App developed by the UCSF School of Medicine in partnership with Bandwdth.

UC San Francisco has launched a new app for the Apple iPad that presents a novel approach to learning the neurological physical exam, a challenging series of assessments aimed at diagnosing neurological disorders in patients.

The app, called UCSF NeuroExam Tutor, helps medical students, residents and physicians overcome “neurophobia,” the feeling many people get when given the seemingly impossible task to learn and master the comprehensive version that has been traditionally taught.

“At UCSF, we are committed to using technology to enhance our students’ ability to learn,” said Catherine Lucey, M.D., vice dean of education at the UCSF School of Medicine. “This app represents a wonderful collaboration between app developers, clinicians and educators, and will help our students master a traditionally difficult set of skills.”

The UCSF NeuroExam Tutor was developed by the UCSF School of Medicine under the leadership of Vanja Douglas, M.D., assistant professor of neurology and Susannah Cornes, M.D., assistant professor and director of the Epilepsy Resident Rotation. It was designed in partnership with Bandwdth, a global educational development company. Fourth-year medical student Dylan Alegria helped spearhead the project as part of his medical education technology fellowship. In recent years, UCSF has invested heavily in the development of a variety of information technology and management resources to give health care providers, educators, scientists and students the tools to succeed in the rapidly evolving digital age.

“It has been a wonderful opportunity for me to help drive this project,” said Alegria. “Having students at the table, alongside clinical experts, designers and programers, helped create an innovative tool that suits the needs of both educators and learners.”

Available in the iTunes Store, the app costs $19.99 and covers seven areas: coordination and gait, cranial nerves, mental status, motor control, reflexes, and sensation. As learners move through the app, they have access to more than 60 high-quality videos, 50 different physical exam maneuvers, flashcards, and advice from master clinicians at UCSF.

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Rural health information exchange will help implement health care technologies.

Kenneth Kizer, UC Davis

The California Health eQuality (CHeQ) program, managed by the UC Davis Institute for Population Health Improvement (IPHI), has launched a new $1 million Rural Health Information Exchange Incentive Program to help physicians, clinics and hospitals in rural California implement technologies that enable the secure and reliable exchange of health information to improve health care quality, lower costs and achieve federal meaningful use criteria.

In describing the new rural HIE incentive program in his keynote address to the recent 2013 California HIE Summit, IPHI’s director and UC Davis distinguished professor Kenneth W. Kizer explained that the effective use of electronic health records (EHRs) and health information exchange (HIE) are prominent features of current efforts to overhaul the U.S. health care system. As part of these efforts, doctors and hospitals must implement electronic information management systems that meet so-called meaningful use standards, which include various core clinical measures such as being able to check for harmful drug interactions.

Kizer, who is also CHeQ’s director, explained that the new Rural HIE Incentive Program aims to address the many challenges that rural health-care providers face when trying to establish HIE systems. Because of the scarcity of providers in rural communities, especially specialist physicians, patients typically have to travel long distances to receive care, often from many different sources, increasing the likelihood that providers don’t have access to all of a patient’s health information. As a result, patients may undergo duplicative laboratory tests or imaging studies, receive prescriptions for incompatible medications and experience others problems resulting from such fragmented care.

“The Rural HIE Incentive Program leverages a new, more cost-effective model for enabling exchange in rural communities,” Kizer said. “The program offers rural providers a choice of five designated HIE service providers who have been pre-screened and qualified for their ability to provide a menu of key health information exchange services, thereby allowing rural providers to procure the services that best meet their needs at a substantially subsidized rate.”

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Free app highlights most effective types of birth control, reveals potential side effects, risks.

Screen shot: Plan A Birth Control app

A new, free iPad application developed at UCLA helps women navigate through the sometimes confusing process of selecting a birth control method using medically accurate information. The easy-to-use app highlights the most effective types of birth control and reveals potential side effects and risks associated with each option.

The app, called Plan A Birth Control or Plan ABC, is designed to help a woman prepare for her visit with a contraception counselor or an OB-GYN. It was developed by Dr. Aparna Sridhar, a clinical fellow in family planning in the UCLA Department of Obstetrics and Gynecology.

“Women using the app will be better informed and already have a baseline knowledge about what they’re looking for when they see their doctors,” said Sridhar, who is completing her master’s degree at the UCLA Fielding School of Public Health. “That way, doctors may need less time to explain the different birth control methods, and can spend more time focused on a more narrow discussion tailored to the individual patient and her particular needs.”

