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Videos highlight UC Global Health Day

Talks from fourth annual event available on UCTV.

Julea Vlassakis from UC Berkeley leads a demonstration in the breakout session entitled, "Innovation and Infrastructure for Slum Health: Advancing Technology to Work in Low-Resource Settings." (Photo by Robert Durell)

Videos of the keynote presentations from the fourth annual University of California Global Health Day are now available for streaming on UCTV.

More than 400 people attended the 2014 UC Global Health Day at UC Davis on April 26. The event was sponsored by the UC Global Health Institute, with support from UC Davis’ Office of the Chancellor, School of Veterinary Medicine and School of Medicine.

The event featured presentations from faculty and students across the 10-campus UC system on topics ranging from global health diplomacy, maternal and child health, animal health, emerging infectious diseases, economics, migrant health, and more. Keynote presenters included UC President Janet Napolitano, UC Davis Chancellor Linda Katehi, USC Institute for Global Health Director Jonathan Samet, and UC Davis professors Jonna Mazet and Andrew Hargadon.

Visit the UC Global Health Institute website for more information, including submissions to the Global Health Video Challenge and a photo collage with some of the highlights of the day.

The 2015 UC Global Health Day will take place at UCLA.

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Pre-med student makes an impact

Axana Rodriguez-Torres of UC Davis honored for her student leadership.

Axana Rodriguez-Torres, who volunteers through the UC Davis Health System, plans to pursue degrees in public health and medicine.

Axana Rodriguez-Torres felt frustration and pain when her medical studies in Colombia were not recognized in the United States, where she and her family had been granted political asylum.

But now, as the UC Davis senior is recognized with the University of California President’s Outstanding Student Leadership Award, she shares a new understanding:

“As I’m pursuing my dreams, I’m helping others to pursue theirs,” said the 31-year-old. “This is why I needed to be here and discover another purpose in my life.”

UC President Janet Napolitano presented awards to Rodriguez-Torres of Elk Grove and a UCLA student wellness campaign at a meeting of the UC Board of Regents in Sacramento May 14.

Her impact across UC

“The work of these bright students has a tremendous impact not only on their home campuses but across the UC system and out in their communities,” said Napolitano. “I’m pleased to have a chance to recognize their efforts and dedication to tackling tough issues that affect us all.”

Rodriguez-Torres, a double major in neurobiology, physiology and behavior as well as psychology, is being recognized for helping coordinate the annual UC Davis Pre-Medical and Pre-Health Professions National Conference, the largest such conference in the nation.

More than 7,500 attend the conference, and more than 80 percent of participants are high school, community college and UC students who are underrepresented in the field of medicine.

For the October 2013 conference, Rodriguez-Torres was responsible for the medical programming that brought to the conference about 50 of 700 speakers, including leaders of national organizations.

Helping with students’ struggles

Earlier, she met one of her own mentors through the conference and is committed to providing such opportunities for other students. “I’ve seen the struggles students go through. I can see I can do something about it,” said Rodriguez-Torres, who continues to serve on the conference’s organizing board as director of medical programming.

In nominating Rodriguez-Torres for the award, Adela de la Torre, vice chancellor of student affairs at UC Davis, wrote that her saga exemplifies a “tenacity of spirit that propels her social justice action.”

Rodriguez-Torres completed three years of medical school in Colombia before obtaining political asylum in the United States, where she cleaned houses, served fast food, and provided child care to help support her family and save for her education. As her English proficiency grew, she worked as an immigration consultant and a tax preparer for people with limited English.

Three associate degrees

Because her medical school credits from Colombia were not transferable, she studied at American River College — where she earned three associate degrees — before transferring to UC Davis.

Drawn to the university by the opportunity to work at the student-run Clinica Tepati in Sacramento, she has helped provide free care for the underserved, mostly Latino patients.

As a winner of a $10,000 Donald A. Strauss Public Service Scholarship, she established a prevention-focused diabetes education class that extended the clinic’s work. Her project provides monthly classes in nutrition and diabetes prevention as well as Zumba fitness classes at All Hallows Parish in Sacramento.

After graduating in June, Rodriguez-Torres plans to pursue a master’s degree in public health at UC Davis and then a medical degree on her way to becoming an internist focusing on diabetes prevention.

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UC inventions on display at Tech Commercialization Forum

Breakthrough technologies creating public benefit, improving health.

A system for removing arsenic from groundwater, developed at Berkeley Lab, is helping to provide safe drinking water for people in India and Bangladesh.

By Carolyn McMillan

Lawrence Berkeley Laboratory scientist Ashok Gadgil has developed an inexpensive and easily maintained system for removing arsenic from groundwater.

It’s a breakthrough technology that could protect millions of people around the world from arsenic poisoning, a silent killer that is especially prevalent in the rural villages of India and Bangladesh.

Across the bay, a UC San Francisco orthopedic surgeon has tackled a different sort of epidemic — the thousands of young athletes who tear knee ligaments every year while playing soccer.

Dr. Jeffrey Lotz has developed a faster, better and cheaper way to assess whether an athlete is at risk for lower extremity injuries. His 3-D movement analysis system lets physical therapists and trainers assess an athlete’s body mechanics in order to prescribe the right exercises to avoid injury.

