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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