Amalga UIS from Microsoft

Editor's Notes

• #5: Over the past twelve years Microsoft has steadily increased its investments and commitment to health. In 2005, the Health Solutions group was created when our corporate VP, Peter Neupert, came on board at the direct request of Steve Ballmer to explore and create solutions for healthcare more deeply. Peter’s been a long time Microsoft employee. He led the OS/2 team and then he orchestrated the MSNBC deal before leaving Microsoft to go on and establish Drugstore.com. After a few years as the CEO of Drugstore.com Peter was on the United States President’s IT Advisory Council when he decided to come back to Microsoft to help us focus very specifically on healthcare and healthcare IT solutions. Over the course of the following 2 years, HSG purchased key technologies to create a foundation of solutions to address pressing challenges that other IT organizations were not meeting. The result is the solution set we have today – a Family of enterprise solutions, Amalga, and HealthVault, a platform for consumer information. Today, we have some of healthcare’s leading providers using Microsoft Health Solution Group’s innovative solutions. Microsoft is the only IT provider simultaneously addressing health information needs from both a consumer and enterprise viewpoint, to advance a vision of unifying health information and making it more readily available, ensuring the best quality of life and affordable care for everyone.
• #6: Over the past twelve years Microsoft has steadily increased its investments and commitment to health. In 2005, the Health Solutions group was created when our corporate VP, Peter Neupert, came on board at the direct request of Steve Ballmer to explore and create solutions for healthcare more deeply. Peter’s been a long time Microsoft employee. He led the OS/2 team and then he orchestrated the MSNBC deal before leaving Microsoft to go on and establish Drugstore.com. After a few years as the CEO of Drugstore.com Peter was on the United States President’s IT Advisory Council when he decided to come back to Microsoft to help us focus very specifically on healthcare and healthcare IT solutions. Over the course of the following 2 years, HSG purchased key technologies to create a foundation of solutions to address pressing challenges that other IT organizations were not meeting. The result is the solution set we have today – a Family of enterprise solutions, Amalga, and HealthVault, a platform for consumer information. Today, we have some of healthcare’s leading providers using Microsoft Health Solution Group’s innovative solutions. Microsoft is the only IT provider simultaneously addressing health information needs from both a consumer and enterprise viewpoint, to advance a vision of unifying health information and making it more readily available, ensuring the best quality of life and affordable care for everyone.
• #7: Amalga, HV and Sentillion customers listed Sentillion customers(bottom left) to the original slide- SHARP, Adventist, Imperial College Healthcare NHS, CHOAHV customers top left column of slide- CVS, Aetna, Kaiser, AHA, VirtuaBumrungard(HIS)And Amalga(rest)- St joseph, Virtua, DCPCA, Golden Living, providence, seattle Kids, John hopkins, tenet,medstar, novant, caritas, El Camino, Scripps.Also grouped together those where can relay similar stories- for example NYP and Virtua both have Amalga and HV.
• #9: KLAS recently came out with a report which featured Amalga and several other vendors, in which it stated . .. That Amalga provides a “major advancement in defining, storing and accessing healthcare data.”
• #11: Now, let’s take a look how far we've come and how we can leverage Microsoft Amalga to take your current assets to the next level... To optimize care.Most organizations have come a long way from the paper based days of old.  Data in a paper base world was manually captured at the point of care, filed on a shelf making it very difficult to analyze one patient’s data, much less a collection of patients.Over the past 20 years, your organizations have increasingly deployed electronic systems to capture and store information at the point of care, which has automated a number of manual processes and increased patient care by giving clinicians a better view of patient data.  This has, however, increased the need for data interfaces across best of breed systems and created silos of data.   Additionally, all hospital staff – clinicians, administrators, leadership -- are getting a taste for the value of real-time data and are becoming thirsty for consolidated knowledge and a unified view of patient care, facility and resource management.[RR] In order to get to the next level you need a system that allows for a consolidated view of all the information assets dispersed in various silos throughout the organization. This new approach should allow you to more easily accommodate new data types, standard or otherwise and function as the platform for your next level of insight.Enter Microsoft Amalga, the new unified intelligence platform that enables your current investments to be ultimately useful.  Amalga brings all of your data together in a flexible repository and enables a four-dimensional view of patients and populations.  Amalga leverages current health data standards but does not require them.  Now you can use all of your health data in evolutionary ways because everything that is fed into the system is stored in the state that it was received and can be replayed for innovative uses in the future.  Finally, Amalga has been built to facilitate changes to your environment with the ability to accept new data and scale with the rate of your organization.