The products of research

These two innovations are just a fraction of the commercially viable discoveries and inventions to emerge recently from the University of California — and part of what makes UC such a powerhouse of economic growth for the state.

UC researchers reported more than 1,700 new inventions last year, according to the recently released Technology Commercialization Report. UC inventions led to 71 new start-up companies and produced roughly $106 million royalty and fee income for the university.

UC President Janet Napolitano, speaking at the university’s annual Technology Commercialization Forum on May 8, said that UC is committed to doing even more to help faculty, researchers and students bring their discoveries to the marketplace.

“Steering UC’s cutting-edge discoveries through our labs and into the world economy is central to our mission as a public university,” Napolitano said. “We are committed to supporting our faculty and students with a strong, nimble infrastructure that will help them pursue patents and develop start-up companies, and we will continue to develop partnerships with industry and investors.”

Gadgil and Lotz were among 20 UC inventors to showcase their innovative research at the forum. The work spanned a huge array of fields and came from eight UC campuses and Lawrence Berkeley National Laboratory.

Improving life and environment

At UC San Diego, a clinical trial is under way to test an oxygen delivery system for people with chronic pulmonary obstructive disorder (COPD), a respiratory ailment. The system automatically responds in real time to a patient’s changing oxygen needs, delivering the right amount of oxygen with each breath.

“Our goal is to increase the autonomy and mobility for people with COPD,” said Dr. Xaxier Soler, associate director of UC San Diego’s pulmonary rehabilitation program. “We want to extend their quality of life.”

The technology was developed  by  co-inventors Stephen Roberts and David Lischer — the latter a COPD patient who was frustrated that current oxygen devices limited his activity levels. Lischer has tested a prototype of the new device since 2010, and it works well enough that he now goes skiing, Soler said.

At UC Davis, Basam Younis has developed the next generation of water disinfection systems using UV light, rather than chlorine, to eliminate pathogens. Younis’ system achieves a higher level of water purification than earlier UV systems — and does it at a lower cost.

Better yet: His system has proven to be particularly effective at eliminating what Younis referred to as “emerging contaminants” — things like pharmaceuticals, flame retardants, human hormones and care products — which increasingly are found in water supplies.

Public benefit

Steven Beckwith, UC’s vice president for research and graduate studies, said that the breadth and depth of innovation is a reflection that UC has created an “ecosystem of discovery” across its campuses and labs.

“This is the largest, and without a doubt, the most prestigious university in the world,” Beckwith said. “Our researchers tackle complex issues and look to answer some of the biggest questions that society has. And ultimately, we are looking to create a benefit for the public.”

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Innovation propels UC Health

Colloquium highlights UC’s efforts to increase quality and decrease costs systemwide.

UC San Francisco's Dr. Rebecca Smith-Bindman leads a project to optimize and standardize computed tomography radiation doses for patients across UC medical centers.

>>Related: Moving toward one UC Health

By Alec Rosenberg

The University of California has taken great strides toward increasing quality and decreasing costs across its medical centers, from reducing blood clots to preventing falls to decreasing hospital readmissions.

To thrive as a system in this dynamic environment, UC Health will need to ramp up such collaborations, speakers said at the UC Center for Health Quality and Innovation’s third annual colloquium, May 2 at the Oakland Marriott City Center.

About 320 people attended the colloquium, whose talks can be viewed on UCTV. Speakers included innovation center leaders, grant recipients and collaborators as well as the head of a leading health care software company and the chair of the state Senate Health Committee. More UC innovators will be participating May 28-29 at the New York Times Health for Tomorrow conference at UCSF Mission Bay Conference Center (view the webcast live at www.nythealthfortomorrow.com).

The colloquium highlighted UC efforts to expand innovations across the system, build partnerships and break down silos amid trends that reinforce the urgency of working together to transform health care.

With 17 professional schools and five academic medical centers (Davis, Irvine, UCLA, San Diego and San Francisco) that have combined revenue of $7.5 billion a year, UC has significant scale as a health system. To leverage that scale, UC’s medical centers have increasingly been working together as a system, from contracting to reducing expenses to improving clinical performance, said Dr. John Stobo, UC Health senior vice president.

UC Health wants to “do the right thing for the patients we serve” and build on the strengths of its nationally ranked medical centers to be known for providing more affordable, more accessible, safe, quality health care, Stobo said.

Tackling the ‘triple aim’

UC’s innovation center, launched in 2010, has funded about 50 grant and fellow projects from throughout UC Health and convened systemwide collaborations from fetal treatment to heart surgery. The center supports innovations at UC medical center campuses and hospitals that seek to achieve the “triple aim” of better patient care and better population health while better controlling costs of care.

“UC Health is leading efforts to reduce variations, reduce costs and produce better outcomes,” said Karyn DiGiorgio, interim director of the innovation center.

Take, for example, the UC Cardiac Surgery Consortium, which has focused on four major areas, compared data and worked to develop evidence-based best practices.

“We were already providing very good care, and we’ve been able to improve upon that,” said Dr. Michael Madani, UC San Diego chief of cardiovascular and thoracic surgery.

