CDHI Presents Research Findings at AMIA Clinical Informatics Conference 2022

The Center for Digital Health Innovation (CDHI) team is excited to present four posters at this year's American Medical Informatics Association (AMIA) Clinical Informatics Conference held from May 24 – 26, 2022, in Houston, Texas. The team will present on Wednesday, May 25 – register for the event!



AMIA is a community committed to the vision of a world where informatics transforms care. Its mission is to transform healthcare through trusted science, education, and the practice of informatics, connecting a broad community of professionals and students interested in informatics, and being the bridge for knowledge and collaboration across a continuum, from basic and applied research to the consumer and public health arenas.

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Following are some of the highlights of the teams' presentations:

Radiology Self-Scheduling

UCSF Internal Medicine Resident Smitha Ganeshan, MD, MBA, recently led a project on CDHI’s radiology web self-scheduling service and its impact on health disparities. The study found significant demographic differences among patients who self-schedule versus traditional methods. Important to show this result to reduce the exacerbation of existing health inequities.

Digital health has the potential to increase care access to all populations. Latinx, Black/African American patients, non-English speakers, and patients of Medicaid/Medicare are less likely to self-schedule. CDHI's research is working to improve this with ongoing systemic efforts to facilitate patient use of portal-based applications.

Team: Smitha Ganeshan, Logan Pierce, Michelle Mourad, William Brown III, Anobel Odisho, Tim Judson, Marc Kohli, Christina Bronsky

 

COVID-19 Symptom Checker Efficacy

UCSF Assistant Professor of Medicine Tim Judson, MD, MPH, and the CDHI team worked to estimate health system efficiency gains resulting from providing patients access to an online COVID-19 triage and scheduling tool as an alternative to calling a telephone hotline and cost avoidance from the COVID-19 symptom checker tool.

This was a retrospective analysis of those who either called the telephone hotline or used the tool used EHR log data, local wage estimates, and estimates of call duration to determine 90-day cost avoidance of $332K. It resulted in substantial cost savings and far outweighing development costs.

It also found that San Francisco county residents were more likely to use the tool compared to other counties and that there were disparities in use between patients of different race/ethnicity, insurance status, and age.

The use of the COVID-19 symptom checker is likely to remain ubiquitous across health systems. The findings help validate the impact of automated chat tools.

Engagement for Post-Lung Transplant Virtual Care

UCSF Assistant Professor of Urology, Anobel Odisho, MD, MPH, presents his poster presentation on patient engagement in CDHI’s home spirometry intervention. The intervention pairs an automated chatbot with home spirometers, allowing lung transplant recipients to report their lung health, report concerning symptoms, and receive education.

CDHI’s digital health intervention was developed using agile methodology and integrated data into the EHR and Clinical Workflows. Home spirometry was found to closely correlate to in-lab traditional spirometry, showing the promise of remote monitoring.

The program had a high sustained engagement with 432/578 (74.7%) patients who submitted ≥ FEV1 values. By integrating home spirometry data, 15 patients would have been diagnosed with chronic lung allograft dysfunction 14 to 178 days earlier compared to in-lab results alone. Having a transplant date > 1 year of enrollment date negative predictor of engagement.

CDHI team: Anobel Odisho, Andrew Liu, Olivia BIgazzi, Eli Medina, Ali Maiorano, Aaron Neinstein, Steven Hays

User Research on Home Spirometry

CDHI Research Data Analyst Andrew Liu presents his poster presentation on findings from CDHI based on user interviews conducted for the lung transplant home spirometry program. Six key thematic concepts are discussed:

• Challenges with devices;

• Communication break-downs;

• Desire for “real” interactions;

• Desire to know that their data is being monitored;

• Understanding purpose of the care chat; and

• Recommendations for newer patients

The interviews showed patients have a strong desire for improved connection to their care team, and that technological illiteracy remains a barrier in digital health to be solved. These findings have paved the way for changes in chat content to improve the experience for patients.

Next steps are helping patients build confidence with home spirometry, focusing on education for patients with tech concerns, making difficult tasks easier, and chat design incorporating more real-time feedback in collaboration with UCSF school of medicine students (bridges curriculum).

CDHI Team: Andrew W. Liu, William Brown III, Ndubuisi E. Madu, Ali R. Maiorano, M. Olivia A. Bigazzi, Eli Medina, Steven R. Hay Anobel Y. Odisho

Engagement for Inflammatory Bowel Disease Virtual Care

CDHI Research Data Analyst Andrew Liu presents CDHI’s findings on Inflammatory Bowel Disease digital health intervention.

CDHI Team: Andrew Liu, Rishika Chugh, Uma Mahadevan, Anobel Odisho, Logan Pierce, Olivia Bigazzi, Ali Maiorano, Eli Medina

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