Michael Blum is Associate Vice Chancellor for Informatics, a Professor of Medicine in Cardiology, and Chief Medical Information Officer at the University of California, San Francisco.
He is responsible for the strategic design and implementation of enterprise clinical and research information systems and technologies across the university, provides clinical leadership for the enterprise-wide implementation and optimization of the campus’s electronic health record system and enterprise data warehousing, and leads UCSF’s new Center for Digital Health Innovation.
As an active clinician, Blum specializes in general and preventative cardiology and is passionate about wellness and the prevention of heart disease through a heart-healthy lifestyle. He has been an advisor to numerous healthcare technology start-ups, early stage companies, and industry stalwarts and was the clinical lead on the joint Intel-Motion Computing development of the first successful healthcare-specific tablet computer, the Motion C5.
TEDMED: What’s the most remarkable innovation you are seeing in health tech or medicine, and what is driving it?
Blum: Outside the technology space, the huge change in medicine is how much more data patients and well people are seeking in trying to maintain their wellness. Their expectations have changed dramatically as they try to assess themselves and see how they compare to what they’re finding.
There are, obviously, all sorts of views about the quality of the information they’re finding on the Internet. Some is misleading in that it appears to quote scientific literature, but does not. There is a bit of confusion. But the change is that society has transitioned from relying on one trusted source to seeking information; Google has transformed the world that way.
In health tech, the remarkable innovation we’re seeing is in sensing and assessment. We’re on the precipice of seeing that things we couldn’t assess outside an intensive clinical environment are now going to be measurable and monitorable at home. We’ve already seen that with the ability to monitor heart rhythm. What is coming is the ability to assess things that previously needed blood draws and lab tests or monitoring in an office, clinic, or hospital.
Monitoring things such as blood glucose, constant heart rhythm, blood pressure, oxygen saturation, and carbon dioxide content in the blood will become straightforward. Communicating that data to ubiquitous smartphone technology and moving from there into much more sophisticated apps with algorithms embedded will be game changing.
TEDMED: What’s the most important factor for entrepreneurial success in health tech—and is that different from your own key to success?
Blum: We’ve seen a lot of entrepreneurial activity in health tech that’s been divorced from the clinical environment and from scientific validation. These devices have been built by technologists outside of the clinical environment without scientific validation that makes sure they’re accurate or that they have the rigor to assess people accurately and reliably.
Patients and individuals who want to assess and maintain their wellness and manage chronic diseases are expecting a device that has been validated and that they can have confidence in. They want to be able to have a discussion with their healthcare provider about the data that comes from it.
One of the critical factors will be validation done in a clinical environment by experts. That’s going to create new health tech partnerships with academics. We need devices that generate data that stands up to the light of scientific scrutiny and is believable.
That’s the environment we provide at UCSF. That’s what led to our collaboration with Samsung, and that’s what we view when we look at a startup or health tech opportunity. We look at their concept, their technology, and their interest in validating it in the clinical environment. A lot of things work, but do they allow us to do things better, faster, and less expensively? Answering that question will be the key to success.
TEDMED: For entrepreneurs with needle-moving ideas in global health, what are the keys to finding collaborators and supporters across specialties, industries, and geographies?
Blum: If you can’t cure something, knowing about how much of it exists is not particularly helpful. But if you have a relatively straightforward and inexpensive technology solution that can lead to affordable treatments that have major impacts on the health of a population, then that’s fantastic.
For example, there are efforts to look at simple photographs of patients’ eyes—of their retinas and corneas—to determine if there is parasitic infection that could be treated with antibiotics to prevent blindness. But doing sophisticated heart monitoring and ultrasounds for people in a socioeconomic environment where treatment is unavailable? That is a different story.
The needle-moving things in global health are when you find technology applications or innovations that lead to assessments of individuals and populations in a state that is curable, treatable, preventable, or even manageable within the context of their healthcare and socioeconomic environment. If just the identification and monitoring makes it treatable, then that makes it needle moving.
Developing technology that finds something that is too intensive, too difficult, or too expensive to treat might be interesting, add to scientific understanding, and point out future areas for work, but it won’t make huge changes right then.
Finding and competing for collaborators, funding sources, and supporters who are philosophically aligned and have the resources is going to be effective. Collaborators and supporters are evolving an NGO approach to global health. For instance, the Bill & Melinda Gates Foundation is making huge efforts and impacts on global health in multiple areas. There’s a new collaboration at UCSF between Lynne and Marc Benioff in partnership with the Gates Foundation to give $100 million to look at efforts around preterm labor and other common healthcare problems in underserved populations. There will be some technology development there that will have a significant impact in global health.
TEDMED: In 2020, you’re asked to give a TEDMED talk about the biggest transformation you helped bring about in your field. What is it?
Blum: Six years from now we will use technology in a way that allows us to provide more preventative chronic disease management and wellness support to patients at home than we could have previously in many of their ambulatory encounters where they had to come to the healthcare environment.
Through the use of technology, in six years we will provide predictive information to individuals without them needing to come to us. The information tells them what they need to do to avoid getting sicker in the future. And it gives them the ability to manage their health much more effectively in real time, without needing to come into the healthcare space or wait for their six-month blood draw visit.
In six years we also will support aging-in-place of the elderly. Through the use of technology, we will know about and treat well in advance simple conditions like urinary tract infections that used to result in very bad outcomes such as urosepsis, falls, and broken hips. Early screenings for dementia will enable us to deliver support at home so elderly patients don’t need to go into assisted living.
We will have major impacts on disease management so that when we look back six years from now, we’ll see that the elderly are now able to enjoy their time at home much longer and individuals with chronic disease are able to manage their disease in a much more effective and less expensive way with connections to providers who advise them at home rather than in the office twice a year.
All of that will result in more satisfied and healthier patients with less cost to the healthcare system overall.