• #12: What’s under the hood in Amalga – point here is they got a lot of stuff in Amalga that is part of the system. All these tools and components are what make Amalga so unique – and the sum of the parts is greater than the whole. Amalga Extensions are in development, and will be offered as part of the core Amalga solution offering & price. These are tools that allow organizations to get to a faster time to value by creating solutions such as quality scorecards, infection control and population management out of the box. These will be offered both by Microsoft and our customers, and we plan to build a connected community to allow our customers to share these.In the future, we plan to offer Amalga Modules – which will be applications developed by Microsoft or partners that will leverage the data stored in Amalga.
• #15: While there has been a move away from best-of-breed to tighter integration, the reality is that:No single vendor can house ALL data We talked about being within an era of hyper-change – this means that niche solutions will always emerge to address unforeseen requirements, creating more silos of dataThese systems typically present data from a patient-centric point of view, which is valuable at the point-of-care. However, to transform organizations, operations, quality, etc. . . . organizations often need to view data from a different angle – by cohorts, by clinician, by disease state, etc. It’s not easy to get these types of views today. Finally, these systems were developed to address well-defined needs, and so are optimized and highly structured to serve a specific “bound” function. As a result, the information stored in these systems are not agile – they tend to be “locked” in a single view, and unfortunately, sometimes even locked within that system.
• #16: While there has been a move away from best-of-breed to tighter integration, the reality is that:No single vendor can house ALL data We talked about being within an era of hyper-change – this means that niche solutions will always emerge to address unforeseen requirements, creating more silos of dataThese systems typically present data from a patient-centric point of view, which is valuable at the point-of-care. However, to transform organizations, operations, quality, etc. . . . organizations often need to view data from a different angle – by cohorts, by clinician, by disease state, etc. It’s not easy to get these types of views today. Finally, these systems were developed to address well-defined needs, and so are optimized and highly structured to serve a specific “bound” function. As a result, the information stored in these systems are not agile – they tend to be “locked” in a single view, and unfortunately, sometimes even locked within that system.
• #17: St. Joseph Hospital is a large Catholic healthcare provider with a tradition and commitment to excellence, based on the vision of the Sisters of St. Joseph of Orange. The hospital system, with its 3,800 employees in California and southern Texas, provides healthcare and collaborates with the 1,000-member medical staffs and other healthcare providers to increase access to quality healthcare. St. Joseph’s of Orange County plans to use Amalga to help deliver on three strategic objectives: Perfect Care – providing every patient with highest level of care possible, Healthiest Communities – working to make the communities they serve the healthiest and Sacred Encounter – ensuring interaction with their community is meaningful and purposeful. Unlike the WHIE, which has a highly complex and disparate number of data sources, St. Joseph’s IT structure is fairly homogenous. However, for the first time ever, they can see data from all 14 hospitals. They have also integrated the data housed in their inpatient and ambulatory systems. The integration of patient data between inpatient and ambulatory settings – across settings of care -- is a pressing need in the health care industry and also one of its most pressing challenges. St. Joseph’s cost-effectively addressed this challenge with Amalga. Amalga is complementary to their core IT systems, including Meditech and Allscipts. St. Joe’s recognizes they cannot get everything from a single vendor. And, because they can compare the raw data in Amalga to the data in their core systems, they can see errors in data in the core source systems that they were unable to see before.Larry Sofko, St. Joe’s CIO, recently discussed in a webinar about how he felt Amalga will help future-proof their organization, reducing the need to bring on new vendors and reduce the cost and complexity of their IT infrastructure. They plan to use Amalga in a number of very exciting ways that will help them drive their mission of Perfect Care – driving better clinical decision-making by being able to ask questions like “for this type of problem, how have others been treated and how did they do with those treatments?“ – providing the required information for continuous quality improvement programs like LEAN, and evaluating data from their CPOE system with outcomes and financial impact information to determine experienced-based best practices in treatment plans.