“Coming together has made a real difference,” added Dr. Jeffrey Milliken, UC Irvine chief of cardiothoracic surgery. “Each of us got better.”

Overcoming obstacles

Working together can be challenging. UC campuses have different priorities, different structures and serve different populations.

“Change is never easy,” said Terry Leach, the innovation center’s past executive director. “But you can learn from the innovators before you, and they’re eager to share what they’ve learned.”

Indeed, obstacles can be overcome, grantees said. Keys include building relationships, forming multidisciplinary teams and gaining leadership support.

“The leadership has to buy in,” said Catherine Walsh of UCLA, who leads an innovation center-funded project that has reduced hospital falls at UCLA and is working to expand it to other UC medical centers.

UC San Francisco’s Dr. Rebecca Smith-Bindman leads the UC DOSE project to optimize and standardize computed tomography radiation doses for patients across UC medical centers. She organized a two-day retreat last month to bring together radiology decision-makers from each of the five UC medical centers. The retreat helped build trust, as participants could see the data showing variation in radiation doses and discuss low-dose protocols, she said.

“My concern is quality,” Smith-Bindman said. “The issue is very important to our patients.”

Tapping technology

UC Davis’ Dr. Elisa Tong leads the UC Tobacco Cessation Network, an innovation center-funded project that targets tobacco use and exposure — the No. 1 cause of preventable death. UC medical centers see about 125,000 smokers a year, and the network aims to reduce that number by using electronic medical records to address tobacco use and exposure at every clinical encounter, she said.

“This is something that can improve efficiency, patient care, quality, outcomes and it will improve return on investment,” Tong said.

Speaker Carl Dvorak, president of electronic health records vendor Epic Systems Corp., said the next frontier of health care innovation is mobile phones. It’s important for health providers to make things as convenient as possible for patients, such as offering mobile billing, payments, appointment scheduling and prescription refills, he said.

“Patients will wonder what’s wrong with you if you don’t offer these in five years,” Dvorak said. “It’s going to be the price of admission.”

Containing costs

Another key issue is implementation of the Affordable Care Act. As of April 17, nearly 1.4 million Californians had signed up for health plans through the Covered California exchange while 1.9 million people newly enrolled in Medi-Cal. UC Health has partnered with Anthem Blue Cross to offer Californians access to UC’s medical centers and physicians for in-network health care on the exchange.

“California has done an incredible job with health care reform implementation,” said state Sen. Ed Hernandez, an optometrist who chairs the Senate Health Committee. “But if we are going to be successful, we have to ensure there is cost control.”

Hernandez said he plans to hold hearings on how to contain health care costs.

UC Health has been focusing on ways to reduce costs. In March, UC announced that its five medical centers will collaborate as a system to save in the range of $100 million to $150 million a year. The “Leveraging Scale for Value” project will focus initially on three areas: supply chain, revenue cycle and clinical laboratories, Stobo said.

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UCSF students offering free dental screenings

Early detection is key to diagnosis potential tooth decay.

Mora Braggs dons a tooth costume to help promote the UCSF free dental screening at the San Francisco's Cesar Chavez Festival.

The Cesar Chavez holiday is a time to remember the late civil rights leader by promoting community service.

This year, UC San Francisco faculty and students answered the call to action by volunteering their time to provide free dental screenings at the city’s Cesar Chavez Festival in the Mission District on April 12.

Dozens of people, including 60 children, participated in the screenings and received fluoride varnishes to prevent cavities. Dental school residents also provided free oral health education and made referrals to the UCSF Dental Center for cases that needed follow-up.

During the festival, at least 15 people were recommended for follow-up with a dentist at the Dental Center and three were found to have serious dental problems.

Early detection is key to diagnosing potential tooth decay, which remains one of the most common diseases. By age 17, more than 7 percent of children have lost a permanent tooth to decay.

The UCSF School of Dentistry offers free screenings throughout the year at locations throughout San Francisco. Its next event will be on Sunday, May 4, at Third & Newcomb at the Bayview Sunday Streets. Download the event flier, or visit the UCSF Community and Government Relations page for more information.

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UC Health community impact

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UCSF children’s hospitals launch global initiative on preterm birth

$100M from Benioffs, Gates Foundation will fund 10-year initiative.

Amanda Zerzan holds her son, Tommy, born at 25 weeks, during his feeding at the neonatal intensive care nursery at UCSF Benioff Children's Hospital San Francisco.

UCSF Benioff Children’s Hospitals today (April 24) announced a $100 million global initiative to address the epidemic of premature birth, the leading cause of death for newborns and the second leading cause of death for children under 5.

The 10-year, global initiative will be jointly funded by Lynne and Marc Benioff in partnership with the Bill & Melinda Gates Foundation.

Approximately 15 million babies are born premature each year, and more than 1 million of these infants die within the first 28 days after birth due to complications of prematurity. UCSF Benioff Children’s Hospitals will lead a collaborative global effort aimed at reducing the number of children born premature and protecting the health of preterm babies and women around the world.

