Foresight Engine

Adaptation in response to:

Teach all med/dent students how to BE with and touch people, and to know surface anatomy and topography thru ancient healing art of massage

Great idea. Can be part of a larger frame-shift to teach different ways to know the people you care for.

played over 7 years ago by David Thom FCM

Adaptation in response to:

Great idea. Can be part of a larger frame-shift to teach different ways to know the people you care for.

We teach getting a Med Hx, PE, labs and imaging studies. But there are many other ways to know someone that can help us care for them.

played over 7 years ago by David Thom FCM

Investigation in response to:

Maybe UCSF needs to be the leader in paying primary care physicians more?

How can the work of a primary care physician be restructured to justify paying more? Not just at UCSF, but also in the wider society

played over 7 years ago by David Thom FCM

Adaptation in response to:

Tech should enhance relationship-centered care and #primarycare humanistic approach, no way it can supplant it

Communication & information tech used to leverage the personal relationship. Less time on mechanics of communication, more on subtance

played over 7 years ago by David Thom FCM

Adaptation in response to:

We already have a huge shortage of primary care doctors--can biosensors and tech really fill that gap?

Tech only part of transformation. Also need to restructure roles and relationships; non-MDs for more primary care tasks as part of team

played over 7 years ago by David Thom FCM

Momentum in response to:

Interesting. I have never thought of medicine as the art of caring for communities. How can UCSF handle this big task?

Can provide resources to help community care for themselves. And make our medical care consistent with and responsive to needs of community

played over 7 years ago by David Thom FCM

Positive Imagination in response to:

How can UCSF lead the way in 2025?

Create more clinic 'laboratories' to study care process, especially for primary care. Start with new model, rapid improvement cycles

played over 7 years ago by David Thom FCM

Momentum in response to:

In order for our staff to be effective and healthy workers who go on FMLA leave should have a year off & guaranteed their job upon returning

I agree. Most European countries have at least 6 months - some up to 2 years, and have done so for decades.

played over 7 years ago by David Thom FCM

Adaptation in response to:

Love this focus on healing relationships. How do we change the culture at UCSF to value and promote high touch and not just hi-tech care?

More study of the relationship as a therapeutic tool.

played over 7 years ago by David Thom FCM

Positive Imagination in response to:

How can UCSF lead the way in 2025?

UCSF will be a leader in understanding, teaching and promoting the therapeutic benefits of the the patient-clinician relationship.

played over 7 years ago by David Thom FCM

Critical Imagination in response to:

What urgent challenges will UCSF face in 2025?

Will need to combine technological and scientific advances with relationship-based primary care to reduce waste, improved outcomes

played over 7 years ago by David Thom FCM

Investigation in response to:

But do robots CARE about patients? Psychotherapeutic research finds relationships with providers consistently predict better Pt outcomes.

But the suggestion is for at least some of the work done by medical assistants. And what if the robot can pass the Turing test?

played over 7 years ago by David Thom FCM

Adaptation in response to:

How does UCSF serve the substantial population that refuse to or are unable to visit a doctor?? #healthySF

Community health workers can bridge between community and the health care system. Some investigators here have/are using this model

played over 7 years ago by David Thom FCM

Investigation in response to:

Tech may replace people, so UCSF should aggressively promote personal doctor-patient relationships that are in danger of going extinct.

If people can become emotionally attached to a machine (e.g., a program that mimics human conversation) can that be helpful for them?

played over 7 years ago by David Thom FCM

Investigation in response to:

Tech may replace people, so UCSF should aggressively promote personal doctor-patient relationships that are in danger of going extinct.

If people can become emotionally attached to a machine (e.g., a program that mimics human conversation) can that be helpful for them?

played over 7 years ago by David Thom FCM

Investigation in response to:

Develop relationships with people (stop calling them patients) across the organization that are akin to the GP-patient bond. UCSF is my doc!

hmm...not sure I get what you are saying here

played over 7 years ago by David Thom FCM

Adaptation in response to:

Say more about the benefits and how this should be different than what we already do? #education

We do teach about interpersonal aspects of care, but not so much about why the potential therapeutic impact.

played over 7 years ago by David Thom FCM

Adaptation in response to:

We do teach about interpersonal aspects of care, but not so much about why the potential therapeutic impact.

In much of research, the relationship is considered part of the placebo effect, something to control away.

played over 7 years ago by David Thom FCM

Adaptation in response to:

In much of research, the relationship is considered part of the placebo effect, something to control away.

Can the relationship be used to help avoid unnecessary tests and referrals? To partner with patients in improve adherence and outcomes?

played over 7 years ago by David Thom FCM

Adaptation in response to:

Can the relationship be used to help avoid unnecessary tests and referrals? To partner with patients in improve adherence and outcomes?

If so, what is the best way to do this? And why only 140 characters?

played over 7 years ago by David Thom FCM

Momentum in response to:

Launch a peer-peer health coaching program where "successful" patients can assist those having more difficulty with disease management.

In our RCT, peer coaching was effective in improving glycemic control. More info re peer coaching at http://peersforprogress.org/

played over 7 years ago by David Thom FCM

Adaptation in response to:

What defines a "successful" patient? And what training will they have? What regulations will be needed?

good questions. Some literature on this - see http://peersforprogress.org/.

played over 7 years ago by David Thom FCM

Adaptation in response to:

Maintaining 'high-touch' (personal interactions) while embracing high technology without alienating both UCSF staff and customers.

Use other members of the care team to provide 'high touch' continuity relationship in coordination with the patient's clinician.

played over 7 years ago by David Thom FCM

Adaptation in response to:

Maintaining 'high-touch' (personal interactions) while embracing high technology without alienating both UCSF staff and customers.

Use other members of the care team to provide 'high touch' continuity relationship in coordination with the patient's clinician.

played over 7 years ago by David Thom FCM

Played

Tracked