Available in iTunes, the app lists the top 10 forms of reversible birth control from most to least effective, ranging from the IUD to hormonal treatments to the female condom. Sridhar drew the content for Plan ABC from respected family-planning websites and vetted it for accuracy. One of her goals in creating the app was to ensure that women could easily access the most current, medically correct information, because much of the information on the Internet is either unreliable or dated, she said.

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Roughly half use social media to help market their business.

Reza Jarrahy, UCLA

Social media has revolutionized the way in which people and businesses interact, and it is taking on a growing role in the health care industry. A new UCLA study looking at the use of social media among plastic surgeons found that roughly half of these specialists use social media tools.

Plastic surgeons have been leaders among medical specialists in the development of interactive websites to promote their practices and educate patients, said the study’s principal investigator and senior author, Dr. Reza Jarrahy, an associate clinical professor of plastic and reconstructive surgery at Ronald Reagan UCLA Medical Center. But until now, there there had been surprisingly little information on whether and how they are using social media.

In the study, published in the May issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS), approximately 50 percent of plastic surgeons polled said they use Facebook, Twitter and other social media platforms to help market their professional practice.

“Social media platforms represent a dynamic and powerful tool to educate, engage, market to and directly communicate with patients and professional colleagues,” said Jarrahy, who is a member of ASPS and vice president of communications for the American Society of Maxillofacial Surgeons. ”However, for plastic surgeons, the potential benefits associated with using this tool must be balanced against its potential pitfalls.”

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New initiative to help drive precision medicine forward.

UCSF physician leaders (from left) Michael Blum, Andy Auerbach, Ellen Webber, Russ Cucina and Seth Bokser helped roll out the medical center's electronic records system known as APeX.

UC San Francisco is creating a Center for Digital Health Innovation (CDHI) to lead the transformation of health care delivery and discovery from empiric, generalized, disease-based diagnostic and treatment approaches to the era of individualized precision medicine.

UCSF Chief Medical Information Officer Michael Blum, M.D., has been tapped to lead the CDHI in the new position of associate vice chancellor for informatics. Blum will continue to report to Joshua Adler, M.D., chief medical officer at the UCSF Medical Center, and now also UCSF Vice Chancellor of Research Keith Yamamoto, Ph.D.

In his new role, Blum, a cardiologist and clinical professor of medicine, will coordinate and leverage UCSF’s information technology assets.

The focus of the CDHI is developing new technologies, apps, and systems that, along with the explosion of social media, will generate enormous new data sets.

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Computer scientist aims to integrate health data and make it globally available by phone.

Ramesh Jain, UC Irvine

Ramesh Jain is wired for health. The courtly UC Irvine computer science professor has a black NikeFuel wristband that flashes blue numbers, an oblong black amulet dubbed Fitbit around his neck, and a special app on his iPhone. All let him know – waking or sleeping, walking to class or waving his arms – exactly the amount of energy he’s burning and other key health indicators. As someone who has conquered cancer, that’s important to him.

Soon, thanks to work he and his team are doing, his doctors and many others should be able to download data from multiple sources and have it processed into a complete picture of a patient’s health. They could then recommend behavioral changes, customized treatments and other lifesaving measures.

Jain wants everyone in the world, rich or poor, to have access to such mobile health aids, via an innovative process he and his students call “social life networks.” Three to four billion people globally have no access to computers but do possess so-called “feature phones” which have wireless Internet access and limited images. Jain thinks mobile networks could be a godsend in rapidly growing economies where food, water, health care, transportation and education are still often substandard.

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UCLA nursing hosting event April 11-13.

New findings on the role gender plays in the diagnosis, treatment and prevention of heart disease will be among the research topics highlighted by faculty members and students from the UCLA School of Nursing at the annual Western Institute of Nursing Conference, which runs from April 11 to 13 in Anaheim.

At a special state-of-the-science panel on Saturday, April 13, UCLA professor Lynn V. Doering will present a review of gender differences in identification, treatment and outcomes for cardiovascular disease, with a focus on coronary atherosclerosis, heart failure and stroke. During the same panel, UCLA professor JoAnn Eastwood will introduce her novel study in which she is partnering with a community organization and using mobile health technologies to reduce cardiac risk factors among young minority women.

