Technology for the Way We Work

by: Sandra R. Hernández, MD, President & Chief Executive Officer                          California HealthCare Foundation

Whether it’s electronic medical records, computerized physician order entry, or e-prescribing, clinics and hospitals have historically approached Health Information Technology (health IT) purchases as they would any other major piece of medical equipment – find it, buy it, and then figure out how to re-engineer the nature and flow of clinical care in order to use it.


Twenty years ago I did the same when I made the case to the San Francisco County board of Supervisors that a major investment in an electronic health system for our county hospital and clinics to share clinical data was a necessary capital investment. The budget was approved, the vendor was chosen, and we implemented the system only then to realize that we hadn’t thought about the intensely personal perspective of care delivery; the “people processes” of care.

Fast forward to today, we of course now know that technology cannot be considered in isolation. With the help of initiatives like HX360 health system CEOs are developing organization-wide strategies to take advantage of technology AND process redesign in tandem. Entrepreneurs have caught on too. Over eighty early-stage companies entered the recent HX360 Innovation Challenge, co-located at the 2015 HIMSS Annual Conference, and they each leverage technology as an engine to make care delivery more efficient, higher quality, or more patient-centered.

As medical centers are built (or rebuilt), they too are looking at technology in a whole new light. This summer the Martin Luther King Jr. Community Medical Center (MLK), will open a state of the art campus in South Los Angeles which will focus on keeping people healthy instead of in the hospital. To accomplish this, the center has invested heavily in technology platforms that help staff manage the health of populations, develop and maintain relationships with patients and caregivers, and collaborate in teams to manage illness. MLK will also stay on the cutting edge through relationships with the University of California, Los Angeles and AVIA – a provider-led accelerator that works with health systems to identify needs and implement emerging tech-enabled solutions.

Investors have also seen the light and are playing a big role in the evolution of health IT. In late 2010 my organization, the California HealthCare Foundation, pioneered a Program Related Investment (PRI) initiative to make direct investments in health care services and technology companies, with the goal of supporting sustainable, scalable models for improving access to care and lowering cost of care within public hospitals and community clinics. Since then our fund has made nine investments in companies that leverage technology to really expand the capabilities of the care team.

One early stage investment, Direct Dermatology, a telemedicine company that provides remote dermatology consultations, quickly demonstrated how technology can expand access to convenient and affordable care. Using a basic digital camera doctors photograph their patient’s skin condition, upload the images to a secure website, and receive a consult report in two days or less. Used by the Health Plan of San Joaquin, Adventist Health Community Care, and others in California this service not only expands a clinic’s capacity to treat patients, it does so while preserving the physician’s workflow and saving patients from having to make an appointment with a specialist.

Another investee, iRhythm Technologies, makes an outpatient cardiac monitor. Piloted by San Francisco General Hospital, which receives over 700 outpatient referrals a year to evaluate suspected cardiac arrhythmias, the iRhythm ZIO® Patch was shown to reduce the delays in diagnosis that were typical with prolonged Holter studies. Not only did the product reduce the time from appointment to report, it also reduced workflow strain experienced by physicians, nurses, and lab technicians.

Our most recent investment is in Seamless Medical Systems, a company whose software allows patients to enter demographic information and provide clinical history, complete risk assessments and surveys all on an iPad, eliminating the need for paper forms. Not only does this improve efficiency and ensure that providers have the correct information at the point of care, the solution also leverages the iPad to deliver personalized health education to patients, providing engaging information on prevention, treatment adherence, and wellness.


The potential for these companies to disrupt the health care status quo and in the process help patients get into the system and get what they need clinically – moves us toward a more patient centered delivery system and allows providers to do the work they were trained for. I look forward to seeing you at the upcoming National Healthcare Innovation Summit, organized by HIMSS, and co-hosted by AVIA and NEHI, where I will share more about the start-ups CHCF has invested in and how we have seen these technology and services companies tailor their solutions to address the needs of underserved markets.

About Ethan Baron

Program Manager, Innovation, Healthcare Information Systems, HIMSS
This entry was posted in National Healthcare Innovation Summit and tagged , , , , , . Bookmark the permalink.

1 Response to Technology for the Way We Work

  1. However, it’s stunning how many hospitals have bowed under the least perceived non-compliance threats with internal policies and tried to shoe-horn paper-based work flows into their EHR implementation processes. This not only undercuts many efficiencies but grates on the nerves of their users who are forced to use systems in ways they really were never designed.

    It’s also stunning how little investment hospitals and clinics make in this digital world in the technology placed in exam rooms making it difficult if not impossible to effectively merge high tech with the human to human interactions necessary. Total exam room technology investments average about half of what is spent on an exam table. That would be laughable if it weren’t so tragic and have so many negative repercussions.

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