Proposals Awarded to Build UCSF's Path to a Continuously Learning Healthcare System

Two proposals selected by campus collaborative to help inform UCSF’s transformation into a Learning Healthcare System

With the aim of developing UC San Francisco (UCSF) as a Learning Healthcare System as envisioned by the Institute of Medicine and NIH Collaboratory, a multi-sponsor committee at UCSF tapped into the experience and knowledge base of the campus community to solicit demonstration project proposals that would support this initiative.

The committee, composed of UCSF’s Chief Medical Information Officer Michael Blum, MD; Chief Innovation Officer Ralph Gonzales, MD, MSPH; Enterprise Information Analytics Executive Director David Dobbs, Institutional Review Board (IRB) Director Christopher Ryan, PhD; and Director of the CTSI Informatics and Research Innovation (IRI) program Mark Pletcher, MD, MPH, represents a cross section of UCSF’s clinical and research offices. It received 14 proposals that elicited more than 90 comments from the UCSF community online through UCSF Open Proposals.

The two selected proposals will receive funding for up to one year and various in-kind support from the above stakeholders:

“An Epic COPD Care Pathway” proposed by Ari Hoffman, MD, aims to improve the quality and adoption of order sets clinicians receive via UCSF’s electronic health record system APeX to deliver care to patients with Chronic Obstructive Pulmonary Disease (COPD). Ordering providers will see different versions of the order set, the standard one versus test versions utilizing drop downs and algorithms to help clinicians follow best practices based on patients’ history and disease severity.

A more effective order set will hopefully prompt changed physician behavior resulting in reduced readmission rates of COPD patients at UCSF, which is nearly double the national average.

“The community forum gave us important feedback on the scope of our project and communication strategy, helping us hone our message for the second round. We are excited for this opportunity to leverage the power of our electronic record system to improve care,” said Hoffman.

The other awarded proposal also utilizes electronic health records as a pathway for better care. “Leveraging the Power of the EMR: Using a real time prediction model to decrease inpatient hypoglycemic events” proposed by Robert Rushakoff, MD, MS, will evaluate and run real-time alerts through APeX to warn providers when a patient is at risk for a hypoglycemic event. The providers will be prompted to adjust the patient’s orders to reduce the risk for hypoglycemia, with the goal of entirely avoiding this event at UCSF.

“This is the type of project that just does not get done without internal support. Without this funding we would not be able to coordinate programmers, analysts and biostatisticians,” stated Rushakoff.

Regarding the open proposal experience, Rushakoff added, “After our initial short proposal, we received comments from ‘fans’ who spoke to our past successful inpatient diabetes programs and the importance of the current proposal. There were also several comments and questions from senior, experienced researchers. In each case, the questions were insightful and specific – the answers to their comments were incorporated into our final proposal.”