SLIDE 1
Healthcare IT Megatrends and the Evolution of High-Value Healthcare
Christopher A. Longhurst, MD, MS (@calonghurst) CIO and Clinical Professor of Medicine and Pediatrics UC San Diego Health (@ucsdhealth)
SLIDE 2 The Rapidly Evolving Landscape
Healthcare Trends
- Precision medicine
- Consumers take charge
- Healthcare everywhere
- More with less: from
volume to value
healthcare systems Health IT Implications
- Analytics / data
- Patient engagement
- Monitoring, telehealth
- Interoperability and
communication
instances
2
SLIDE 3
SLIDE 4
New England Journal of Medicine, Nov 2011
SLIDE 5
Health Affairs, July 2014
SLIDE 6
Figure 1 – The Green Button in Action
SLIDE 7
- J. Comp. Eff. Res., May 2015
SLIDE 8 8
Informatics Consults (Stanford and University of California)
More information at http://greenbutton.stanford.edu
SLIDE 9 Combining healthcare data from across the six UC medical schools and systems
Clinical Data Warehouse
A UC Healthcare Big Data Analytics Platform
SLIDE 10 Bringing UC’s clinical data together creates an asset with few (if any) peers
10
UC Big Health Data Platform Phenotypic (Epic) Image Repository ‘Omics Bio‐banking Platforms Technology Foundation
Metadata Mgmt Master Data Mgmt Terminology Mgmt KB/Ontology Mgmt Natural Language Processing Analytic Tools
Operational ‐ Readmissions ‐ Sepsis ‐ Quality ‐ Patient Sat. ‐ Efficiency ‐ Pop Health ‐ etc.
Use Cases
Research ‐ UCRex ‐ PCORNET ‐ NCATS ACT ‐ OMOP ‐ Cohort Discovery ‐ Patient Data Sets ‐ etc.
UC Big Health Data Governance Outputs/Visualizations
Big Data Technologies Geospatial Processing
Public Data Sources High Frequency Data Financial / Claims
Information Discovery Scorecards/ Dashboards Predictive Analytics Alerts/Decision Support Statistical Analysis
BI Technologies
Reports
SLIDE 11 The Rapidly Evolving Landscape
Healthcare Trends
- Precision medicine
- Consumers take charge
- Healthcare everywhere
- More with less: from
volume to value
healthcare systems Health IT Implications
- Analytics / data
- Patient engagement
- Monitoring, telehealth
- Interoperability and
communication
instances
11
SLIDE 12 12
Health Record Data Banks?
SLIDE 13
Who is using your EMR…?
SLIDE 14 14
Patient Portal at UC San Diego Health
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Direct and Open Scheduling @ UCSD Health
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OpenNotes in Australia?
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EHR-Integrated Home Monitoring (JAMIA, 2016)
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Pre-Visit Questions / Patient-Reported Outcomes
Before Optimization After Optimization
SLIDE 19
Clinical Trials Recruiting
SLIDE 20 Jacobs Medical Center, Nov 2016
Bedside tablets control lighting, blinds, temperature, entertainment system, and “smart” portal with care team photos, medical record access, education videos
SLIDE 21 Grand Rounds, 1971 HIMSS Symposium, 2013
21
Larry Weed (1924 – 2017)
“Patients are the largest untapped resource in medical care today.”
SLIDE 22 The Rapidly Evolving Landscape
Healthcare Trends
- Precision medicine
- Consumers take charge
- Healthcare everywhere
- More with less: from
volume to value
healthcare systems Health IT Implications
- Analytics / data
- Patient engagement
- Monitoring, telehealth
- Interoperability and
communication
instances
22
SLIDE 23 Is EMR Interoperability Solved in the USA?
Breadth of the Epic EHR System Nationwide 35,483,991 patient records were exchanged using Epic CareEverywhere in April 2017 alone At UC San Diego Health, we’ve exchanged
> 1 Million Patient Records in 2016
with organizations spanning
50 States, including 830 Hospitals 1,050 Emergency Departments and 22,830 Clinics
“1 9 0 m illion,
5 4 % of patients in the U.S. are now served by Epic products .”
Faul kner , Epic
SLIDE 24 24
San Diego Outbreak of Hepatitis A (October 2010)
SLIDE 26 The Rapidly Evolving Landscape
Healthcare Trends
- Precision medicine
- Consumers take charge
- Healthcare everywhere
- More with less: from
volume to value
healthcare systems Health IT Implications
- Analytics / data
- Patient engagement
- Monitoring, telehealth
- Interoperability and
communication
instances
26
SLIDE 27 UC Health CIOs
Joe Bengfort UCSF John Cook UC Davis Health Mike Pfeffer, MD UCLA Health Chuck Podesta UC Irvine Health Chris Longhurst, MD UC San Diego Health Tom Andriola UC Office of the President
SLIDE 28
Cloud EMR?
SLIDE 29
- Clinical and business transformation with be sponsored by clinical and
business leaders with full transparency from IS leadership.
- Identify and support opportunities for strategic business alignment and
leveraging scale for value (e.g. tele-radiology, telehealth, revenue cycle, call center, pharmacy, population health, clinical research, materials management).
- UCI will accept standard UCSD build for similar departments unless both
sites agree that build should be changed for patient safety, revenue capture, or other best practice. All other requests will be subject to combined governance review.
- Perfect is the enemy of good – decisions need to be timely.
- Identify, acknowledge, and minimize risk.
UCI/SD Collaboration Guiding Principles
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UC San Diego Health and UC Irvine Health
Sharing Roles Shared Epic Support Model Expansion Of Shared Services
Today FY18/FY19 FY20+
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How do we ensure our healthcare system learns from every patient, at every visit, every time?
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Thank you!
Chris Longhurst, MD, MS cio@ucsd.edu @calongurst
(copies of all papers available by request)
