Voalte Story: A conversation with Michael Blum, MD

After attending yesterday’s closing presentation at VUE15, where Voalte’s Founder and Chief Executive Officer Trey Lauderdale unveiled three new clinical communications solutions that his company will launch in 2016 (we will publish a rundown of each solution on November 16), I had the opportunity to speak with Michael Blum, MD, Director, Center for Digital Health Innovation (CDHI) at University of California at San Francisco (UCSF). I was given this exclusive interview as a means of learning more about the origins and the goals of one of the new offerings announced at the conference, Voalte Story, a co-development venture between Voalte and CDHI that provides an interactive patient wall similar in nature to Facebook that clinicians may access to post and link texts or alarms to a specific patient. 

(Editor’s note: To hear audio excerpts of this interview, click on the media player buttons that run throughout this article.)

Free: Please describe the history of CDHI, as well as your role within the organization today.

michael blum

Michael Blum, MD, Director, Center for Digital Health Innovation

Blum: I’m the Director of CDHI. I’m also the Associate Vice Chancellor and Chief Medical Information Officer at UCSF.

When we came out of our enterprise data and electronic health record (EHR) implementation at UCSF, it became more obvious that there were many next-generation issues and opportunities that we needed to tackle in order to leverage our evolving technologies to generate the best ideas and practices that we need for our work. We knew that we had to really get out and engage with our patients and consumers in a much deeper way, requiring us to make moves far beyond the EHR. 

While EHR is critically important to running a complex center today, that with the changes that are going on in healthcare from healthcare reform and a move toward precision medicine, we were going to need much more than electronic data warehousing.

We also understood that the digital technologies and consumer engagement were driving very rapidly towards a different, much more consumer, ambulatory look at healthcare. There were new data sources that we were going to need to consider as we went forward like patient-generated data, device-generated data, genomic data, other omic data, and we needed ways to think about those streams of information. That lead to the creation of CDHI. 

Free: CDHI works with only a few corporate partners. What are some of the more exciting developments occurring around your combined work?

Blum: We collaborate with Samsung, where we evaluate their new sensor technologies. They are developing wrist-worn technologies and phone technologies. We look at all of that and collaborate with them to make sure that those are accurate, that they’re reliable, and are meaningful in healthcare.

We are building an interoperability platform with Cisco where we are attempting to create the foundation that allows healthcare data to flow freely around the healthcare ecosystem, and create a foundation that apps and analytics and other devices can work on top of and address the data.

And now we have our large collaboration with Voalte which centers around CareWeb which is now Voalte Story, a project that began with our internal faculty, staff and student innovators who had many ideas around how to use social and mobile technologies to redefine healthcare communications.

Free: How did that project move from an idea to CareWeb and then become Voalte Story?

Social-Media-communicationBlum: We wanted to transition clinical communications from the single-point, either texting or telephone calls or paging, and transition them into the new world of team-based healthcare and social and mobile communications and really take advantage of much more contemporary communications like Twitter and Facebook. So, we created the first iteration of CareWeb as a proof of concept and then in a pilot fashion internally. We tested it at UCSF, and then we came out with a second version to address what we identified in the first pilot. It’s been deployed across UCSF and running for about a year. It made such a significant improvement in our communications capabilities that we knew our next step was to the find a software or a platform partner who could take this technology and really scale it out and deliver it nationally or globally. We’re an academic health center. We’re not going to become a software provider or a commercial technology provider.

We were already working with Voalte at our Mission Bay campus, and there was a natural fit between CareWeb and Voalte Platform. We knew by putting these two technologies together and creating Voalte Story that we would be able to move forward in a strong fashion and offer this next-generation communication functionality to care teams outside UCSF. 

Free: Please describe how Voalte Story is linked to much of the enterprise social-based communication (ESBC) that is becoming so pervasive within our everyday lives.

Blum: A few years ago, there was a general recognition at UCSF that the communications paradigm that we had needed to evolve. When we first started talking about this issue, our communications were essentially pagers, and nurses using landlines to call residents and attendings on their pagers. They would would call back-and-forth, and it was incredibly inefficient.

When we started working on the issue, our initial approach was to use what was evolving to unified communications and cellular technology. Cellphones were starting to get pervasive in the environment as a potential pager replacement, but there were many technical challenges that came with that, not to the mention the organizational challenges. Who would buy the phones? Who would buy the plans? How would you provide them as you are moving away from pagers and providing everyone cellphones? It really hadn’t been done, and in places where they tried to do it, it got very costly and benefits were hard to demonstrate. When we started thinking around the question of how do we use a hybrid of the cellular technology that exists with the evolving social and mobile pieces coming into the market, we saw that we could create the more sophisticated method and record of communication that healthcare needs today.

We knew that we needed to have a much more sophisticated approach to clinical communications because healthcare has moved away from what we think of as an independent sport of just a doctor or a nurse, helping a patient. That single provider-to-patient relationship has really changed and we now have teams taking care of patients. But, while new care teams have been formed and these teams were taking care of patients in new ways, their communications were still very individual and point-to-point. So we took the concept of a Facebook-like approach where you have walls of communications and used that kind of thinking to communicate across the entire care team with the patient at the center of it linked to the EHR. That step is what began us down the path toward Voalte Story.

