1. UCSF mHealth Projects June 15, 2011

2. mHealth@UCSF The mHealth projects fall into four broad categories: Architecture & Framework Reusable tools which decrease the time and cost of implementing projects Health Research and Clinical programs for patients and clinicians Learning Educational programs for patients, staff, students, clinicians, and the public Business Automate and streamline business processes for staff and clinicians 2

3. 3 Architecture & Framework Reusable tools that decrease the time and cost of implementing projects

4. 4 UCSF mHealth Mobile Framework Client device platforms include J2ME, iOS, and Android. Runs entirely on the mobile device. Provides mobile software services such as alerts, reminders, metrics, gaming, network communication, etc.. Specifically for healthcare mobile applications Accelerates the construction of mobile solutions. Most UCSF mHealth mobile solutions are based on this framework. Supports data integration with Salesforce and other backend clinical/patient systems. Status: deployed.

5. wStack Mobile Framework 5 Core engine component of the UCSF mHealth Mobile Framework. Client device platforms include J2ME, iOS, and Android. Runs entirely on the mobile device. Framework for rendering paper- based clinical protocols and complete care plans on mobile devices. Research framework for patient-facing mobile applications. Intended to be open sourced. Status: deployed.

6. OpenmHealth.org Mobile Framework 6 Industry-wide effort to deliver open source software for the effective construction of mHealth mobile solutions. Represents the entire software stack from the mobile device to the backend servers. The mHealth Group is driving the mobile-based software portion of the framework. Direct collaboration between UCSF and the UCLA Sensor Group. Status: deployed.

7. UCSF Companion 7 Dynamic platform for delivering mobile applications directly to a patient. Mobile application which follows the patient during their entire life. Contains and maintains the patient’s health record. Implemented using the UCSF mHealth Mobile Framework. Collection of applications geared specially towards the patient. Application list can be managed remotely by the care provider. Example of new research directions in managing patient well-being. Status: proof-of-concept.

8. 8 mHealth Research and Clinical Programs

9. 9 UCSF School of Nursing RO1 grant. Mobile implementation of the American Heart Association’s Choose to Move Participants keep a daily diary on a Motorola Razr phone, including the number of steps they walked. Research into patient behavior intervention and patient behavior modification. Includes videos, SMS daily reminders, daily time-based encouragements, and graphical tracking of efforts. Status: completed.

10. 10 Health-E You Department of Pediatric – Adolescent Medicine grant proposal. iPad replacement of a kiosk application sponsored by the California Family Health Council Health-E You allows young women to self-screen for chlamydia testing while at a clinic. iPads are distributed to clinic waiting rooms. Data logged to secure data servers hosted by ISU. Uses videos to share experiences with previous women. The data is securely shared with the originating clinic. Status: completed.

11. 11 Athena iPad iPad interface Clinician preps the app by selecting the right survey for the patient. Patient completes survey and returns iPad to the clinician. Clinician reviews results with patient and securely uploads data for integration with Athena’s data server at UCI. Status: completed.

12. 12 Stop Smoking iOS implementation of Ricardo Munoz’s Taking Control of your Life smoking cessation program Users track cigarettes, mood, and healthy activities to support a behavioral intervention rooted in cognitive behavioral therapy and years of research With the users’ permission, the application reports anonymous usage to a secure database server hosted by ISU With users’ permission, the application logs anonymous analytics data to ISU’s Google Analytics. Status: completed. Available from the Apple App store.

13. Remote Patient Monitoring using Medical Devices 13 UCSF Pediatrics Device Consortium grant proposal. Android phone communicates directly with a pediatric medical device using Bluetooth. Phone guides the patient on the management of the medical device. Patient enters events through the phone such as pain, discomfort, medical device usage. With FDA guidance, customize reporting to create FDA-approved documentation for safety and efficacy monitoring. Status: in development.

14. Depression Management Exercises 14 Depression management using UCSF established exercises from the Department of Psychiatry. Use of pictures, video, patient preferences. Implemented using the UCSF mHealth Mobile Framework. Example of developing patient- centric and patient-specific mobile applications. Driven by clinical pathway derived specifically for the patient. Status: proof-of-concept.

15. SMS Messaging Depression Management 15 Depression management using UCSF established exercises from the Department of Psychiatry. Implemented using the UCSF mHealth Mobile Framework. Patient exchanges SMS messages with their mobile device “virtual care provider”. Application learns and evolves its conversational abilities. Example of new research directions in behavior modification using innovative user interfaces. Status: proof-of-concept.

16. 16 Oral Cancer Screening UCSF Department of Oral and Maxillofacial Surgery grant proposal. Android phone with an attached dental camera to take pictures of a patient’s oral cavity. Used by trained volunteers, trained clinicians, and trained dentists. Reduces the need to have a cancer specialist at the time of screening. Phone transmits the images to a clinical database. Cancer specialist examines the photos and replies to the technician for further patient treatment. Status: in development.

