Groove: A cure for healthcare's fractured ecosystem
Updated: June 6, 2006
In healthcare, there is plenty of available software to help payers and providers record and manage patient and clinical data. And, there's a wealth of valuable information about patients and disease management, increasingly stored in electronic systems. But even with all the software and information, there is still a shocking lack of online coordination and sharing of information between constituents, including the disconnected community ecosystem of care managers, patients, providers, and family members.
Without familiar, easy-to-use collaboration tools in place to bridge the fragmentation, it is no surprise to see inconsistency in the quality of care across organizations. One troubling outcome: Medicine that is evidence-based only 55 percent of the time. A Rand Corporation study recently estimated that the United States can reduce healthcare spending by 30 percent—$500 billion US per year—if patients routinely received evidence-based care.
Since most healthcare processes and decisions involve multiple people and teams throughout the ecosystem, there is a clear need for rich, online communications and collaboration tools that can work seamlessly across organizations and software platforms. One solution to bridge this gap is something called Groove, collaboration software acquired by Microsoft in 2005. The next Microsoft Office release will include Microsoft Office Groove 2007.
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Case in point: High-risk patients with chronic conditions
Patients with chronic conditions consume the most care and the highest percentage of healthcare spending, and "demand the highest level of collaboration among providers and payers," according to market research firm Gartner, Inc., Information-Driven Collaborative Care Management 2004. Typically, the health plan hires a highly-skilled nurse care manager to coordinate the care of patients with chronic conditions. Yet, despite the nurse's best efforts, the existing analog system typically breaks down in the midst of various exchanges of voice mail, paper, faxes, e-mail messages, and lab reports—none of which are accessible from one place, shared, or updated on a regular basis.
"The problem is the patient sees multiple physicians, but each provider prescribes their own care plan. And the care plan, the information, and the insights don't follow the patient," explains Dennis Schmuland, M.D., FAAFP, director, Microsoft Healthcare and Life Sciences, Health Plan Industry Management.
Alternatively, Groove can help all of the providers exchange information about the patient's care.
How Groove can help providers work together
Groove provides a secure collaboration platform that enables health plans and providers to:
| • | Work as a team no matter where they are—on an airplane, at home, in your organization or not, online or offline. |
| • | Set up a virtual workspace to hold and exchange information, documents, messages, forms, meetings, and calendars, and also to facilitate real-time chats. |
| • | Store individual copies of each patient's workspace on a fixed or mobile PC, which synchronizes with other members' copies of the workspace each time they connect to the Internet. |
A virtual chart for each patient
"In the chronic care example, the care manager or the care management system itself can create a Groove workspace (or virtual chart) for a patient who has just had emergency surgery," Schmuland explains. When the patient leaves the hospital, the virtual chart can be programmed to send an electronic invitation to each attending physician to join the Groove workspace. When the patient arrives at each follow-up appointment, medical documents, insights, communications, and other pertinent information are instantly available in each provider's virtual chart (think of it as a chart on your desktop). Health plans also can share their versions of the patient's health record with authorized providers in the Groove virtual chart.
In essence, the patient's entire team of providers and health plan care managers can be on the same page, able to access and coordinate tasks around a common care plan, managing the patient's care, updating progress notes, and even consulting with one another through real-time chats about decisions. Each provider can also subscribe to Groove alerts, so they know when information is updated in each virtual chart.
A virtual meeting place for patient-centric care management teams
Groove works best in scenarios where team members are highly mobile, geographically dispersed, working for different organizations, and occasionally connected to the network (a LAN or the public Internet). For example, community providers and distributed care management teams are good examples of providers who could benefit. Groove helps these disparate providers share information by enabling files to pass through corporate firewalls. This is unlike Microsoft SharePoint, which is typically used as an intranet platform for storing and sharing documents and data on the same private network.
One other distinction from SharePoint: You can access your Groove workspace and work on these files when you're offline. Once you reconnect to the network, all your file and data changes within that workspace are automatically updated for you and other members over what's called a relay server.
Looking beyond the barriers
"There are a number of ways Groove can help health plans create a trusted and convenient space for collaboration," Schmuland says. "Beyond sharing patient information, Groove can enable health plans to collaborate with brokers to close deals in less time, facilitate mergers and acquisitions, equip product teams to collaborate and quickly bring new innovative products to market, and automate the setup process for new group enrollments," Schmuland explains.
"Each team member would need a version of Groove software installed on their computer to access the workspace and virtual charts. But given the widespread use of Microsoft Office products, presumably this would not be a long-term barrier," Schmuland observes. "And while payer self-service Web sites for providers might offer some collaborative functionality, it's not particularly convenient for providers who work with up to 100 health plans, requiring them to log on to multiple Web sites during the course of a workday. Furthermore, self-service Web sites were never designed for geographically distributed and intermittently offline teams to work together," Schmuland adds.
Security is another obvious concern, particularly when it comes to handling patient information over public networks. Using 192-bit encryption, Groove automatically encrypts each user's account, all workspace content locally on the user's computer, and all content and activity transmitted across the network.
A great advantage of Groove over other collaboration tools is its integration with Microsoft Office products and Microsoft Windows Server System integrated server software technologies—which will grow over time. And, Groove has backward compatibility, so you can exchange Microsoft Office Word documents, Microsoft Office Excel spreadsheets, Microsoft Office PowerPoint presentations, and other files from earlier versions of Office products within a Groove workspace. Users can also synch Groove files with a SharePoint workspace with the upcoming releases of Microsoft Office SharePoint Portal Server and Windows SharePoint Services.
Healthcare organizations that are not ready to upgrade to the 2007 release of Office products can acquire Groove software separately. Groove is also available by subscription through a product called Office Live Groove.
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So what's the problem with simply using e-mail messages and instant messaging for collaboration? Ryan Hoppe, a marketing manager with Microsoft Groove, explains: | • | E-mail applications are best for communications not specific to a project. Endless e-mail threads involving 10 or more people trying to coordinate a task or project can be painful. | | • | With all of the different applications and devices that we use today, it's hard to keep track of the information related to a particular project or case. | | • | Without a common virtual chart, the patient information and records will remain trapped, and often spread across individual hard drives. |
"There is no one single place to go to get a common view of each project or patient,” Hoppe explains. “With Groove, you can create a new virtual office (or chart) on your machine with two mouse clicks, and then invite someone to it in seconds. Literally, if everyone on my team was online, I could pull the team together in less than a minute." |
