Virtual Care at UCSF Health and in the Digital Patient Experience Program: It’s Here

Last month’s launch of the Virtual Lung Transplant Care program at UCSF Health marks an important and exciting milestone: automating the use of patient-reported symptoms and patient-collected device data to advance higher quality and lower-cost care for UCSF Health patients. At the Center for Digital Health Innovation, we’re thrilled to be working with our partners at UCSF’s Lung Transplant program to begin this journey. For decades, chronic medical conditions have been managed through the same basic mechanism: a synchronous one-to-one interaction between a healthcare provider and a patient. However, people with diabetes, heart failure, or inflammatory bowel disease have symptoms that get better and worse, disease courses that wax and wane, and have changes in their management needs based on their progression through life. Chronic illnesses of all kinds don’t wait for that 15 minute interaction between doctor and patient a few times a year. Those frequent low blood sugars related to a new exercise regimen? They don’t wait for the scheduled doctor’s visit. Worsening shortness of breath after eating a holiday meal full of salty foods? That is not waiting for the scheduled doctor’s visit. That new bloody diarrhea and crampy abdominal pain? Those don’t wait for the scheduled doctor’s visit. Worse, when those patients do get to their scheduled office visit, the issues they may have experienced could no longer be relevant, or they may not have a fresh memory of what has transpired.

The traditional synchronous, one-to-one care model should no longer be the only option, and we are thrilled to take the first step forward into a more personal, more connected healthcare: UCSF Virtual Care. Device technology now makes it possible, even easy, to have home medical devices that capture medical data specific to a particular medical condition – whether a continuous blood glucose reading, blood pressure, heart rate, weight, or lung spirometry. Software now makes it easy to engage with an individual via an automated chatbot on her mobile device to gather information about her recent symptoms and behaviors. If you combine these things – home-generated medical device data, patient-reported symptoms, and an awareness of the patient’s clinical context – along with a way for your doctor to be notified of when an issue arises, this allows you to connect with your doctor when you most need it, and allows you to stay away when you’re doing fine.

We see this as a huge step toward the future of healthcare. A healthcare that occurs at a time and place convenient for the individual. A healthcare that incorporates all that is going on in your life – not just what happened in the few days before your scheduled doctor’s appointment. A healthcare that provides you and your doctor with the information needed to make better decisions about your care. A healthcare that engages you with your whole healthcare team – not just your doctor. A healthcare that helps keep you keep track of what is going on with your medical condition amidst your busy life juggling so many other things.

We look forward to the ongoing collaboration with our Lung Transplant colleagues to strengthen this program and keep our lung transplant patients at their healthiest, and only needing to travel to San Francisco when absolutely necessary. We also look forward to the opportunities that abound to apply these modern capabilities to advance the care for people with other chronic medical conditions.

— By Dr. Aaron Neinstein