Aaron Neinstein, MD
Datica Podcast

Aaron Neinstein, MD: Emerging Healthcare Data Challenges from Patient Centric Technologies

August 30, 2017   EHR Workflows Cloud Computing Startups Innovation Open Source Apps

Never has so much patient-generated data been available. Yet, without a way to organize, digest and make sense of it all, most of these kernels of insight are left untapped. Many digital health companies from coast to coast are working on technologies to remedy that situation. In today’s podcast, we talk to UCSF’s Dr. Aaron Neinstein who gives us a glimpse into some of those promising technologies. He also offers an inside look at the patient-generated data challenges for doctors and what the future may hold for combining this data with what physicians presently can gather in a clinical setting.

On openness to patient generated data: “A big thing is more incentives from the payors, so over the last two years, we’ve seen the introduction of the Medicare chronic care management codes which create the payment opportunity for use of patient-generated health data. What those codes do is allow you to bill on on a monthly ongoing basis for taking care of a patient who has two or more chronic diseases. You could theoretically have a nurse or someone else on your staff managing the patient remotely and be billing for that time.”

On empowering consumers to push for change in healthcare: “So absolutely, certainly in the diabetes space there has been over the past 5 to 6 years a huge groundswell of people pushing for change in the use of patient-generated health data and in consumer-driven technology.”

On other disease communities using diabetes for a model for technology and tech services: “One place in particular where we are seeing similarities to diabetes is with asthma. If you think about capturing the action and activity that a patient takes in the normal course of the day. That’s what we are talking about here; these are chronic diseases, where coming in for an office visit three or four times a year allows a narrow snapshot of what’s happening in somebody’s life. The reason we care about patient-generated health data is in theory, because it gives us the opportunity to see what somebody is doing day-to-day, 24/7, 365 in the context of their life, and tweak their treatment regimen or change their behavior to improve the management of their chronic disease.”

On how EHRs fit into the future of patient-generated data: “I think one of the things that people don’t think about is how many different categories of patient-generated health data there actually are. If you break it down, you are talking about 7 or 8 categories of things that comprise what we now called PGHD.”

On different initiatives that might help with sharing data: “I hate to say it because it’s definitely the buzzword of the year, but I think one of the things that is floating out there that’s a possible way to help this problem over the next 10 years is blockchain. I realize there’s a lot of hype around it and we are still completely unsure of where this is going to end up, but in theory, blockchain allows a centralized ledger for data so that there’s a single source of truth that could be controlled by the person, by the user, by the patient. So, I think there’s a lot of theoretical potential.”

Today's Guest

Aaron Neinstein, MD
Aaron Neinstein, MD

Professor of Medicine, UCSF; Director of Clinical Informatics, UCSF Center for Digital Health Innovation

Dr. Aaron Neinstein is an Assistant Professor of Medicine at the University of California, San Francisco, as well as the Director of Clinical Informatics in the UCSF Center for Digital Health Innovation. He is board-certified in Endocrinology, Clinical Informatics, and Internal Medicine. In addition to his UCSF clinical Endocrinology practice, he has helped lead the implementation of the Epic EHR at UCSF and many projects to improve clinical care and efficiency.

He believes strongly that the industry needs to make health information easier for patients and doctors to access, share, understand, and use in day to day care. By creating tighter feedback loops between doctors and patients when communicating and sharing health information, Dr. Neinstein believes we can improve care. He also helped found Tidepool, a non-profit, open-source cloud platform and modern apps for managing type 1 diabetes. He is now Clinical Director for a collaboration between Cisco and UCSF to build a Connected Health Interoperability Platform.

Our Interviewer

Travis Good, MD
Travis Good, MD

Datica Alumni — Former Co-founder & Chief Technology Officer

As CTO, Travis leads Datica’s engineering team. His background in compliance, security, and cloud infrastructure gives him technical expertise that, when paired with his experiences as an MD, allows for a unique view on the challenges of healthcare.