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A New Digital Health Center at UCSF is Clearing the Path for Innovation

July 18, 2013
by Rajiv Leventhal
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The new initiative aims to drive precision medicine forward
Michael Blum, M.D.

Next is Health eHeart, a social media-based cardiovascular study in which we are developing a scalable social media clinical trials platform that integrates with the campuses’ clinical and research information resources. The Health eHeart Study expands on the Framingham Heart Study, [which tracked 5,209 men and women in Framingham, Mass., starting in 1948]. That study tracked participants in one city; think about that model on a global scale and taking the collected data to treat heart patients so precisely that we can account for their gender, age, ethnicity and lifestyle factors.

Then there is CareWeb, which is a collaborative, team-based clinical communications platform. Think of this as changing the game from an individual sport (patient-doctor relationship; doctor-nurse relationship, etc.) to a team sport, where there is a whole team caring for you. Think about Facebook for healthcare—no one wants to use Facebook for privacy reasons obviously, but imagine a secure platform that integrates with the EHR so the entire care team could see everything.

Expanding on that, how do you plan to manage the social media digital deluge?

While healthcare has not experienced the full force of the social media revolution, it will shortly. It has already changed the way we fundamentally communicate as a society. But how is that going to play out in healthcare? Well healthcare isn’t typical or traditional communication, so no one is putting his or her healthcare information on Facebook, right? But what they are doing is using Facebook to talk about it and gather information. So the question is, “How can we use the fact that people are communicating about healthcare and looking for information to get them to engage in healthcare more effectively?”

We are also studying what creates stickiness in social media around healthcare. People in social media tend to be very in and out and very transient, and that’s not how you want to do healthcare. Transient doesn’t maintain wellness. It’s about stickiness, about persistence, and about true lifestyle change. We need to learn how to assess which apps, systems, and sensors will be reliable, persistent data sources, and which will be a flash in the pan. Some of these tools will be incredibly valuable and will change the way we understand and deliver care, but most will not. There are a whole variety of ways in which social media can change things, but you need to understand its place in healthcare.

Ultimately, what is the key to advancing precision medicine?

We need to leverage our digital assets to build the knowledge network and information commons that are the foundations of precision medicine. The knowledge networks not only link sources together but then bring this knowledge to providers at the time they’re providing care.

So when I have a patient in front of me now, I can go to different risk calculators, and say, “Based on your family history and risk factors, you have a five percent chance of having a heart attack in the next 10 years.” Although that is better than nothing and sometimes it might motivate a patient to change behavior, it’s ultimately not enough. What I really need to be able to tell them, based on what we know, based on the censored data, the biomarker data, and the 100,000 patients similar to you—genetically and life wise—your risk is actually 50 percent, or your risk is actually a quarter of a percent. We need to make those strong predictions, and prescribe the right drugs that they’ll respond to. That’s the real move to precision medicine.