Microsoft turns 45 years old on April 4th. It is one of the older generation big tech companies, a fierce competitor with a sometimes contentious relationship with antitrust laws.
They have been a leading software company with many business offerings, including business software, web browsers, and video games. Microsoft has been the de facto source of business software tools. In a way, they have already been in healthcare for decades in an administrative capacity. They are among the big tech companies adding healthcare to their portfolio. How are they participating?
Microsoft Teams has been a part of 365 since 2017, providing collaboration and communication tools for the workplace. In 2019, they added features to make Teams healthcare friendly. More specifically, these features are intended to facilitate better clinical coordination between clinicians engaged in team-based care. EHR information can be integrated into Teams using the FHIR interoperability standard, filling a need where some clinicians have been using chat apps that were not HIPAA compliant. The features also include priority notification, which continually alerts a recipient until a response is received, and message delegation, which delegates a message to another recipient if the clinician is unavailable to respond. The messaging system also has a secure image sharing feature with annotation.
Chatbots are being employed increasingly in healthcare to assist patients with health-related queries. Microsoft Healthcare Bot is a service that institutions can use to build virtual health assistants and chatbots. Its features include healthcare intelligence, medical content and terminology, as well as the capability to access EHRs. Some institutions have built symptom checkers to triage patients’ issues and help them find the right place for appropriate care. Microsoft says its healthcare bots help clinicians interact with medical information systems using natural language processing (NLP) and artificial intelligence (AI) technologies.
Cloud computing is becoming an integral part of healthcare data as institutions require more storage and computing power than on-site servers can provide. Microsoft has a cloud computing service called Azure that added interoperability via FHIR API in 2019. Artificial intelligence is a feature of Azure that Microsoft hopes will attract more healthcare institutions that want to aggregate and analyze their data. In one application, they are working with UCLA to "implement an algorithm that aims to predict when a hospitalized patient's condition is at risk of deteriorating".
Microsoft is also positioning to have a presence in the precision medicine field with its Microsoft Genomics service based on Azure. They have made several partnerships with genomics labs and healthcare institutions to provide computing for research and point of care analysis. Specifically, Microsoft partnered with St. Jude Children's Research Hospital and Mt. Sinai Klein lab in cancer research and treatment efforts. Mt. Sinai uses the platform to "archive big-data files and analyze complex genome-sequencing data cost-effectively—and understand the underlying biology of various medical conditions".
Microsoft is well established in all things computing, but its sprawling workforce and bureaucratic approach to business can make it slower to innovate. It tried to get into the consumer-facing EHR market with Microsoft HeaththVault, but with low adoption, it shuttered in 2019. Their offering took a traditional approach to EHRs, not taking into account the push for integration with wearables and other smart health devices. It also didn't include a mobile component, where many prefer to access their health data.
Although not part of Microsoft itself, it is notable that Microsoft founder Bill Gates and his wife Melinda have funded many worldwide medical initiatives through the {Bill and Melinda Gates Foundation](https://en.wikipedia.org/wiki/Bill_%26_Melinda_Gates_Foundation). Medically, they are focused on finding solutions for health problems in developing companies, including HIV/AIDS, Malaria, Tuberculosis, and other neglected tropical diseases. They have donated more than $6.6 billion in global health initiatives.
Microsoft focuses its efforts on cloud computing and artificial intelligence as its main foothold in the healthcare market, as are other big tech companies, notably Amazon and Google. They have the years of experience over everyone else, but will the ability to innovate quickly in the changing healthcare landscape be able to match those that are half Microsoft's age?