Manage To Change

Microsoft’s Azyxxi

I saw a demonstration of Azyxxi at HIMSS07. This system pulls healthcare information from the various systems supporting a medical facility into a common database.

The information is used by clinicians and healthcare professionals to create their own views of patient and facility related data relevant to their roles in delivering, monitoring, or managing care. 

Even though the data is stored in SQL, they say it’s not a relational database. Instead of a series of tables with multiple columns and primary keys, Azyxxi is “one big bucket” with multiple (virtually unlimited) rows of entities, attributes, and values.

Why do this? Performance and flexibility are the primary reasons. 

To quote the demonstrator, Azyxxi “is banking on the continued decrease in the costs of storage”. They keep all of the data ever imported and have dumped the traditional table structure of a relational database in favor of the power of search and query. 

I’d be lying if I said I understood the technology behind this.  

What I am beginning to comprehend is the end result - a “connected health framework” in which patient information is available to practitioners in virtually any form or view they find useful, the content and appearance of which they can alter at any time.

That’s pretty amazing.

Steve Ballmer at HIMSS 2007

I'm in New Orleans this week at the Healthcare Information and Management Systems Society (HIMSS) 2007 conference.

If you’re not familiar with HIMSS, the organization’s tag line says it all - “transforming healthcare through IT.” 

On Monday, Steve Ballmer (CEO Microsoft) delivered the opening keynote address.

He described how personalized medicine and our digital lifestyle are causing an information explosion in medicine. 

This explosion makes it difficult for care givers, and patients alike, to effectively discover and apply the information that is relevant to them.

Microsoft believes “software as a strategic asset is required to bridge the gap”. 

The explosion
Individual patient information is increasing. As it does, it becomes possible to use very personal and unique patient characteristics (e.g., genetics) to determine someone’s predisposition for a disease or to customize a treatment.

General medical knowledge is increasing. 

On the patient side, more (and less medically technical) information is becoming available to individuals who are increasingly becoming more active in their own healthcare management.

Patients are beginning to expect richer and more extensive electronic interactions to assist them in this effort, regarding “computing as a fundamental access point to information.”  

Microsoft’s Response
Observing that healthcare is the largest segment of the world economy as well as one of the fastest growing segments, Microsoft has been building capabilities in healthcare for the last 10 years.  

They now have 600 people devoted to healthcare, many of whom are medical professionals. They have also acquired Medstory and Azyxxi (more on that later).

Steve believes that three technological trends have now reached a level of maturity where they, with the proper guidance from medical professionals, can positively impact healthcare: 

1. Connecting systems (health systems)
2. Driving informed decisions (providing and filtering information)
3. Improving collaboration (for researchers, medical professionals and patients)

I’m planning to spend some time at their booth today and see what else I learn. One thing on my list is a demo of Azyxxi, which I will report on later.