Big news in digital health this week with several pharmacies putting a pause on filling telehealth company-driven prescriptions. Mohana Ravindranath interviewed me and wrote a thoughtful piece in STAT News capturing so much of the nuance. The broader story could easily turn into a media pile-on against telehealth, which I think would be a mistake. I previously wrote with Judd Hollander in NEJM Catalyst, discussing the need for telehealth to mature from adoption to quality-based metrics.
A team from UCSF Health and our Center for Digital Health Innovation was recently privileged to submit a letter to the Office of the National Coordinator for Health Information Technology’s (ONC) Request for Information on Electronic Prior Authorization Standards, Implementation Specifications, and Certification Criteria.
Continuous glucose monitoring (CGM) has increased eight-fold in usage in the United States in the last decade, and it is estimated that 50% of patients with Type 1 diabetes use a CGM device. Although we see CGM increasingly in mainstream media and advertising, the American Family Physician reported that it is not ready for widespread adoption in Type 2 patients. Yet, many endocrinologists feel CGM is the greatest advancement in Type 1 diabetes since the discovery of insulin. Should more diabetes patients be utilizing this digital health tool?
In the American Hospital Association’s webinar “Leveraging Modern Tools and Approaches to Transform Complex Care Delivery,” Aaron Neinstein, M.D., Vice-President of Digital Health, shared nine learnings from UCSF Health’s digital transformation to propel the health system to become a digital-first organization (link internal to UCSF) providing more empathetic, accessible care to patients wherever they are and whenever needed. Check out the recap here or download the infographic below.
ONC’s proposed regulations take a giant leap forward for interoperability and health care by requiring standardized application programming interfaces (APIs) for patient and population services. We applaud and wholeheartedly support this requirement as an essential prerequisite for moving digital health forward and establishing a national digital health ecosystem. Based on our experience, we recommend that ONC adopt FHIR Release 4 as the API standard. We urge ONC to require API access to “all data elements of a patient’s electronic health record” as the Cures Act requires, not “API access to a limited set of data elements” as ONC proposes. This would effectively place a significant cap on data available for nationwide interoperability, and we propose two solutions for ONC’s consideration. We also urge ONC to include “write” access now as well as “read” access for bi-directional or multi-directional interoperability.
At UCSF, we talk about being there for people on the worst day of their lives. I still can’t think about my worst day without getting a lump in my throat remembering the fear and struggle that I went through to get to the emergency room at Parnassus on March 1 five years ago, where I slid to the floor, breathless, exhausted, and alone before I could even reach check-in. It was the third time in several days that I could not stay on my feet from dizziness and shortness of breath.
Artificial Intelligence (AI) is revolutionizing healthcare systems like UCSF Health and changing the way they operate. Though healthcare generally lags behind other industries in digital transformation and innovation, UCSF is well underway. With about 1.4 million faxes received a year at UCSF – 300,000 of which are referrals – UCSF Center of Digital Health Innovation’s Referrals Automation (RefAuto) 2.0 is estimated to save more than 25,000 hours of staff time and 5,000 hours of clinician time annually.
Congratulations to Aaron Neinstein, M.D., UCSF Health Vice Presidentof Digital Health, who was appointed to the Health IT Advisory Committee (HITAC) by the US Government Accountability Office (GAO).
Financial and e-commerce industries like Amazon and Netflix have long since made the leap to digital. By leveraging user data, they are better informed about their consumers and able to delight their customers with rich, personalized, and intuitive experiences. While healthcare made the transition from paper records to electronic health records several years ago, they are still lagging behind other industries in providing modern digital experiences for patients, families, caregivers, providers, and staff.
Two groups of patients who need frequent monitoring are post-lung transplant patients to detect and prevent chronic rejection, and those who live with inflammatory bowel disease (IBD) to detect and treat flares. While monitoring their health is crucial, it is expensive, time intensive, involves travel, and also takes up capacity of patients who may have more urgent needs. In their presentation “Virtual Care for Specialty and Chronic Care” at the UC 2021 Telehealth Summit, Anobel Odisho, M.D., M.P.H., Associate Professor of Urology, and Olivia Bigazzi, Product Manager, both at UCSF’s Center for Digital Health Innovation (CDHI), talked about the virtual digital innovation they are working on that helps improve the patient and provider experience.