“The time has come to address the issue of premature birth on a global scale,” said Sam Hawgood, M.B.B.S., interim chancellor of UCSF, dean of the UCSF School of Medicine and a neonatologist at UCSF Benioff Children’s Hospital San Francisco. “The vision of the Benioffs and the Gates Foundation creates a partnership that can have a dramatic and sustainable impact on this major cause of mortality and morbidity to babies worldwide. We are delighted that they have chosen UCSF Benioff Children’s Hospitals as the platform to execute this idea.”

Working together with scientists in other regions of the world, the initiative will focus on the biological, behavioral and social factors that drive prematurity – defined as being born before 37 weeks – and how to protect children from its consequences. The team will explore the barriers at the family, community and society level that prevent good practices from being widely adopted, and they will contribute to the development of new drugs, diagnostic tools and medical devices.

Larry Rand, M.D., director of perinatal services at the UCSF Benioff Children’s Hospital San Francisco Fetal Treatment Center and the principal investigator of the initiative, will co-direct it with Jaime Sepulveda, M.D., M.P.H., M.Sc., Dr.Sc., executive director of UCSF Global Health Sciences.

“Premature birth is one area in global health where little progress has been made,” said Sepulveda. “We will work with local communities and global partners to translate science into solutions that make a measurable impact on the health of babies and mothers.”

UCSF Benioff Children’s Hospitals will join with other major groups working to alleviate preterm birth, including the March of Dimes, the Global Alliance to Prevent Prematurity and Stillbirths (GAPPS), the National Institutes of Health and the World Health Organization. In support of its public mission, UCSF will work closely with the San Francisco Department of Public Health, which includes the UCSF-affiliated San Francisco General Hospital and Trauma Center. The initiative will freely share the technology and practical developments that arise from its work with partners in sub-Saharan Africa and around the globe.

“We want to move away from the model of isolated impact, in which one organization tries to do all the work or make all the discoveries,” said Rand, who holds the Lynne and Marc Benioff Endowed Chair in Maternal Fetal Medicine at UCSF Benioff Children’s Hospital San Francisco.

“To be successful, this has to be a team effort,” he said. “Effective collaboration will accelerate discovery, increase access to interventions that work and optimize the project’s impact on rates of early preterm birth and mortality.”

“We are thrilled to be partnering with the Bill & Melinda Gates Foundation, which is as interested in addressing the global issue of preterm birth as we are,” said Lynne and Marc Benioff, who with this gift have committed more than $250 million in gifts to advance children’s health care. “The incredible doctors and scientists at UCSF Benioff Children’s Hospitals will bring their expertise to help save mothers and children around the globe.”

“Premature births are one of the leading causes of newborn mortality, in both rich and poor countries. We don’t know enough about why babies are born preterm, but we know that when they are, it can lead to serious health consequences,” said Melinda Gates, co-chair of the Bill & Melinda Gates Foundation. “The Benioffs’ leadership will help to advance progress and enable children all over the world to realize their full potential.”

Democratic Leader Nancy Pelosi said the global epidemic of preterm birth requires a broad and thoughtful approach.

“We’re fortunate to have a biomedical powerhouse like UCSF put its scientists to work on this problem, which affects so many women and children around the world,” she said.

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UCSF Benioff Children’s Hospital, Children’s Hospital Oakland receive $100M gift from Lynne and Marc Benioff

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UC medical centers team up to reduce costs

Systemwide effort expected to save in range of $100M to $150M a year.

The University of California announced today (March 20) that its five medical centers will collaborate as a system to save in the range of $100 million to $150 million a year.

The “Leveraging Scale for Value” project, presented to UC Regents during their meeting at UCSF Mission Bay Conference Center, initially will focus on three areas: supply chain, revenue cycle and clinical laboratories. The effort, developed in consultation with UC leadership, is aligned with UC President Janet Napolitano’s push to identify cost savings and operational efficiencies.

“We are leveraging the UC system’s collective strength to become more efficient,” said Dr. John Stobo, UC senior vice president for health sciences and services. “By collaborating more, we can ensure the financial well-being of our clinical enterprise, allowing us to continue improving the health of Californians.”

UC’s $7.5 billion clinical enterprise, with essentially no support from state general funds, provides approximately $500 million in support of UC’s medical and other health professional schools. But to continue such educational support, fulfill its public service mission and maintain quality in a competitive health care market, UC’s clinical enterprise must lower its costs.

Without changes, UC medical center expenses are projected to exceed revenues in 2017. Challenges include declining reimbursements for clinical services from commercial insurers and government sources such as Medicare and Medi-Cal. By coordinating more as a system, UC Health can take advantage of its medical centers’ size to operate more efficiently and reduce expenses, as other successful health systems have done.

UC has developed the Leveraging Scale for Value project over the past year, considering 10 areas for achieving operating efficiencies and quality improvement, and selecting three to focus on first.

The decision to embark on the project came after a series of meetings that included selected regents, President Napolitano, chancellors, CEOs of the five UC medical centers, deans of the UC schools of medicine, medical center CFOs and COOs, clinical laboratory directors, and CEOs of health systems at the University of Michigan, Vanderbilt University and BJC HealthCare in St. Louis.

The university also engaged with other successful health systems such as the University of Pittsburgh, Johns Hopkins and University HealthSystem Consortium. These discussions confirmed the financial challenges facing UC Health’s clinical enterprise, as well as UC Health’s need to leverage its impact as a large system to achieve significant cost reductions.

