TeleHealth at UCSF

June 29th 2012

Jeff Jorgenson Deputy Director, TeleHealth

January 2010

• Many discrete systems/silos

• No single directory or listing

• Lack of standards (hardware, naming, etc)

• Multiple bridges / gateways

• Uncoordinated support

• Most systems not “connected”

• Lack of training and documentation

• Confusion on scheduling

• No Policies / Best Practices

• Network issues

• Undefined user awareness and expectations

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Prop 1D Active Projects• OSHPD Buildouts at SFGH and Moffitt

• City of SF Telemedicine Municipal Area Network– DPH VMI Cart deployment

– DPH Telepsychiatry deployment

– DPH Medical Cart deployment

• DPH Diabetic Retinopathy deployment

• Multi-Lingual Resource Center

• TeleDentistry

• TelePharmacy

• Neo-Natology

• Berkeley JMP

• 360 HIV

• MyHero HIV Positive Care

• UCSF Fresno

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The Core – Prop 1D

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Classic Telemedicine• Live Video

• Remote PCP or Patient

• Central hub of specialists

• Hardware end points– Medical Peripherals (stethoscope,

otoscope, etc.)– Desktop sharing

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Mobile Video - MOVI

• Turns a desktop or laptop into a secure video end point

• Encrypted, inexpensive, inter-operable, manageable, mobile

• Total to date: 618 accounts•

•

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UCSF Non-Prop 1D Projects

• Pediatric ICU – Med Ctr

• TeleDermatology – Med Ctr/DPH

• Mt Zion Pilots – Med Ctr

• Mission Bay Hospital – Med Ctr

• NFS TeleNutrition – Med Ctr

• UCSF MedCtr Prenatal Diagnostic Center –Monterey

• Block 25 and Bldg 19

• Buchanan St. Dental

• Radiology, CTSI, Pharmacy on boarding

• CTN Grant with SFCCC

• Link with VA

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Next Phases• Video and Voice integration• “Consumer” video gateway• Expansion of connectivity via CENIC,

California Telehealth Network etc.• Expansion of programs• Cutting Edge Technologies/ Integration

with mobile

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Areas of opportunity

• Billing– Per consultation vs contract

• Onboarding– Operations

– Security, Privacy, Risk and Legal

– Technical support

• Increase margin per patient/procedure– Expanding access to care

– Push triage and chronic care closer to patients medical home

– Increase referrals of higher acuity patients

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UCSF TeleHealth Experience

• 360 HIV – Malcolm John • TelePharmacy – Bill Soller• CDCR – Kevin Grumbach• Pediatric ICU – Arup Roy-Burman• Neo-natal ICU – Yao Sun• Dermatology – Toby Maurer• Psychiatry – Hamilton Holt• Tumor Boards – Gerrie Shields

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Other modes

• Store and Forward– Asynchronous image, lab, notes sharing

– Encounter management

• mHealth and eHealth– Remote Patient Monitoring and information capture

– Simulation

– Reminders and interventions

– Collaboration and communication

– Workflow efficiencies

– http://www.mobileopenpath.org/

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