“Cardiovascular disease is the No. 1 killer of women and accounts for more female deaths than all cancers and lung disease combined,” Doering said. “Heart disease — particularly its symptoms — presents differently in women, and it is not so obvious in current testing, so it is harder to diagnose. The cutting-edge work that is being presented will provide critical information on diagnosis, treatment and prevention of cardiovascular disease in women.”

Also during the three-day conference, UCLA School of Nursing faculty and doctoral students will present symposia on health care and nursing education for vulnerable populations and on the behavioral symptoms of dementia.

During the symposium “Cultivating Nurse Leaders: A Framework for Nursing Education in Vulnerable Populations” on Friday, April 12, three UCLA nursing researchers will discuss their work on finding ways to eliminate the cultural, financial and language barriers that impact health care delivery. Health disparities continue to exist among vulnerable populations, the researchers stress, and addressing inequities requires mentoring and guiding new nurse–scientists to conduct research in this important area.

On Saturday, April 13, “Promoting the Health of Vulnerable Populations” will take a look at the challenges of meeting the health care needs of four vulnerable populations: homeless men on parole, homeless men and women who suffer from frailty, methamphetamine users who are mothers, and American Indians suffering effects of abuse.

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Ambitious UCSF project highlights promise of precision medicine.

Heidi Dohse has spent much of her adulthood monitoring a pacemaker implanted into her chest at the age of 19 to repair arrhythmias, or rapid irregular heartbeats.

For years, that’s meant that Dohse, 49, has had to fly several times a year from her New York home to California for check-ups with the medical team at UC San Francisco that performed the life-saving procedure to correct her heart rhythms when she was a teenager.

Those time-consuming trips are no longer as necessary since she’s enrolled in an ambitious UCSF-developed online cardiovascular study that harnesses the power of mobile technology to monitor patients using their smartphones and send the information to doctors who can analyze the data and provide instant feedback.

“Because I live in New York and my UCSF doctors are here in San Francisco, I can use all these mobile devices and tools to feel like I’m still a patient of theirs,” Dohse said. “It’s one of the reasons my staying with UCSF makes sense.”

Through the Health eHeart Study, which launched today (March 19), physicians hope to better understand how the heart functions and to develop new ways to predict and prevent cardiovascular disease. The study – funded by the Salesforce.com Foundation – aims to enroll 1 million people from around the world.

“We hope to be able to collect copious amounts of data on a large segment of the population so we can develop very robust and accurate models to predict the occurrence of heart disease in people who don’t yet have heart disease, or slow the progression in people who already have heart disease,” said cardiac electrophysiologist Jeffrey Olgin, M.D., chief of the UCSF Division of Cardiology.

A major goal of the Health eHeart Study is to make health care delivery more precise.

The study allows participants to submit data via a secure online survey and uses smartphone technology to measure a participant’s heart rate, blood pressure and pulse rate. The information is sent back to researchers, who can make recommendations to help prevent or treat heart disease.

The concept of precision medicine – which emerged from a 2010 National Academy of Sciences report co-authored by UCSF Chancellor Susan Desmond-Hellmann, M.D., M.P.H., and Charles Sawyers, M.D., of Memorial Sloan-Kettering Cancer Center – is to transform medical care worldwide by integrating the wealth of data emerging from both the human genome and research on the molecular basis of disease, with information from patients’ health records and environmental data. It has become a driving vision for UCSF, which is convening a summit in May to create a roadmap for precision medicine nationwide.

“With this platform, we hope to be able to diagnose and treat heart patients more rapidly than is currently done with traditional research, since we’ll have a large patient population,” Olgin said. “And because these patients are connected to us electronically and through their smartphones, we can deploy the study very quickly.”

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Corporation for Education Network Initiatives in California honors UC Santa Cruz’s CGHub.

David Haussler, UC Santa Cruz

The UC Santa Cruz Cancer Genomics Hub (CGHub) has been honored by the Corporation for Education Network Initiatives in California (CENIC) as the recipient of the 2013 Innovations in Networking Award for High-Performance Research Applications.

UCSC has built CGHub, a 5-petabyte database, to store tumor genomes sequenced through National Cancer Institute (NCI) projects. Through this effort, CGHub is tackling the significant computational challenges posed by storing, serving, and interpreting cancer genomics data.