The medical centers at UC Davis, UC Irvine, UCLA, UC San Diego and UC San Francisco already work together on systemwide contracts with commercial insurers and on some group purchasing. The Leveraging Scale for Value project will increase supply-chain coordination, identifying five areas for systemwide procurement.

By improving revenue cycle management, such as billing and collection processes, UC medical centers are expected to create operational savings and potentially improve revenue. And by sending more lab tests to UC medical centers instead of external labs, the university is expected to save additional money.

A shared services management council made up of the medical center CEOs, medical school deans, two chancellors, three external expert advisers and Stobo is looking at how to manage the project in an effective, efficient and accountable manner.

“The ‘scale’ project does not replace what each medical center must do on its own to contain costs,” Stobo said. “The systemwide efforts focus on what individual medical centers are unable to do on their own. Both local and systemwide efforts are needed to get us where we need to be.”

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UC awards four grants to expand health care innovations

Projects have shown potential to improve care.

The University of California has awarded four grants totaling $2.5 million to scale up proposals that have shown potential to improve health care while delivering a return on investment to UC medical centers.

The fellowships expand proposals that already are funded by the UC Center for Health Quality and Innovation (CHQI) and that have demonstrated they can provide better care and better health with lower costs.

The grants include UC Health projects to reduce emergency room visits among psychiatric patients, expand access to specialty care, develop a tobacco cessation network, and support efforts to standardize treatment for hip and knee replacements.

“We’re excited to extend our support to proven projects so that they can be replicated across UC medical centers,” said Karyn DiGiorgio, CHQI interim director. “By scaling up transformative projects like these, UC Health will see even more improvement in the quality and value of the health care we provide Californians.”

The grants, awarded to previously funded CHQI fellows and principal investigators, are part of UC Health’s efforts to improve patient care and increase value at medical centers at UC Davis, UC Irvine, UCLA, UC San Diego and UC San Francisco.

The awardees include:

      • Patient-centered recovery program and emergency department community placement program: $1.2 million over two years
        Project director: William Perry, Ph.D., UC San Diego
        Campus leads: Debra Kahn, M.D., UC Davis; Nathan Kuppermann, M.D., M.P.H., UC Davis; Tina Allee, M.D., UC Irvine; Scott Rudkin, M.D., M.B.A., UC Irvine; Erick Cheung, M.D., UCLA; Lynne McCullough, M.D., UCLA; James Bourgeois, O.D., M.D., UC San Francisco; and Steven Polevoi, M.D., UC San Francisco

        Perry

        Overuse of emergency department services by psychiatric patients is a national crisis. This fellowship, building on Perry’s 2011 CHQI grant, will expand to all five UC medical centers a project that provides screening, intervention and referral services to psychiatric patients with substance use disorders, with the aim of reducing the length of their stays and their return visits to the emergency department. The project began at UC San Diego, where the Patient-Centered Recovery Program reduced the average ED length of stay of psychiatric patients by 12 percent and reduced 30-day psychiatric patient return visits to the ED by 15 percent. The ED Community Placement Program has worked at UC San Diego to further reduce ED visits by placing high-risk patients into community partner programs. The project will work with the other UC medical centers to identify and develop partnerships with community service providers, so that similar results can be achieved.

      • Scale-up eReferral and eConsult program: $709,000 over 18 months
        Project director: Nathaniel Gleason, M.D., UC San Francisco
        Campus leads: Mark Avdalovic, M.D., UC Davis; Elizabeth Rosenblum, M.D., UC San Diego

        Gleason

        Access to specialty physicians at UC medical centers commonly involves wait times of several weeks, which is anathema to patient-centered care. The eReferral and eConsult program improves coordination between primary care and specialty physicians in order to expand access and reduce avoidable in-person appointments. It aims to improve patient outcomes, save patients time, reduce out-of-pocket costs for patients and reduce the overall cost of care. Gleason received a 2013 CHQI fellowship to begin this program at UC San Francisco. The program provides primary care physicians with point-of-care decision support on referral appropriateness (eReferral) and allows them to receive timely specialist recommendations on clinical questions that do not require an in-person evaluation of the patient by the specialist (eConsult). At UCSF, eConsults now represent 8 percent of referrals to participating specialties and have reduced referral rates for standard office visits by 20 percent, improving access to specialty care and saving costs. This grant will expand the project to include UC Davis, UCLA and UC San Diego, with the option to amend the proposal to include UC Irvine and possibly UC Riverside.