17. 17 Cancer Treatment Summary As recommended by the American Society of Clinical Oncology, all cancer survivors should carry a record of their diagnosis and treatment history Cancer survivors enter summary information about their cancer diagnosis and treatment Users may email the record to their primary care physician, family members, and other individuals whom they Application logs anonymous, non-PHI analytics and application usage data Status: In development.

18. 18 Mood Monitor Dynamic iOS tool designed to allow users to track their mood on scales they set themselves Users set end points mood visual analog scales and alert frequency Over time, Application modifies scales and alert frequency based on actual usage and algorithms to maximize engagement With the users’ permission, the application reports anonymous usage to Salesforce Application logs anonymous analytics data to Urchin Status: in development.

19. miAmigo Type 2 Diabetes 19 UCSF Department of Medicine grant proposal. J2ME-based mobile device monitoring of Type 2 diabetics. Participants are surveyed daily using demographics-based questions. Survey results analyzed on- board the mobile device with immediate recommendations based on research algorithm. Provides information on local farmer markets for better eating habits. Research into patient behavior intervention and patient behavior modification. Status: proof-of-concept.

20. 20 Contraceptives Refill Reminders A participant signs up for reminders either at a clinic or on-line. The request is stored securely in UCSF’s data center When reminders are due, UCSF sends SMS messages to the participant’s phone Status: in development.

21. 21 mLearning Deliver content to students, patients, staff, and clinicians

22. 22 iOS implementation of the California Poison Control Center’s popular web game, Pills vs. Candy. Pills vs. Candy Users attempt to identify pills, medicine, vitamins, and poison from candy. Anonymous usage data logged in Google Analytics. Users may post their scores to Twitter and Facebook. Status: completed. Available from the Apple App Store.

23. 23 UCSF Mobile Public application, native on iOS and Android Contains the UCSF Directory, shuttle schedule, maps, and more Integrates with the Library’s catalog Powered by Blackboard Mobile Status: beta testing

24. 24 Business Automate and streamline business processes

25. 25 California Department of Public Health 2011 Medical Record Review The MRR iPad solution allows CDPH medical record abstractors to review medical records at diverse clinics around the state, report their findings, and communicate with the program administrators in Sacramento Administrators record scheduled site visits and randomly selected medical records UCSF pulls the data and selectively transmits it to each Abstractor as needed Abstractors use the MRR to record their findings, which are transmitted back to CDPH Status: in development.

26. 26 Emergency Preparedness iPad version of UCSF Medical Center’s Emergency Operations Plan and associated documents, forms, and plans Integrated push strategy: when updates are made to Sharepoint, they are propagated to the mobile app Native app caches content so it remains available during an emergency Status: in development.

27. Pipeline Projects 27 mHealth Diabetes IVR CKD IVR Peyronie’s Assessment MOST v2 Urinary Incontinence Screener Pain Management SMS for Health NIHL Intervention Saving Lives at Birth Breast Cancer Survivorship UNICEF Childhood Illness Protocol Skin Anomaly Tracking Pediatric Cancer Nausea mLeanring Mad as a Hatter Anatomy Labs Curated PubMed Home Care Flashcards Business Patient Intake Forms Informatics Discharge Tracking MDM Implementation Run Safe Online

28. Governance and Oversight IT Governance Committee – mHealth reports to the Mobile, Media, and Web Working Group of UCSF’s Committee on Technology and Architecture, which reports to the IT Steering Committee SMS Taskforce – Charged with documenting UCSF security and compliance issues, vendor selection criteria, and developing industry partnerships for SMS/texting programs mHealth Brown Bags – Cross-functional group of UCSF faculty and staff devoted to mHealth innovation and collaboration Business Development Officer – Full-time position in CTSI charged with developing UCSF strategy to deliver and monetize mHealth programs 28

29. UCSF mHealth Team Highly experienced team in medical, Silicon Valley software startups, and advanced technology. Opinder Bawa – CTO. Twenty five years in the software industry, eight years in medical. Companies include Boston Medical Center, 3COM, and SCO. Jeff Jorgenson – Assistant Director. Twenty five years in the software industry including Apple, 3COM, and ASK. Tom Manley – Project Manager. Fifteen years in the software industry including ten years in medical at UCSF. Melwin Yen – Lead Developer. Ten years in the software industry including two years in medical. Companies include Booz Allen (NASA projects) and InnoDepot. Larry Suarez – Architect. Twenty five years in the software industry including ten years in medical. Companies include Sybase, Teradata, Commerce One, and Restech (medical devices). 29

30. Contact: Jeff Jorgenson (Jeff.Jorgenson@ucsf.edu) Opinder Bawa (Opinder.Bawa@ucsf.edu)