UCI Health, Orange County’s only academic health system, continues to invest in what it believes to be the future of healthcare: digital tools and medical devices.
The health system on Sept. 16 announced a two-year clinical study in partnership with managed healthcare company Anthem Inc. and tech giant Apple to determine how individuals with asthma can better self-manage their condition with wearable devices.
Anthem and its 40 million members can apply “digital technologies to advance health and wellness,” Steve Goldstein, vice chancellor of health affairs at UCI, told the Business Journal on Sept. 21.
“UCI shares that vision. This is a beautiful marriage that drives healthcare forward, from hospital to home.”
The collaboration represents UCI Health’s greater focus on predicting outcomes, preventing harm, personalizing medicine and providing care to the entire population, Goldstein said.
It’s just one example of its efforts to advance care with data and digital technologies, Goldstein said.
Anthem, Apple Collab
Up to 1,000 participants in Anthem’s network will be provided with a Beddit Sleep Monitor and Apple Watch to monitor their activity and heart rate, and measure blood oxygen and other health metrics to better understand triggers and effective treatment regimes.
UCI Health decided to target asthma for its first large-scale, remote trial because of the potential to make an impact on thousands of patients with a condition that often affects the entire family, Daniela Bota, medical director for the UCI Center for Clinical Research, said.
Nearly 25 million Americans are currently diagnosed with asthma and nearly 1.8 million emergency room visits each year are counted as a result of asthma attacks. Furthermore, asthma costs the U.S. an estimated $82 billion a year, Bota said.
“The bulk of the cost comes from care in hospitals,” she explained. “If we can help patients avoid hospitalizations, we can make a big difference on a national level.”
The trial is focused on data collection, which will inform future care. It’s also an important reminder that research and care for chronic conditions must continue amid the pandemic, Bota said.
“UCI decided we couldn’t halt research because of the acute needs of COVID-19. We need to adapt to our current circumstances and keep going, so that we can bring care and hope to every patient who needs it.”
COVID-19 Care
UCI Health has applied its health data to a number of real-world scenarios, including COVID-19 care.
Researchers from UCI’s Center for Artificial Intelligence in Diagnostic Medicine developed a Vulnerability Scoring System to calculate the likelihood that a COVID-19 patient would need a ventilator, based on lab results and patient information.
This database helped ensure vulnerable patients went to the ICU, and as a result, UCI Health has the third lowest mortality rate and fourth lowest length of stay rate for COVID-19 patients among 100 academic health centers, Goldstein said.
Furthermore, UCI Health’s average length of hospitalization for COVID-19 patients is almost three days shorter than it is for the average academic medical center; and its mortality rate is about half that of the average academic medical center, according to a quarterly assessment from Vizient Clinical Dashboard.
UCI Health also used Masimo Corp.’s SafetyNet continuous pulse oximetry system to monitor COVID-19 patients who needed to be closely watched, but didn’t require immediate hospitalization.
Irvine-based Masimo (Nasdaq: MASI) is OC’s ninth-largest device maker by local employment count with 700 area workers, according to this week’s Business Journal list (see page 26).
Masimo’s SafetyNet system is now monitoring patients with heart issues and end-stage chronic obstructive pulmonary disease at-home.
Outpatient Boost
Data and digital tools, as well as routine visits and frequent communications between patients and physicians, are key to prevention, according to several UCI Health leaders.
UCI Health has grown its Ambulatory Care division, which encompasses 80 outpatient clinics and 1,000 staff members, in recent years under the leadership of Nasim Afsar, chief operating officer of ambulatory care.
“I became interested in population health management as an internist, because I realized the root cause of many health issues came from a lack of robust outpatient care,” Afsar said.
Since Afsar’s appointment in 2018, UCI Health has expanded its number of clinics by over 20% and increased its number of annual patient visits by 24%.
What’s more, a new outpatient pavilion is expected to open along Jamboree Road in Irvine by the end of 2022, at a cost topping $220 million.
A new hospital and surgery center in Irvine could be next, officials told the Business Journal in August. Additional space UCI owns on the south side of Jamboree Road is being eyed for that project.
The importance of routine care and chronic care management has only been further realized, Afsar said, since a number of patients with a variety of conditions delayed or paused care in the first half of the year.
One of the ways UCI Health connected with patients for outpatient care amid the pandemic was through telemedicine.
Interpersonal Connections
Prior to COVID-19, the number of telehealth visits was less than 1% of UCI Health’s total visits. In April it was 55% of its volume; and in July it began to stabilize at 25%.
“We have a number of areas in telemedicine that are foundational and well-constructed,” Chief Medical Officer William Wilson said.
Ira Lott, director of UCI Mind’s Down Syndrome Research Program, has been using telemedicine for more than a decade as a research tool to connect with adolescent Down syndrome patients, in his investigations of the relationship between Down syndrome and the development of Alzheimer’s disease.
Lisa Gibbs, chief of the division of gerontology at UCI Health, has been using telehealth for nearly a decade to reach senior populations and reduce the need for vulnerable patients to come to offices or hospitals to receive care. Gibbs has continued to do this work amid the COVID-19 outbreak, as well as utilized telehealth pharmacy services to help seniors.
“We had been gradually rolling out our telehealth capabilities to our clinics. When COVID hit, there was a rapid acceleration of that effort,” Wilson said.
Telemedicine also plays an important role in keeping patients connected with their physician, Goldstein said.
“The personal relationship between a patient and their physician is so important. That can’t go away,” he said. “We’re leveraging technology and digital tools to improve health, but that doesn’t supplant the importance of interpersonal connections.”
