Telemedicine at ucsf


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Presentation to the IT steering committee

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  • The problem as we entered the current fiscal year. Video conferencing was unorganized, uncoordinated and not effective. There was duplication of equipment, effort and support infrastructure.
  • Much progress has been made to date. Some of the key basic element have begun to come together. However much remains to be done to make this technology widely adopted.
  • It’s very complicated. Both technically and organizationally. There are a lot of technical elements that cut across San Francisco’s largest enterprises. UCSF, UCSF Medical Center, the city and County of San Francisco, and the SF Dept of Public Health. Other enterprise across the state also.
  • Much progress has been made to date. Some of the key basic element have begun to come together. However much remains to be done to make this technology widely adopted.
  • Telemedicine at ucsf

    1. 1. TeleHealth at UCSF June 29th 2012Jeff JorgensonDeputy Director, TeleHealth
    2. 2. 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 2
    3. 3. 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 3
    4. 4. The Core – Prop 1D 4
    5. 5. Classic Telemedicine• Live Video• Remote PCP or Patient• Central hub of specialists• Hardware end points – Medical Peripherals (stethoscope, otoscope, etc.) – Desktop sharing 5
    6. 6. 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•• 6
    7. 7. 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 7
    8. 8. 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 8
    9. 9. 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 9
    10. 10. 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 10
    11. 11. 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 – 11