This blog post was co-authored by Sharlene Jerome, Manager of Marketing and Communications, Sensoria Health

This blog is part of a series in collaboration with our partners and customers taking advantage of the newly announced benefits Azure Health data services. Azure Health Data Services, a platform-as-a-service (PaaS) offering built solely to support protected health information (PHI) in the cloud, is a new way of working with unified data and provides care teams with a platform to support it of transactions and analytics workloads from the same data store, and enabling cloud computing to transform how we design and deploy AI across the healthcare ecosystem.

According to the World Health Organization, over 422 million people have diabetes. Diabetes is an emergency of epidemic proportions and diabetic foot complications have one of the most painful consequences – every 20 seconds someone in the world loses a lower extremity to diabetes. The total global cost of diabetic appendage complications is estimated at US$46 billion, and in the United States, the direct costs associated with these complications exceed the cost of any of the five most costly cancers¹

These astonishing figures show that connected shoes will play an important role in the future of diabetic care. As one of the most innovative applications of IoT in healthcare, remote patient monitoring is essential to ensure effective treatment, improve patient care and reduce hospital readmission rates. This requires a smooth flow of data from patient to clinician and from clinician to clinician. However, the current siled healthcare industry, with data stored locally and a lack of interoperability between those local systems, makes it difficult for clinicians to access data in a timely manner to proactively treat patients. And when diabetic foot ulcers can potentially lead to limb loss, the stakes are remarkably high for all involved.

Making data from the real world accessible

To better manage data in the cloud and enable healthcare organizations to access patient data in a timely and secure manner, Microsoft has published Azure Health data servicesa PaaS offering built on the Fast Healthcare Interoperability Resources (FHIR®) and Digital Imaging Communications in Medicine (DICOM) global open standards.

One of the biggest challenges in treating diabetic foot ulcers is the ability to monitor the patient’s progress outside of the hospital setting. The inaccessibility of this data prevents physicians from working with patients to ensure they are adhering to clinical recommendations, reducing the effectiveness of treatment and care. With Azure Health Data Services, providers can now access this data easily and in a timely manner, giving patients the best chance of fighting diabetic foot ulcers. Microsoft’s technology, along with Sensoria’s innovative footwear for diabetics, will enable the creation of a new category of solutions for podiatrists that will not only provide valuable feedback to and from patients, but also align physicians with patient compliance and usage patterns for healing treat diabetic foot ulcers. Supporting the goal of reducing the risk of entry.

As a leading provider of wearables for remote patient monitoring and AI software solutions Sensory health already uses FHIR and Azure Health Data Services.

“There is no such thing as a ‘small’ diabetes. Just as there is no such thing as a “small” crab.”–dr David Armstrong, Professor of Surgery and Director, Southwestern Academic Limb Salvage Alliance (SALSA) at Keck School of Medicine, USC and Director, USC Center to Stream Healthcare in Place (#C2SHiP)

Sensoria's diabetic foot ulcer bootSensoria’s diabetic shoes are a wonderful example of how health data from the Internet of Medical Things (IoMT) can be used to improve clinical workflows and process valuable data to support both patients and physicians in creating individualized care plans . Supported by Microsoft Azure Health data servicesIoMT health data can be ingested from the Sensoria shoes and compiled to provide a valuable holistic view of a patient’s home care, self-care knowledge and care plan adherence. The IoMT health data coming from the shoes can be anonymized, compiled and stored in Azure Health Data Services. Microsoft Azure Health Data Services is HITRUST CSF certified, helping organizations store PHI in accordance with HIPAA and GDPR requirements and the mandates of the Office for the National Coordinator for Health Information Technology (ONC) and the US Centers for Medicare and Medicaid Services (CMS) to be fulfilled. Once health data is stored in a standardized and interoperable format, trends can be created and tracked to visualize patterns and identify early warnings, or to enable further analysis to support physicians and treatment options. Sensoria Health uses Azure IoT Central To connect the shoes and bring valuable IoMT data to the cloud – Azure Health Data Services helps manage IoMT data collected from the shoes to provide the clinician with a more comprehensive view of the patient population, treatment compliance, daily adherence results and behaviors to support real-time feedback, and capture historical gaps in care and best practices.

Powered by Sensoria Core, a wearable sensor platform that is modular, self-contained and fully integrated to provide highly accurate data, the Sensoria Diabetic Foot Ulcer Boot can measure adherence, whether the patient is wearing the shoe, how active they are and adherence of the recommended clinical protocol. The physician dashboard provided by the Sensoria Diabetic Foot Ulcer Boot provides a holistic view of the patient population. The dashboard is color-coded so clinicians know which patients are most at risk due to non-compliance. In these cases, an escalation of care can be identified and the boot can be made irremovable.

Sensoria Health is excited to partner with global diabetic footwear partners such as ossur, DARCO Internationaland Defender Operations.

Foot Defender®“In the US, CMS embraces remote patient monitoring and introduces a new reimbursement model for remote therapeutic monitoring. Our partnership with Sensoria Health will place both of our companies in a leading position for smart podiatry footwear products around the world.”—Darrel Darby, CEO, DARCO International

“The combination of Foot Defender® with the Sensoria ® core is the marriage of modern manufacturing, advanced textiles, cutting-edge engineering and advanced electronics. Bringing these two cutting-edge technologies together creates a product that patients want to wear and can help them monitor activity and usage, engage patients in their care while empowering them to make behavior changes.”—dr Jason Hanft, DPM, FACFAS, CEO and Founder, Defender

Do more with your data with Microsoft Cloud for Healthcare

Part of the Microsoft Cloud for Healthcare, Azure Health data services empowers healthcare organizations to transform their patient experience, discover new insights with the power of machine learning and AI, and securely manage PHI data.

We look forward to being your partner as you shape the future of health.

®FHIR is a registered trademark of Health Level Seven International registered with the US Trademark Office and is used with permission.

¹ WHO Library Cataloging-in-Publication Data Global report on diabetes. 1. Diabetes mellitus – epidemiology. 2. Diabetes mellitus – prevention and control. 3. Gestational Diabetes. 4. Chronic illness. 5. Public Health. I. World Health Organization. ISBN 978 92 4 156525 7 (NLM Classification: WK 810) © World Health Organization 2016 9789241565257_eng.pdf;jsessionid=27AFE586B882A75AA68600E65BD3E049 (

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