• #23: Is the miss in aspirin administration a result of ordering, pharmacy delivering or nurse administration process issues?
• #27: Showing screens shots that went live in the St. Joseph Health system on July 1st. This is a view listing current emergency department patients within Orange County. St. Joes has three hospitals in Orange County St. Joseph Hospital, Mission Hospital and St. Jude Medical Center. In this example you can see 223 current ED patients across those three hospitals. To quote Larry Stofko, CIO. “This is something we could never do before Amalga. We have independent instances of our MediTech system we would typically run reports, and those transaction systems are very good but this is a snapshot, a real-time access to this information across our Orange County organization.”Within a single system, Amalga allows St. Joe’s to get a listing of ED patients across all three hospitals, then they can drill down into patient detail. Then they can even roll-it up to get view of the ED department across the region.
• #28: Prior to implementing Amalga, the Quality analysts at St. Joseph’s were “data nags.” Much of their time was spent calling each hospital to collect information. The challenge and annoyance was magnified because there were multiple analysts, all requiring information for their various reports. Each would call the same person at each hospital to ask for information. From the analyst’s viewpoint, most of their time was spent on the mundane – collecting data, putting it into reports, working amongst themselves to verify information. And after all their “annoying” requests for data, it would take them 4 months to put together a dashboard to send back to the hospital. By that time, who is really interested in 4-month old quality reporting? How relevant is that? How can you make improvements based on information that old.With Amalga, the quality analysts can now see data from ALL 14 hospitals in real-time. With no need to call and nag for information, and with a single store of data that the different analysts can choose from, these analysts can NOW spend their time focusing on how the information can be used to improve care quality.
• #31: By clicking on any of the arterial blood gas components, the viewer is zoomed into Lab Details. In this view, all the component test results from the Arterial Blood Gas panel are displayed horizontally along with the historical ABG results. This can be transposed, graphed or printed. If the ABG panels had different normal ranges, they would appear in additional columns to highlight the differences, and could be merged for viewing purposes if necessary.
• #32: St. Joseph’s is very excited about the continuity of care record information and supports how St. Joseph’s is addressing community health and health information requirements. These 2 overlayed screens support these objectives. The first one on the top is actually a continuity of care record diagnosis or problem list that is coming across from the outpatient AllscriptsTouchWorks system from a patient’s primary care provider. So you see as there are different diagnoses out there – it’s essentially a problem list. So imagine a patient shows up unconscious at one of our Emergency Departments, the ED can basically call up within Amalga, and can see the problem list. Then the second view, the bottom half of the screen, are the medications that this patient was actually prescribed and is receiving from his primary care or specialist provider outside of the hospital. This is quick, a couple of clicks to information that most people can only hope that they are able to share even in a conscious state. In this case, it’s four medications, the doses, the names, whether they’re active or not, are displayed. You’re not basing it off of the patient or their family members’ recollection of what medications they are receiving outside of the hospital. To quote Larry Stofko, “This is really, really exciting for us, and actually taking something we’ve hoped to do and to bring it into reality in a real-time basis.”
• #36: TALKING POINTS -- BenefitsImproved care45% of patient visits to one hospital already had information in the WHIE from another institution (20 patients/data with > 3 ED visits within the last year).Patient encounter history supports critical continuity of care20 patients/day with > 3 ED visits within last year Reduced costsReduced ancillary services in 25% of encountersReduced required level of service from comprehensive to basic for 5 patients/dayEstimated facility ED charge savings @ $2,000 - $3,500 per encounter = $3.6 – $6.3 million annuallyPublic health improvementsNear real-time effortless public health survellience
• #37: Here is one of our Amalga early adopters. Larry Stofko, the CIO of St. Joseph, believes that they will be able to reduce their IT spend on new applications over time.Complementing applications . . . Lets us go either way . . .