      • UC Tobacco Cessation Network: $541,000 over two years
        Project director: Elisa Tong, M.D., M.A., UC Davis
        Campus leads: Linda Sarna, R.N., Ph.D., UCLA; Mark Avdalovic, M.D., UC Davis; Alpesh Amin, M.D., M.B.A., UC Irvine; Sheldon Greenfield, M.D., UC Irvine; Allison Diamant, M.D., UCLA; Timothy Fong, M.D., UCLA; Robert El-Kareh, M.D., M.S., M.P.H., UC San Diego; Tyson Ikeda, M.D., UC San Diego; Eliseo Pérez-Stable, M.D., UC San Francisco; Sujatha Sankaran, M.D., UC San Francisco; and Jyothi Marbin, M.D., Children’s Hospital Oakland

        Tong

        UC has shown its commitment to provide a healthy environment for faculty, staff, students and visitors by implementing a systemwide tobacco-free policy that began in January 2014. This project aims to further reduce tobacco use and exposure – the leading cause of preventable death – by developing a UC Tobacco Cessation Network. Building on a pilot project that Tong started at UC Davis with a 2013 CHQI fellowship, the UC-wide network will use electronic medical records to address tobacco use and exposure at every clinical encounter. There will be assistance with counseling and medication for greater success, with the Joint Commission tobacco treatment measures serving as a framework. The network will partner with the California Smokers’ Helpline, a UC San Diego-based free telephone counseling service that doubles the chances of quitting, to create a two-way electronic referral, and with the UCSF-based Smoking Cessation Leadership Center to promote systemwide training opportunities. Champions at each site will coordinate electronic medical record modifications, conduct outreach and education to inpatient and outpatient departments and nursing units for workflow integration, and collaborate as a network through information sharing and evaluation. This project is expected to demonstrate a significant return on investment and national leadership on health systems change for tobacco cessation.

      • Bundled payments for hip and knee replacements: $78,000 over one year
        Project director: Kevin Bozic, M.D., M.B.A., UC San Francisco
        Campus leads: Zeev Kain, M.D., UC Irvine; Ranjan Gupta, M.D., UC Irvine; Scott Ball, M.D., UC San Diego; Lisa Rhodes, UC San Diego; Mervyn Maze, M.B.Ch.B., UC San Francisco; Lorrayne Ward, UC San Francisco

        Bozic

        Bundled payment, where providers are reimbursed a set fee for an episode of care, is a health reform aimed at improving the coordination, quality and efficiency of care. This project will build on Bozic’s 2011 CHQI fellowship to establish bundled payments for hip and knee replacements at UC San Francisco. It will establish a learning collaborative with UC Irvine and UC San Diego that seeks to standardize clinical practices and administrative procedures for hip and knee replacements to both improve patient outcomes and reduce costs. This will enable UC to compete for regional and national employer-based contracts for hip and knee replacements.

Media contacts:
University of California Office of the President
(510) 987-9200

UC Davis
Dorsey Griffith
(916) 734-9118
dorsey.griffith@ucdmc.ucdavis.edu

UC San Diego
Jacqueline Carr
(619) 543-6427
jcarr@ucsd.edu

UC San Francisco
Karin Rush-Monroe
(415) 502-NEWS (6397)
karin.rush-monroe@ucsf.edu

About UC Health
University of California Health includes five academic health centers — UC Davis, UC Irvine, UCLA, UC San Diego and UC San Francisco — with 10 hospitals and 17 health professional schools on seven UC campuses. For more information, visit http://health.universityofcalifornia.edu.

About the UC Center for Health Quality and Innovation
UC Health launched the Center for Health Quality and Innovation in October 2010. The center is designed to promote, support and nurture innovations at UC medical center campuses and hospitals to improve quality, access and value in the delivery of health care. For more information, visit http://health.universityofcalifornia.edu/innovation-center.

Related link:
Register to attend UC innovation center colloquium

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Good Bruin Samaritans

UCLA students bring much-needed medical aid to Mexican community.

In a community less than 150 miles south of UCLA, Enrique Juarez Gonzalez, his wife, Mercedes, and their children live without running water or electricity. Their sanitation system is sub-standard, and access to health care was almost nonexistent.

There are many families just like them in Tijuana’s Colonia Margarita Moran, families that are struggling to survive in an area where poverty is rampant and opportunities are slim.

Thanks to life-changing efforts by UCLA undergraduates, a small community medical clinic is the family’s only source of medical care. It was there late last year that they received an invaluable gift that lifted a huge weight off the family’s shoulders — a wheelchair for their 14-year-old son, who had to be carried everywhere because he has cerebral palsy.

“Watching Mercedes wheel Emmanuel out of the clinic with such relief, and realizing the impact the chair will have on their family, illustrates the reason we operate our clinic,” said UCLA senior Becky Barber, who along with fellow neuroscience student Lyolya Hovhannisyan founded the UCLA chapter of Flying Samaritans in 2013. The nationwide group brings together volunteers and health care providers to deliver basic medical services, including clinical evaluations, medication and health education classes.

“On a micro-level, knowing we can improve the quality of life for people in this community makes our work here worthwhile,” said Barber. She and Hovhannisyan, both seniors and aspiring doctors, received a $10,000 scholarship from the Donald A. Strauss Foundation in 2013 to support their efforts.

Volunteer student and patient Enrique Juarez Gonzalez

Barber learned about the need in Colonia Margarita Moran after hearing about the work of Dr. Maria Sarabia, a Mexican-trained doctor and Huntington Park resident who, for roughly three years, had been providing religious education and the best medical service in the Tijuana colonia. After speaking with Hovhannisyan about Dr. Sarabia’s efforts and considering what they could do to help, they founded UCLA Flying Samaritans and its small medical clinic in Colonia Margarita Moran.

