms, it'll listen to everything, it'll transcribe all documents, all conversations, it'll be able to separate out speaker from speaker, even if there's 30 people in the room talking at once because it can analyze the wave patterns. And it will be able to take that and put it into text, a readable format, after it's been spoken, and automatically catalog it. That's where the future's headed.

Jason Rigby (14:51):

Yeah, and I think to close, and you can speak to this to oversimplify it, whenever you look at Picasso paintings, it's cool to get 50 of them and protect them and put them in a sheet and store them in a perfect environment and put them somewhere. It's cool to collect all this raw data, but when it's really appreciated it is when it's put out to that audience.

Alexander McCaig (15:14):

When it's in the impression exhibit at the Philadelphia Museum of Art or the Louvre, right? [crosstalk 00:15:18].

Jason Rigby (15:19):

Then it has an opportunity not only to be expressed to the public, but it has an opportunity to be valued and shared.

Alexander McCaig (15:26):

Right. And that metaphor is exactly what TARTLE is doing in its architecture for how that information is shared, moved, and that value is actually received.

Jason Rigby (15:36):

I love that.

Alexander McCaig (15:37):

Cool deal. Thanks everybody.

Jason Rigby (15:38):

Yep.

Speaker 1 (15:45):

Thank you for listening to TARTLE Cast with your hosts, Alexander McCaig and Jason Rigby, where humanity steps into the future and the source data defines the path. What's your data worth?

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