Free: You have been using Voatle Story for quite some time. What would say are some of its short term benefits and how do you see it evolving over the next couple of years?

 Blum: The short-term benefit of moving to this kind of a collaborative communications platform is the transformation that happens when the entire team can see the communications that are going on between individual providers and nurses and other staff is they can plan the entire patient’s encounter much more efficiently.

People don’t need to reach out all the time and ask other members of the care team when things are going to happen or what the plan is around a patient. They can just look at the communications thread and see when the providers and the nurses are talking about getting the patient ready to go home, what the patient’s going to need when they’re planning for discharge, and they can see that as it’s happening, not hours later when it’s posted in a note in the patient’s chart.

There are many other efficiencies that can be gained via Voalte Story, many of them experienced by people who are excluded from the communications previously. If you think about people like care coordinators and discharge planners, with Voalte Story they now have hours and hours earlier insight into what’s going on with the patient and what’s planned for the patient. Before this sort of communication, they would have not had it previously. Even in more evolved organizations where they do discharge planning rounds and multidisciplinary rounds, those plans are still based upon just a single point in time in the day. But when you can watch a conversation feed and you can watch essentially a patient’s log through the day, you can see how things are evolving in real-time and adjust your plans accordingly. So, it’s a much more efficient way to take care of the patients, by watching a collaborative communications stream.

The other thing to note about Voalte Story is that it’s written around the patient and includes the entire team, which keeps everyone much more on the same page so you have way less of the inefficient back-and-forth redundancy of the communications.

healthcaresocialmediaIn terms of the future of Voalte Story, this is an in-patient communications platform right now, but the next step is including all of the ambulatory providers for those patients, so they’re on board. They now can see the whole thread of communications, so once the families of their patients call them, they’re up to speed. When the patient leaves the hospital, they know about it. They know the issues that were resolved prior to discharge and they’re in a much better place to transition the care out as an out-patient. They’re much better informed when the patient and family show up, which is an incredibly uncomfortable time if patients show up and you don’t have all the details around a recent hospitalization. That’s a very difficult conversation. But in the future, when they have access to all this, they can see all that very quickly and clearly.

The other thing that’s going to happen fairly quickly, I anticipate, is that patients and patient surrogates will be included in these threads. They will be able to be part of the conversation and see what everyone else is saying is going to happen. They’ll be better prepared for upcoming events and all of the information flow.

We’re really moving towards a patient-centered model of care in our communications as well as all other aspects of the care. It’s something we’re aiming for in the near future, as well. That’s going to be a significant change and that’s something we’re going to have to approach carefully, and we’re going to have to test it out. We’ve already developed the technology and pilots and proofs of concept for that, but figuring it out organizationally and with our patients with patient counsels, how that should happen and what’s the right way to include the patient in these conversations is very exciting and holds great potential, so we expect to see that in the not-too-distant future as well.

Free: You have been working with some of the biggest companies on the planet, and some would ask, ‘Why Volate?’ I know you had been working with one another in terms of an implementation at one of your campuses, but what makes you feel comfortable about working with Voalte on such a cutting-edge implementation and how has it worked so far in terms of this partnership?

Blum: That’s a great question.

We’ve certainly worked with very large partners. We’ve worked with Cisco. We’ve worked with Salesforce. We do a lot of work with Intel and many others. 

When I think about these challenges and how healthcare is really a unique beast in terms of who the right partners are and how to engage with the customers and the customers are very varied, depending on the different technology in each case, choosing the right partners is critical.

An ideal partner would have significant experience selling mobile communications into healthcare, first of all. Deploying them in healthcare with significant success would be really paramount. And then, a rapid development cycle for their technology platform is key. There are certainly larger partners, but we needed someone who was very agile and had a very rapid turnaround time.

All of this is needed because in the new social mobile world, the technology life cycles are much much shorter. The handset life cycles and what people expect out of the technologies, these have to be getting updated very quickly, not in the older model of every two, three, four years we’ll come out with a new version of things but need to be developed much more on a six month turnaround cycle, and from working with Voalte, they really checked those boxes.

Voalte has documented many successful deployments of mobile technology showing us the ability to really adapt to the challenging situations and the ability to sell into healthcare. They are very eager to adopt new cutting-edge technologies and build them into their platform. So, we were comfortable with them as a partner and we think that we’ll be able to excel. They aren’t looking for something that they just take and we go away. They want to continue the partnership, to grow the application and grow the functionality, to really move beyond the hospital into the full, end-to-end healthcare spectrum, and that’s we’re looking for.

In short, CDHI and Voalte are partnering to generate transformational successes throughout healthcare. We have just begun, but I have to tell you that we could not be more excited about what we believe is just now coming into our grasp. It’s going to be quite a ride. 

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