In May 2013, the group began the first of nearly a dozen visits to the clinic and saw 26 patients. Now they see more than double that number each month, with the group’s outreach efforts making more residents aware of the clinic’s services. The clinic opens the third Saturday of the month with volunteer doctors and often more than a dozen UCLA students.

Most of the ailments the volunteer doctors see are preventable, said Hovhannisyan. They include hypertension, diabetes, sexually transmitted infections and waterborne illnesses, all of which can be sharply reduced through education and outreach programming, she said.

Other factors, including little to no access to fresh fruits and vegetables, clean water or warm dry places to live, make health prevention efforts more challenging. Barber said that ongoing community assessments and speaking with locals will help them better serve the people living there.

“This is a big part of our current efforts to identify the resources available to the community and give us a better understanding of the factors that are leading to a decreased quality of life,” said Hovhannisyan. “Our clinic will target the issues we find to be most clearly decreasing quality of life and implement projects to directly address these problems.”

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Pharmacy education growing rapidly, easing workforce shortages

Growth seen in California and across the nation.

Enrollment in pharmacy education programs has increased significantly, according to a new report from the University of California. (iStock photo)

>>View pharmacy education report

The landscape for pharmacy education has changed dramatically in recent years, as rapid growth in new schools and student enrollment has eased state and regional workforce shortages, according to a new report from the University of California.

An Era of Growth and Change: A Closer Look at Pharmacy Education and Practice” follows a report UC issued last May examining growth and recent trends in health professions education.

Enrollment in pharmacy education programs has increased significantly, following a nationwide pharmacist shortage that developed in the late 1990s. National trends now suggest that the supply of pharmacists is growing much faster than previously projected. Since 2005, the number of accredited U.S. pharmacy schools has increased by 48 percent, from 87 to 129, with most of the growth occurring at private institutions.

“Enrollment in pharmacy education programs has grown substantially in the past decade – faster than the previous 25 to 30 years,” said Cathryn Nation, M.D., UC associate vice president for health sciences. “This report will be an important tool for policymakers and higher education leaders, highlighting trends that will inform efforts to address the challenges posed by health care reform, an aging population and the ongoing demand for pharmacy services.”

In particular, California has been home to significant growth in pharmacy education. Since 2002, four new pharmacy schools have opened in the state, doubling the number of programs in California from four to eight over the past decade. Other institutions appear interested in opening new pharmacy schools in California within the next few years.

Highlights of the report include:

  • Demand for pharmacists in California is beginning to fall in balance with the state’s growing   supply of pharmacists.
  • Significant growth in pharmacy educational opportunities has occurred throughout California, with the majority of enrollment increases happening at private institutions.
  • California faces a shortage of well-qualified faculty to train future pharmacists.
  • Disparities in health status, changing demographics and the evolving roles of pharmacists in health care delivery will require increased diversity and cultural competence of the workforce.
  • There is a substantial mismatch between the number of residency training positions available and increasing student interest (pharmacy residency positions are post-graduate, advanced training positions that are available following completion of a Pharm.D. degree).

The report includes findings about California’s educational programs and recommendations relevant to the UC system, which operates two pharmacy schools: UC San Francisco, ranked as the nation’s top pharmacy school by U.S. News & World Report, and UC San Diego, whose pharmacy school opened in 2002.

“As we look to the future, pharmacy education must remain relevant and aligned with the needs of patients,” said B. Joseph Guglielmo, Pharm.D., dean of the UCSF School of Pharmacy. “This report provides an overview of the pharmacy landscape and a valuable resource for the UC system and our colleagues throughout the state.”

The UC system operates the nation’s largest health sciences instructional program, with 17 professional schools in seven major health professions, including pharmacy education. UC’s two pharmacy schools accounted for 182 (approximately 21 percent) of California’s 849 graduating pharmacy students in 2011.

California pharmacy schools:

Public schools/institutions
UC San Francisco
UC San Diego (first class admitted in 2002)

Private schools/institutions
University of the Pacific
University of Southern California
Western University of Health Sciences
Loma Linda University (first class admitted in 2002)
Touro University (first class admitted in 2005)
California Northstate University (first class admitted in 2008)

Media contacts:
University of California Office of the President
(510) 987-9200

UC San Francisco
Kristen Bole
(415) 502-6397 (NEWS)
kristen.bole@ucsf.edu

UC San Diego
Jacqueline Carr
(619) 543-6427
jcarr@ucsd.edu

About UC Health
University of California Health includes five academic health centers with 10 hospitals and 17 health professional schools in seven fields on seven UC campuses – UC Berkeley, UC Davis, UC Irvine, UCLA, UC Riverside, UC San Diego and UC San Francisco. For more information, visit http://health.universityofcalifornia.edu.

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A night at the UCSF Homeless Clinic

First-year medical student describes volunteer experience.

At the UCSF Homeless Clinic, students work with preceptors to provide medical care for some of the men and women who need it most in San Francisco.

By Jeffrey Chen

The first time I go to the St. Vincent de Paul Society of San Francisco, I leave my white coat at home.

The Society provides shelter for over 400 transient men and women each night. It’s also the location of the UCSF Homeless Clinic, which is where I’m headed tonight, dressed in jeans and a T-shirt. Many of the men and women who come to the clinic have had negative experiences with healthcare providers in the past. A white coat may be the last thing they want to see.

