2. 關於我…
• 1999年於南加大(University of Southern California)取得M.S. Degree
in Computer Science後,留美由一間小新創公司的軟體工程師開始職
涯;後歷任 US. Interactive Inc.資深工程師、Sierra Systems專案技術
主管等職。
• 2005回台後加入微軟,擔任微軟技術中心資深顧問,目前擔任開發工
具暨平台推廣處資深協理;負責微軟開發技術及平台在學校、中小企
業及新創公司的導入及應用。
• 具多年協助企業、新創公司及軟體業者導入新一代技術平台之經驗,
如 Windows Azure公有雲解決方案、企業搜尋解決方案、企業單一整
合平台及 Windows 8/Phone Apps、Kinect等開發應用。
3. 新科技被廣為應用前,總會遇到阻礙
• 柏拉圖警告: 書寫會削弱記憶力;同時擔心書面
文字只是口語的虛影,無法充分表現意義。
• 數百年後,古騰堡的印刷機以其產出的創新文
件備遭批評,反對者宣稱印刷機破壞了寫作者
與紙頁之間那種自然而且近乎靈性般的連結。
• 打字機在一八七○年代出現的時候,也沒有獲
得普遍的喜愛,反對者認為這種機器打印出來
的文件缺乏人性氣息,並會導致書寫技能衰退。
A Better Pencil: Readers, Writers, and the Digital Revolution
Dennis Baron, professor of English and linguistics at
the University of Illinois at Urbana-Champaign.
24. App 世代…
和企業 IT 支出的關係?
$37.4
Billion
85 Million
9.2%
1/3rd
* IDC, Worldwide and U.S. Custom Application Development Services 2012–2016 Forecast, doc #234645, May 2012.
**IDC Predictions 2012: Competing for 2020, doc #231720, December 2011.
***Gartner, IT Metrics: IT Spending and Staffing Report, Jan. 2012
25. 使用者的行為改變? Apps vs. Web
http://gigaom.com/2012/12/05/us-spends-35-percent-more-time-using-apps-in-2012-while-web-usage-drops/
2012
31. 32
Dr. Mark Smith (left) and Dr. Craig Feied (right), MedStar Health‘s Washington Hospital Center
“Instant access to patient information is key to lifesaving care,
especially in the emergency room and intensive-care unit, where delays
may mean the difference between life and death.” — Dr. Mark Smith
“The reality is that most hospitals have islands of data that can’t
easily be shared with other systems because of disparate data types.” —
Dr. Craig Feied
32. 33
醫療院所內的「資訊孤島」現象
IHI Triggers
PHR Integration
Quality Scorecard
Ambulatory vs. Inpatient
Infection Tracking
Core Measures
Charge & Payment Analysis
Rapid Response
Care Quality Analysis
Throughput Tracking
Financial
System
Labor and
Delivery
Time and
Attendance
Ambulatory
EMR
Integrated
Clinical
Information
System
Lab
Anatomic
Pathology
Dictation
EMPI
Patient
Monitoring
System
Advanced
Visualization
Hospice
Ambulatory
Specialty
Laboratory
Blood Bank
PACS
CT
Interface
Engines
Anesthesia
Ultrasound
Ventilators
Budgeting
Other
Medical
Devices
Fetal
Monitors
34. Recent X-Rays
and readings
Recent labs
No. of
ER visits
Chief
Complaint
Recent CT scan
Recent medications
No. of dictations
Days since last visit
Arrival time
Age and sex
ER Workflow
急診室醫師: Dr. Allen
急診室「白板」(Excel-like: 排序、搜尋、過濾, etc.)
– Dr. Allen 即時觀察所照顧病人之生理訊號、是否有最新檢查報告出爐, etc.
35. ER Workflow
Past complaints
Range of ages
Old CT scans and
EKGs are available
for comparison
急診室醫師: Dr. Allen
一按即取得某病人的完整病史、藥史、過敏史。
發現曾作過不尐次的CT Scan。
39. 60%
of Clinician time is spent
searching or waiting for
patient information
Only 16% of time is available
for direct patient care.
Seeking Data
Patient Care
Source: MedStar Health
Washington Hospital Center
Clinician Landscape
Doctors are frustrated
42. Health Example
Patient Admin
Anti Malware
Email
Elec. Health Rec.
Personal Health
Information
Pandemic/Disaster
ERP
Patient Admin
這個系統有太多客製化;而且營運
成本實在太高了!
43. Health Example
”
Patient Admin
Anti Malware
Anti Malware
Email
Elec. Health Rec.
Personal Health
Information
Pandemic/Disaster
ERP
Email 及防毒產品已是很一般性的服務
,不但沒有客製化需求,委外營運的
話成本可以降得很低。
Email
46. Health Example
Patient Admin
Anti Malware
Email
Personal Health
Information
Pandemic/Disaster
ERP
市面上找不到符合本院需求的ERP系統,
而且目前維護及營運成本都在可控制的範
圍。
47. Health Example
Electronic Health
Records
Patient Admin
Anti Malware
Email
Personal Health
Information
ERP
我需要連結病人及一般使用者的資料,同時
又要提供外部服務給其他合作的醫護中心、
健局,同時要確保安全性及隱私權。
Pandemic/Disaster
HealthVault
48. 49
小小結
• 雲端運算 + App 浪潮
雲端運算: New Business Model
移動性裝置->鄉村包圍城市
C
C
4
4
C
1
C
C
3
3
Facility
C
2
C5
C
5
Hype Cycle: 泡沫是必然
使用者才是王(后)!
On the business side, this opportunity is true as well since apps are an increasingly important part of the all-up IT stack. You guys have a ton of experience to do a ton of work all up and down that stack and I’m thrilled to tell you about the opportunity on the app side to continue providing value to your partners.The app services market is huge. Last year, the total dollar amount was $37.4 billion. Not only that, it’s growing extremely quickly: 9.2%. A big part of that is tablet apps specifically. One in five businesses is building custom tablet apps. That’s something you should be doing both for business consumers and also for your line-of-business needs. To put it in context, we’re talking 7 billion people in the world, 85 billion apps downloaded last year. That’s a lot of apps and as you know, that number is only skyrocketing. Last year, one-third of all IT costs for businesses were associated with app support and development. Not only is that a lot of money, it’s a big opportunity and Windows 8 is going to be a big player in this regard. I’m here to tell you exactly how you can take advantage of that opportunity on Windows 8.
Disparate systems are great for individual patient workflows but they are generally not designed to support systematic reviews or to bring groups of patients together to understand how care is being delivered to a wider audience 1) Diabetics 2) CHF 3) Acute MI 4) Deep Venous ThrombosisThese common diseases require distinct care patterns and procedures. The data used to facilitate quality for each Dx is unique.Clinical nurse managers need to be able to get at “group” data as well as drill down into individual care history to understand how your institution is performing.Amalga enables this by pulling all your data from different systems together in an easy to use, implement and understand client.Nurses, MDs, security personnel can all use the “client” and “Smart Lists” either developed by themselves or colleagues.The key point is that having all the data in one place creates an entirely new “Asset” that functions as a platform to “dive off from” and or build broader tools upon.