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2013: Important Dates for UCSF Orthopaedic Surgery

Recipe for Relevance: Blend Digital Health Developers and Clinical Providers

I wanted to capture a few quick top-of-mind reactions to a much-needed, well-executed event I attended Tuesday night, a “Meeting of the Minds,” co-sponsored by the digital health incubator Rock Health and the UCSF Clinical and Translational Science Institute (CTSI). The goal: bring together healthcare providers who have specific pain points with technologists eager to develop solutions.

This event happened to showcase several of my favorite themes: the importance of “field discovery” (i.e. innovation driven by practitioners, as described by MIT Professor Eric von Hippel), the need to create more useful digital health companies (vs more trivial apps); and the need to crowdsource problems not just solutions.

The organizers – particularly UCSF surgeon Aenor Sawyer – clearly put a lot of effort into selecting the handful of healthcare speakers, and in guiding them to succinctly describe their key problems.

The result was a captivating, diverse series of presentations highlighting key challenges with which various folks at UCSF were actively struggling:

- Ralph Gonzales, an internist and epidemiologist with an interest in health systems, discussed the increasing use of specialists, and the associated impact on healthcare costs; his specific question was whether alternative approaches (perhaps technology-enabled) could reduce the need for follow-up visits with specialists.

- Christine Ritchie, a geriatrician, discussed the increasing use of potentially dangerous opioids to manage chronic pain in the elderly, and asked whether there were approaches that could permit the more comprehensive monitoring of such patients between visits.

- Kate Possin, a researcher in UCSF’s Center for Memory and Aging, discussed the rising incidence of dementia, and emphasized the need for improved assessment tools for early cognitive impairment, tools both sensitive and efficient.

- Kirby Lee, a faculty member of UCSF’s School of Pharmacy, provided an overview of the remarkably complex challenges of medication adherence; he highlighted some of the solutions already available, and emphasized that an effective solution might bring together existing tools in a creative way.

- Christine Kennedy, a researcher and pediatric nurse, discussed the need for health applications that are relevant in the community, where the degree of “health literacy” may be appreciably lower than most developers appreciate. In particular, she highlighted the need for greater use of images and videos, and tools that help “regular” people (i.e. not QS fitness freaks [my phrase not hers]) increase activity in their daily lives.

- Michael Turken, a thoughtful fourth year med student at UCSF, reviewed the existing process of medical training, and pointed out a number of specific areas where technology-enabled approaches might be helpful.

Is tonight’s forum going to lead to the next (some wags would say first) great digital health company? Who knows. But I was delighted and heartened by the approach, which in many cases surfaced opportunities that those outside of healthcare might never have known about, or conceptualized correctly.

I was also pleased by the range of topics; while perhaps a bit heavy on the operational improvement side, you could also see how some solutions (e.g. to the improved assessment of early cognitive impairment) might lead to profound basic scientific insights as well.

If some of the presentations today were flawed, it was in their vision of their problem, a perspective that (understandably) tended towards the immediate and pragmatic. For example, during the discussion of how technology might be used to help med students memorize anatomy, metabolic pathways, and differential diagnoses, all I could think (not for the first time) was how pointless – especially given our access to technology — so much of this rote memorization is. As Clay Christensen might say, we might want to take a more careful look in some of these areas at the underlying problem that truly needs to be solved.

Given the size, energy, and motivation of the developer community, and the number of challenges healthcare providers contend with every day, I can imagine that it might make sense for Rock Health and UCSF’s CTSI program to consider repeating this event, virtually – bringing together geographically dispersed developers to address discrete pain points described succinctly by similarly dispersed providers and researchers.

True, provider/technologist meetups – whether live or virtual – are unlikely to provide a panacea for our nation’s healthcare challenges; however, they could easily spark ideas and establish connections, and lead to new approaches to medically-relevant questions.

David Shaywitz, Contributor

PBS NewsHour followed up with some of their favorite stories from the past year and asked them what they see in the year to come. Dr. Richard Coughlin was among their favorite interview subjects from the past year and was asked he hoped to see in the next 12 months.  Read his commentary here.

PBS NewsHour followed up with some of their favorite stories from the past year and asked them what they see in the year to come. Dr. Richard Coughlin was among their favorite interview subjects from the past year and was asked he hoped to see in the next 12 months.  Read his commentary here.