People come to this shelter in the South of Market neighborhood to find reprieve from the vicious cycles of homelessness, violence and substance abuse that they encounter on the streets. Here, they are able to get help, whether it’s to find permanent housing, employment, education, or simply a warm bed to stay for the night and food to sustain them through the day.

And since 1992, on every Tuesday and Thursday night, these men and women have been able to get free medical care right at the shelter.

Jeffrey Chen, a first-year medical student at UC San Francisco

Since its founding 22 years ago, the UCSF Homeless Clinic has drawn medical students and local community physicians to volunteer their time caring for the patients most in need in San Francisco. Since then, the clinic has expanded to include nursing, pharmacy, premedical and even law students.

The clinic draws student volunteers from UCSF schools of medicine, nursing and pharmacy, as well as premedical students from the University of San Francisco and law students from the UC Hastings College of the Law.

Each group has their role: pharmacy students, for example, will help patients go over their medication lists and help them figure out how to stick to their regimens, while premedical students will help coordinate referrals to San Francisco General Hospital, the Tom Waddell Clinic or other local health centers that focus on care for indigent populations.

Because some patients have needs that are hard for the biweekly general clinic to address, students now also hold a dermatology clinic one Tuesday a month and a women’s clinic 1-2 Sundays a month.

As we walk in the doors of the shelter, our stethoscopes set off the metal detectors, loudly declaring our arrival. Before we cross the room to set up shop, a few residents approach us, asking if they can be seen. One man needs help with his diarrhea, which has been keeping him up at night; another with his swollen, painful toe.

Matt Bald, a second-year student and veteran volunteer assures them that we’ll be back to check on them as soon as we’re set up. I will be shadowing Matt throughout this night.

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UCSF Benioff Children’s Hospital, Children’s Hospital Oakland complete affiliation

Top Bay Area pediatric institutions form partnership to advance children’s health.

Volunteer Alyson Van Hardenberg, left, colors in the playroom at the UCSF Benioff Children's Hospital with Chirag Jana, whose sibling is a patient.

Volunteer Alyson Van Hardenberg, left, colors in the playroom at the UCSF Benioff Children's Hospital with Chirag Jana, whose sibling is a patient.

UCSF Benioff Children’s Hospital and Children’s Hospital & Research Center Oakland (Children’s Oakland) have affiliated, building on the hospitals’ mutual commitment to provide outstanding care to children in local communities, and advance medical discovery and treatment for the world. The affiliation, effective Jan. 1, 2014, brings together two leading Bay Area children’s hospitals, strengthening their abilities to meet marketplace expectations, including the Affordable Care Act. The affiliation has the potential to provide better health care value to consumers through higher quality care, lower costs and more coordinated access to services at hospital locations on both sides of San Francisco Bay, as well as medical facilities throughout Northern California.

“This partnership between two world-class children’s hospitals promises to elevate the health of all children, especially our most vulnerable patients,” said Mark Laret, CEO of UCSF Medical Center and UCSF Benioff Children’s Hospital. “Both institutions have a longstanding commitment to public service, and by working together we are better able to deliver on that commitment.”

The affiliation allows children and their families to have access to what is now the largest network of children’s medical providers in Northern California, including a coordinated network of high-quality pediatric care from the Oregon border to San Luis Obispo, and as far east as Reno.

In addition to the two main hospitals in San Francisco and Oakland, patients can access more than 800 pediatricians and pediatric specialists delivering specialized care daily at UCSF Benioff Children’s Hospital and Children’s Oakland, as well as hundreds of community-based pediatricians affiliated with the two hospitals who provide pediatric diagnostic services and specialty care. The two hospitals jointly offer more than 65 different pediatric medical specialties and subspecialties including transplant, sickle cell, orthopedics, neurology, cardiology, thalassemia, pediatric rehab, and asthma and diabetes care.

“The synergies created by these two respected institutions coming together allows children and families to benefit from greater depth and breadth of pediatric expertise as well as innovation that is possible by working together,” said Bert Lubin, M.D., CEO of Children’s Oakland.

“The affiliation of these two well-regarded children’s hospitals is good news for children and their families,” said Diana S. Dooley, secretary of the California Health and Human Services Agency. “Together, they will serve children throughout Northern California who need the state-of-the-art care they can provide.”

Dooley also previously served as president and chief executive officer of the California Children’s Hospital Association, which advocates for children’s health on behalf of the eight, nonprofit regional children’s hospitals in California.

While Children’s Oakland will remain separately licensed and retain its own board of directors and separate medical staff, the hospitals will collaborate and share best practices for the delivery of the highest quality pediatric care.

Individually, the two hospitals are highly regarded nationally as well as internationally, each having made significant advancements in developing new treatments and achieving better health outcomes for children. Together, they are positioned to become the most comprehensive providers of pediatric care and strengthen their national leadership in pediatric education and research, and advocacy. Combined, the hospitals will be among the top ten largest children’s health care providers in the country when the new UCSF Benioff Children’s Hospital opens in February 2015.

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Related link:
Special grand rounds address Children’s Hospital affiliation inquiries

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