UCSF HIPSTER: Hypertension - Innovating Personalized STrategies for Excellent Results
UCSF HIPSTER: Hypertension - Innovating Personalized STrategies for Excellent Results
UCSF HIPSTER: Hypertension - Innovating Personalized STrategies for Excellent Results
Key team members:
Sirisha Narayana, MD, Alvin Rajkomar, MD, Victoria Valencia, MPH, James Harrison, PhD MPH, Sumant Ranji, MD, Division of Hospital Medicine, UCSF.
Gurpreet Dhaliwal, MD, Department of Medicine, SF Veterans Affairs Hospital.
Background:
Physician note-writing is an opportunity to teach, share ideas, and solidify clinical decision-making. Yet as billing requirements and copy-paste functionality have increased in recent years, the utility of writing and reading these notes has declined steeply. In addition to the dehumanizing "tyranny of clicks and auto-populated fields," (Rosenbaum, "Transitional Chaos or Enduring Harm?
Database of abbreviations that live in apex. When someone includes an abbreviation in a note, the reader can hover over the abbreviation with their mouse and see the full text of potential abbreviations.
Examples:
PCA = Patient Care Assistant, Patient-Controlled Analgesia
s/f = scheduled for
Among the most important components of the hospital discharge summary is the section titled "Follow-up Needs for the Primary Care Physician." This contains specific "to-do's" such as "follow up blood culture results" or "check potassium level in 1 week." These items are often crucial continuations of care needed to close the loop on productive and high-quality hospitalizations. However, they are buried in the bottom of a several page-long discharge summary, making them less likely to be seen and acted on by PCP's.
It is a common perception on campus that "Epic is closed and doesn't want to talk to outside systems."
Aim:
1) To reduce redundant and unnecessary specimen collection from patients with a new order entry strategy
Background:
Create a program to allow investigators to directly solicit crowdfunding support for their research projects. Similar to Indiegogo and Kickstarter but for UCSF vetted scientific research.
Efforts to improve physician education and patient safety often start by gathering data about when and where housestaff are engaging in direct patient care, administrative work, and learning activities. But the information from these self- or observer-reporting surveys is inherently unreliable, meaning that any conclusions based on its interpretation are faulty, and interventions to improve housestaff experience are unlikely to succeed.
Anecdotal evidence from discussing with Gastroenterology providers at UCSF suggests that patient-provider messaging has become a major aspect of clinical care at UCSF, taking up significant time and providing valuable service to patients. However, there is no formal requirement to provide this type of care, nor is there a mechanism to provide re-imbursement. It is clear that this type of care will continue to increase in importance and use over time. I propose a project to formally study its use, highlighting the following aspects: