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Behind The Tweet: Microsoft Surface at Texas Health Resources

I recently had the opportunity to talk with Dr Ferdinand Velasco (@ftvelasco) Chief Medical Information Officer, Mike Skupian (@mikeskupien) Application Architect and Rease Alvarenga-Smith (@PearlMustafa) of Texas Health Resources about some of the work they are doing with Microsoft’s Surface Technology. Texas Health Resources is one of the largest faith-based, non-profit health care delivery systems in the United States and the largest in North Texas in terms of patients served. The system’s primary service area consists of 16 counties in north central Texas, home to more than 6.2 million people. Texas Health Resources has a number of interesting patient centered initiatives in process some of which you can read about below and some that I will discuss in a future post. In this post you can read and see how Texas Health Resources is using Microsoft’s innovative Surface technology to enhance patient education and understanding of their condition. In addition you can read about planned Surface use for neurological therapy and diagnosis.


Mike Skupien: We have two general initiatives with Microsoft Surface. The first is a patient clinician consultation application.

The second application was heading up a vein of interest that we had in dealing with education and consultation between a clinician and a patient. The second area that we’re looking into is more therapy and diagnostics and research. And along those lines, we’re working with one of our neurologists in Dallas, who does a lot of neurological research.

We are in the process of developing an application where he can take some of his tests that neurologists use on their patients and we’re putting it onto Microsoft Surface. And the hope is we can collaborate on collective information, and we are able to analyze the data quicker and easier than they can in the current manual process.

For example, where a person traces a course around a maze of sorts and we track that path that they take. And we’re hoping that the Surface unit is sensitive enough to be able to capture tremors or deviations from the desired path.

If that’s able to work and we’re able to get the data fine enough for research, then they can trick things up, things that we wouldn’t normally think of, the normal human wouldn’t think of, but neurologists think of weird things, changing the color, changing the speed requirements, if there’s flashing lights on the screen while they’re doing it and so on and does that affect people differently. So that’s what we’re hoping for.

So that’s the two areas, patient consultation and then more of a therapy/research.

Liza Sisler: So let me ask you about the first area, the patient consultation and can you tell me a little bit more about that?

Dr. Velasco: As you know, what’s novel about the Surface platform, as is many of the sort of emerging smart phone technology that was ushered in by the iPhone is this idea of touch interaction with a device.

So unlike a traditional personal computer or laptop where your primary interaction is with a keyboard and a mouse, with a Surface unit, the interaction is with your fingers on the actual user interface itself. And it gives you a much more intuitive interaction with the application, with the objects that are contained with the application, whether they’re documents or images, medical images and things like that.

So the idea being that it would be a way to leverage this concept of an intuitive, natural user interface in the context of a patient interacting with a clinician, a doctor or a physician extender, that would be less intrusive, less foreign than the physician, with their back turned to the patient clicking away at a keyboard, looking at a computer screen and saying, oh yeah, I see some lab results here and not really allowing the patient to participate and engage in that kind of interaction with the technology.

So that was the idea behind the development of the patient clinician consultation application, is to transition away from the traditional interaction that a clinician has with a computer and the electronic health records with the patient basically being isolated from that interaction, to really being more of a bi-directional kind of activity with the patient now, actually, not only being face-to-face with the doctor but actually having an opportunity to be directly involved in the process of reviewing the data and manipulating the content in the consultation application.

So that’s the general premise of it. As you know, the Surface unit goes beyond the iPhone, in that it’s a multi-user application, so you can have multiple users, not only the physician and the patient but even family members or other clinicians interacting on the Surface unit concurrently. So there are a number of advantages to the platform itself that extend the benefit of just having a natural user interface on a large scale.

As Mike may have already mentioned, it is just a prototype application, it’s not something that we have in place for existing patient care interactions. It is something that we eventually hope to have in a production mode. We’ve had discussions with Microsoft about integrating the application with HealthVault so that if a patient has data that they’ve entered or documents that they’ve uploaded to HealthVault, it’s something that they could be able to make accessible through the application.

Dr: Velasco: Conversely, we’ve had conversations with our EHR software vendor, Epic Systems in Wisconsin, to have some kind of interoperability with our application. But it’s proven to be a very challenging – it’s been challenging going from the prototype to an actual clinical application that can be used in the healthcare setting, because that requires significant investment in technology and integration.

So basically we’re kind of in a holding pattern right now, looking for funding to move forward with ongoing development of this application. And we’re looking at the second application, the one that Mike described, working with our neurologist researcher, because we think these are some applications that we’ll be able to develop with less investment, if you will, in terms of development, in terms of programming. And he, himself, has access and connections with funding opportunities or funding sources to jumpstart, if you will, some of this development for the neurology application. But it’s not something that we’ve abandoned entirely, it’s something that is just right now waiting for funding.

The other thing, too, that Mike may have mentioned as well is that when we look at development, we just don’t look at a particular device, such as the Microsoft Surface platform, although it’s certainly an intriguing and innovative platform. Ideally, what we’d like to be able to do is whatever we develop is integrated and contiguous with other platforms. So, obviously, a patient is not going to have a Surface platform in their house, at least not initially. Right now, they’re too expensive for most people to have as a home piece of technology.

Dr. Velasco: So what we would like to do is if we develop applications that run on the Surface platform, they’re also accessible, in a different type of user interface experience, on the Internet, on our own equipment in the hospitals, perhaps even on the iPhone. So that the application is something that, at many different levels, is accessible to these different types of devices. So that’s another thing too that I thought would be important to emphasize.

Liza Sisler: Have you had a chance to look into the multi-touch capabilities of Windows 7, just as you’re developing on Surface and that that may be another avenue for you that’s maybe less expensive?

Mike Skupien: the neurological application that we’re developing is going to take advantage of some aspects of Windows 7. If we go forward onto the next neurological, we hope to incorporate more and more of Windows 7 for the purpose of being able to go multi-platform, just as Dr. Velasco was referring to. For example, our next neurological app may not be Surface related by we might take the same application and do it on HP’s new multi-touch monitor. And we’re – again, we’re hoping to utilize Windows 7 for that.

Dr. Velasco: Yes, it’s still a bit early, and – I assume you’ve been to the Chicago O’Hare Airport in the last few months? So you know that they’re using Touch Smart PCs as a kiosk for getting flight status information and to navigate their way around the airport. Since we are working with HP on a number of things, that may be something that we will utilize Windows 7 for – apart from these more specialized clinical applications that we’ve talked about.

In my next post I’ll share more form my discussion with Texas Health Resources and some of the ways that they are enhancing patient experience. In the meantime, what do you think about Microsoft Surface in Healthcare and if Window’s 7 multi-touch capabilities will have a significant impact in how Healthcare applications will be designed in the future? Is cross platform application development & compatibility something that you are considering?

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