The CGHub mission is to facilitate the work of scientific researchers. It is designed to be a fully automated resource, appearing to the user as an extension of the user’s home institute computing system. Making such vast amounts of data accessible to collaborating researchers nationally and internationally requires advanced networking to allow the research to be carried out as seamlessly as possible.

The project is led by UC Santa Cruz bioinformatics expert David Haussler. Haussler is a distinguished professor of biomolecular engineering in the Baskin School of Engineering at UCSC and a Howard Hughes Medical Institute investigator. “By providing researchers with comprehensive catalogs of the key genomic changes in many major types and subtypes of cancer, these efforts will support the development of more effective ways to diagnose and treat cancer,” Haussler said.

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Disparities found in communications offered at well-resourced and resource-poor settings.

Urmimala Sarkar, UC San Francisco

Lower-income patients want to communicate electronically with their doctors, but the revolution in health care technology often is not accessible to them, due to inadequate health information services within the health care clinics they frequent, according to a survey by UC San Francisco researchers. Increasing numbers of health care systems are offering online services to patients in order to manage care outside of office visits, and this often includes the ability for patients to communicate electronically with health care providers.

The UCSF research team found that a significant majority of uninsured and underinsured patients currently use email, text messaging and the Internet in their everyday lives and would like to extend that to their health care, but the “safety net” clinics they use generally do not offer the necessary patient portal or secure messaging to support this communication.

“Electronic health-related communication is becoming the standard of care in well-resourced settings, and should be implemented and supported in resource-poor settings,” said senior author Urmimala Sarkar, M.D., M.P.H., who is an assistant professor of medicine with the UCSF Department of Medicine, Division of General Internal Medicine, and the UCSF Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center.

The analysis is reported online Monday in the Journal of General Internal Medicine.

San Diego Supercomputer Center to host infrastructure.

Researchers at UC San Diego have been awarded a new National Institutes of Health (NIH) grant to expand and enhance a cyberinfrastructure designed to provide scientists with easily accessible, Web-based resources to help fight diabetes and metabolic diseases.

The grant, awarded through the university’s Center for Research in Biological Systems (CRBS), will focus on establishing, coordinating, and making available large pools of datasets to researchers as part of a project to further develop the National Institute of Diabetes and Digestive and Kidney Diseases’ (NIDDK) Interconnectivity Network community and infrastructure.

About 25.8 million children and adults in the United States, or 8.3 percent of the population, have diabetes, according to the American Diabetes Association. Obesity has been cited as a contributing factor to approximately 100,000 to 400,000 deaths in the U.S. each year.

Established in 2010, a prototype of the current system called dkCOIN was initially created to explore requirements for information sharing between four NIDDK-supported consortia, including the Nuclear Receptor Signaling Atlas (NURSA), the Beta Cell Biology Consortium (BCBC), the Mouse Metabolic Phenotyping Centers (MMPC), and the Diabetic Complications Consortium (DCC).

The new NIH grant will allow UC San Diego researchers to expand the data federation and develop and enhance a user-friendly Web portal that will seamlessly integrate information, resources, and data held by NIDDK-related research groups, with the goal of providing a valuable resource for NIDDK investigators.

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UC Irvine smartphone app permits secure storage, testing of DNA data.

Gene Tsudik, UC Irvine

“Imagine you’re on a first date,” says Gene Tsudik, UC Irvine professor of computer science, hoisting a smartphone to illustrate his team’s latest work – an app that will let people safely store and use their own DNA on a mobile device. “You and the other person could hold up your phones, exchange tiny amounts of encrypted information and be able to determine how much common ancestry you have. Or you might be able to estimate the odds of your future children being born with something like Down syndrome.”

Tsudik and others at the Donald Bren School of Information & Computer Sciences have dubbed the app GenoDroid and say it could also be used for secure paternity tests, customized cancer-fighting drugs and more.

Tested on the Android platform with publicly available genome data, the app can determine in less than half a second whether one individual is another’s father. More importantly, Tsudik says, because of advanced encryption techniques, only a small fraction of each person’s DNA is needed, while the rest remains secure.

“A virtual treasure trove of frighteningly personal and sensitive information is contained in one’s genome,” he and fellow authors wrote in a recent paper for the Association for Computing Machinery. “Our protocols only yield the test results and do not disclose individuals’ genomic information.”

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