The Center for Digital Health Innovation is looking to technology for both disruptive and incremental improvements to healthcare.
As the boundary between digital technology and physical well-being shrinks, professionals in various fields who never had any reason to speak to each other before are now finding common ground for fruitful cooperation.
About 50 miles north of Silicon Valley, on Parnassus Heights in the approximate center of San Francisco, the University of California, San Francisco (UCSF)—dedicated solely to medicine and health care—is actively establishing links to the digital ecosystem all around it, and beyond.
With roots going back to the Gold Rush days, UCSF has since evolved into a world-class medical center producing five Nobel laureates. From its elevated perch overlooking much of San Francisco, it is home to the UCSF Medical Center, UCSF Benioff Children’s Hospitals (a gift of Marc Benioff, founder of Salesforce), and professional schools in dentistry, medicine, nursing and pharmacy.
It is also home to the Center for Digital Health Innovation (CDHI), founded in 2013 on the premise that exchanges between the creative minds and practitioners at UCSF, and beyond, can help drive successful development, implementation, and adoption of new digital health technologies.
The Center works with researchers and practitioners throughout the UC system to help them collaborate and turn ideas into beneficial medical products and treatments. It also works with start-ups outside the UC community who need to evaluate their product ideas in a clinical environment before seeking regulatory approval.
With corporate partners such as GE, Salesforce, Samsung, and the Gordon and Betty Moore Foundation, it provides innovators a place to meet and make the connections that lead to new ideas, new processes and new products.
Such fruitful exchanges among a variety of people have been a hallmark of the San Francisco Bay area. For over a century, the place has attracted and inspired generations of shoot-for-the-moon innovators: in atomic, electronic and genetic engineering, music, entertainment, fashion, as well as medicine.
Dr. Michael Blum in his office at
UCSF's Center for Digital Health
Innovation (CDHI). Dr. Blum is the
director of the CDHI, associate vice
chancellor for informatics, and a
professor of medicine in cardiology
at UCSF. (Image: EE Times/Tom Mahon)
CDHI seeks to build on this long tradition of interdisciplinary conversation to develop and commercialize novel applications, devices, sensors and platforms to pioneer the field of precision medicine.
Along with other centers of excellence such as the Mayo Clinic and Stanford, this emerging field seeks to harness technology, science and medical data to better understand the roots of disease, develop targeted therapies, and ultimately save lives.
The director of the CDHI is Dr. Michael Blum, associate vice chancellor for informatics and a professor of medicine in cardiology at UCSF.
Prior to his medical career, Dr. Blum was trained as an engineer, and is thus able to consider precision medicine both from the perspective of a product designer as well as a clinician involved in positive medical outcomes.
“And while healthcare has not yet experienced the full force of the digital and social media revolutions, it will shortly,” says Dr. Blum.
As UCSF’s chief medical information officer, he serves as an advisor to numerous start-ups and early stage companies and is working across the entire UC system to establish a data warehouse that captures the experience of the 13.5 million patients who have been served by that system over the years.
Such data collection on a massive scale (big data) is opening up an entirely new approach to healthcare. The practice of medicine has always been as much about statistics as it is about treating the individual, as in “Given your history, your gene makeup and lifestyle, and comparing that with all those who have had similar symptoms in the past, you have a 75 percent chance of recovery.”
But now with massive amounts of data from the general population never available before, mapped against information from the individual made available with genomics, medicine can indeed become more precise.
Imagine a treatment regimen tailored to an individual, not to a statistical average. Not only would outcomes be better, but costs could be contained much more efficiently.
That is only one of the changes Dr Blum sees. “Ambulatory office visits will go away soon as well,” he says.
A visit to a physician now includes a few minutes of data gathering first (taking vital signs), before the doctor discusses the findings with the patient. But if wearables and other digital devices had been monitoring the patient between visits, the interchange with the physician can be done by phone or video much more efficiently and economically.
The opportunities this new world of digital health opens up to the design community are enormous. And while early products in mobile health (mHealth) like Fitbit have been consumer oriented, and often lose their appeal in a short time, much more precise and sophisticated devices are just beginning to appear on the horizon, says Dr. Blum.
There are several paths a designer can take to bring a product to market in the healthcare field.
One is the traditional approach of raising capital from venture investors. But healthcare devices are in an entirely different category than consumer electronic devices like PCs and mobile products.
In the latter case, the market decides if the product is useful. But with healthcare, there are regulatory bodies with lengthy review cycles that need to approve new devices and techniques before they ever get to market.
And this is where CDHI can make a big difference for a startup in the new digital health ecosystem. Properly validating a product before even submitting it to the strict and lengthy FDA approval cycle is a rigorous and expensive process itself, costing hundreds of thousands of dollars, according to Dr. Blum. CDHI has decades of experience doing that work that it can make available to innovators.
This difference between time-to-market in the consumer electronics field and TTM in the digital healthcare area is important to factor in a startup’s timeline. The experience of Theranos demonstrates that. The company may have had a brilliant product and a huge potential market, but it didn’t seem to recognize the role that the FDA plays in the approval (and disapproval) process, and how much time and effort it takes to get past the gatekeeper for the nation’s health.
Dr Blum says that sophisticated devices are only now beginning to be seen in the startup channels, and he expects to see advanced chip technologies such as the SoC (System on a Chip) used in many of them.
Several inaugural projects exist already, including:
- Careweb—a team-based collaborative care platform that uses social and mobile communications technology, built on Salesforce.com;
- Tidepool—building the infrastructure for a new generation of smart diabetes management apps;
- Health eHeart—a clinical trials platform using social media, mobile technology and novel real-time sensors to revolutionize treatment of heart disease, and
- Trinity—providing precision team care by integrating patient data with multi-disciplinary input and evidence.