Health IT, Hospitals, Patient Engagement

UCSF: Harnessing technology for patient engagement

Patient engagement has shifted rapidly in healthcare over the last five years, and new technological […]

Patient engagement has shifted rapidly in healthcare over the last five years, and new technological advances are helping to drive the trend even further. At UCSF’s forthcoming, $1.52 billion Mission Bay campus in San Francisco, that will especially be the case, according to Seth Bokser. He is medical director for IT at the UCSF Center for Digital Health Innovation. Dr. Bokser has designed, and is implementing, the UCSF vision for patient-centered technology at its newest healthcare facility at Mission Bay, which will open Feb. 1, 2015.

He’s held numerous roles with UCSF, including assistant medical director for IT and assistant clinical professor. He is also associate professor of pediatrics. Dr. Bokser shared a few of his thoughts just ahead of MedCity’s ENGAGE Conference, where he will be speaking.

Learn more about the other innovative payers, providers, policymakers and health IT professionals who will be sharing the stage, or register here.

You’re tasked with implementing UCSF’s patient-centered technology efforts at a brand new facility in San Francisco. What are those efforts? And how are such efforts different from previous efforts by both the industry as a whole and UCSF?

Our patients and families in the San Francisco Bay Area use — and in many cases create — technology applications to empower people in banking, travel, socializing, and many other areas of their life. They desperately want to use technology to empower themselves in healthcare. Our EHR-based patient portal with over 90,000 participants has been a strong start for us in meeting this demand. The opening of UCSF Mission Bay Hospital highlights how we are using the next generation of technology tools to bridge the health literacy gap between clinicians and patients. The bridging of the gap enables true partnership between our clinicians and our patients and families.

This transition from “you’re a patient in my hospital” to “I’m a doctor in your room — your empowered place of healing” is not an easy one. My colleague physicians are learning to function in a world where their patients can use our apps to access a critical lab result before they have an opportunity to see it. And, as we pull back the curtain and use technology to democratize medical information for patients, families grapple with sometimes conflicting evidence and uncertainty.

I think what makes our implementation of Health 2.0 tools at Mission Bay different is that our information technology reflects the uniqueness of UCSF and the building that we have built. In addition to empowering patients with information, education, and entertainment, we are using technology to promote our very broad definition of health to include emotional wellness, opportunity for reflection, and human connection. Our in-room platform enables personalization by theme, language, and age; connection through social media; and access to patients’ own cloud-based entertainment. Patients can upload photos of their key support network onto their in-room system to give them warmth and strength. And our Benioff Children’s Hospital San Francisco lobby introduces our families to who we are with a fun, immersive wall that projects their own body silhouette and allows them to interact with a variety of whimsical bouncing shapes. Additionally, our Child Life department is opening an expanded visual arts studio to provide our pediatric patients with important unique outlets for expression.

Tell us a bit about the new facility in Mission Bay.

UCSF Mission Bay Hospital is a 289-bed children’s, women’s, and cancer specialty hospital complex.  The hospital will be the clinical hub in an already incredibly exciting UCSF Mission Bay campus, which is a hot-bed of discovery and public-private partnership for innovation.  The project budget was $1.52 billion, and we are targeted to come in on time under budget. We will start taking care of patients in the building by Feb. 1, 2015.  Financing included a $600 million capital campaign. We have benefited from inspiring and enthusiastic philanthropic partnerships.

What unique challenges do you face with a children’s hospital versus an acute-care hospital in terms of implementing new, effective technologies for patient care?

UCSF Mission Bay will house our Benioff Children’s Hospital San Francisco, our Betty Irene Moore Women’s Hospital, as well as our Bakar Cancer Hospital. So, we are applying leading edge patient engagement tools for all these patients. I’m a pediatrician, so I don’t view a children’s hospital as challenging, but only as a lot of fun. I love pediatrics because I spend my days factoring growth into everything I do. And so that gift persists with technology.

Of course, we have to determine what technologies and content are developmentally engaging and appropriate — or not appropriate — in our children’s hospital. We have partnered with the San Francisco Exploratorium, who are experts in this regard. They are providing many technology-based exhibits that teach life-science to kids through play and exploration. Our in-room interactive patient care system gives us the ability to white-list content and websites based on patient age. And of course, in pediatrics we almost always have more than one patient because we consider the whole family in our care. So, for example, in our post-partum area, it’s fun to think about how we represent both the mother’s treatment team and the baby’s treatment team clinicians to the mother. Our newborns at UCSF are advanced but they don’t yet interact with the tablets, although it is through the camera on those tablets that many of them will meet their grandparents.

What other new technology efforts, in addition to patient-centered, will occur at the new hospital?

We will, of course, be using our full electronic health record and automated medication delivery system at Mission Bay. We will be moving to a next-generation communication system, though which voice call, text messages, traditional “pages,” and alarms will all be transmitted to mobile smartphones. Another area, which is closely related to patient engagement, is telehealth. We are preparing to do more telehealth at Mission Bay to ensure that our patients have full access to all the expertise throughout UCSF Health System — no matter where the patient or doctor is located. We will also be deploying transport robots, which will roam the halls delivering supplies and patient meals. I, personally, know little about these robots, except that the kids, and even the adults, are sure to think they are cute — as long as they don’t go rogue.

In your time as a professional within healthcare, how would you characterize the shift in patient engagement?

Now is the time. I think patients have been ready for a while. What has changed now is that reimbursement incentives are moving enough to incentivize providers to invest in patient-engagement tools. What also changed is that clinicians have become more comfortable with incorporating information technology in their practice — specifically as electronic health records have proliferated throughout healthcare in the last five years. The combination of patient demand, incentives heading in the right direction, and increasing clinician IT know-how is really exciting for the patient-engagement revolution.

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