After visiting Sebastopol with Veenu, we were able to visit with other leaders in patient centered care, including James Kahn, MD, from the Positive Health Program at University of California, San Francisco.

I was first exposed to Jim’s work when I shadowed at Lifelong Medical Care in Berkeley, which uses the electronic health record, HERO (Health Care Evaluation Record Organizer (HERO)), developed by the team at UCSF. When I was at Lifelong Medical Care, I appreciated the fact that practitioners caring for HIV patients looked forward to using the electronic health record system to manage these patients’ care. This occurred early on in my shadowing work, and gave me the sense that more physicians in more practice settings are interested in HIT than has been commonly believed.

On this day, at a very hip (yet affordable and with a health care surcharge for employees, we do work in the non-profit world after all) San Francisco eatery, Jim showed us the myHERO portal, which facilitates the care of patients with HIV as part of the Positive Health Program’s work. Veenu and I have been interested in patient connectivity outside of commercially insured groups, and this is the welcome reality that myHERO brings to health care.

Here are some images of our lunchtime tour (Note, as with any demo of systems like this, we only looked at mocked up patients, never at any actual patient information):

myHERO is connected to the electronic health record that the PHP team uses, and it is being set up to support secure portability of information to the places where patients need it. Jim has been leading this effort as both as a clinician and an Informaticist. myHERO brings the concept of a multilingual personal health record forward (it has a spanish version), and Information therapy, through linkages to MEDLINEplus.

It was/is overall terrific to see inroads being made into patient access to health information technology in diverse populations. Jim and UCSF will be able to add information to the best ways to engage patients with chronic illnesses from a variety of backgrounds, an area of health informatics where there is very little data.

As fellow patient-centered care providers, we also had an engaged conversation about how much to share and when, and about the challenge of whether to build something yourself or buy something when it comes to technology. These are great topics to talk about (”the how”), but the core is really “the what,” which is less about the technology and more about the intent to involve patients and their families, which is what we saw, a perfect companion experience to our time in Sebastopol. MyHERO is yet another burst of innovation from the Golden State.

Grumbach K, Mendoza R. Disparities In Human Resources: Addressing The Lack Of Diversity In The Health Professions. Health Aff. 2008;27(2):413-422. [Accessed March 27, 2008].

This is a nice analysis of solutions from the Family and Community Medicine Team at University of California, San Francisco, to support diversity in the health professions, which unfortunately have not yet reached levels comparable to the general population, especially in allopathic medicine.

There are two concepts that reinforce that this is not just an issue for health care, it is an issue for society, and the people and businesses that depend on a strong health care system:

The business case highlights the customer service and competitive advantages to the health industry of having a workforce that is culturally and linguistically attuned to the increasing diversity of the nation’s health care consumers.

and

A wide group of organizations—including the AAMC and other health professions educational organizations, higher education institutions, consumer groups, and Fortune 500 companies—contributed amicus briefs and other documents in support of the University of Michigan in Grutter v. Bolinger, signifying a more concerted effort to identify and organize stakeholders interested in supporting diversity efforts.

Many physicians, myself included, work in the most downstream parts of this ecosystem, and it’s therefore helpful to consider that there are places we can be to create a more effective care system for everyone. From my travels to date, it’s clear to me that these are worthy investments of my physician colleagues’ expertise. None of us enjoy waking up to a world where the quality of health care is dependent on things other than the fact that you are a human being.