Future of health care

UCLA Health article

UCLA Health Sciences sets direction for future of healthcare

  Dr. A. Eugene Washington, vice chancellor for health sciences and
  dean of the David Geffen School of Medicine at UCLA
UCLA Health Sciences, one of the world's premier health institutions, is taking its leadership role to a whole new dimension: the future.
Dr. A. Eugene Washington, vice chancellor for health sciences and dean of the David Geffen School of Medicine, has announced a new strategic plan that envisions 24/7 medical care delivered by multidisciplinary health care teams, fast-track translation of groundbreaking research into hands-on health care, and wide-reaching collaborations to take on critical health issues in communities plagued by a plethora of problems and a paucity of resources.
"This plan is about shaping the future of medicine - and more than medicine," said Washington, who launched the yearlong planning process just weeks after arriving at UCLA in March, 2010, from UC San Francisco, where he was executive vice chancellor and provost. "It's also about shaping the future of science, the future of education and - ultimately - the future of health."

Last April, 17,000 faculty, staff and students in the medical school, research labs, hospitals and clinics received a detailed survey that posed such questions as, "What do you think our strengths are ... and our weaknesses?" and "What are the biggest challenges we face?" Focus groups, retreats and other forums were held to hear from a wide range of voices, including colleagues from UCLA's professional schools and the College of Letters and Sciences. Finally, 120 faculty, staff and students on four "design teams" took on the massive task of transforming a mountain of input into a blueprint for the David Geffen School of Medicine and the UCLA Health through 2015 and beyond.
The decisively inclusive process was a natural for the collegial culture that is UCLA, Washington said. "You can't help but notice the esprit de corps. All we had to do was tap into our vast reservoir of talent." The end product, he pointed out, "isn't the vice chancellor's plan or the dean's plan, but a shared vision that engages all of the rich intellect of the community."
The new strategic plan sets goals spanning four key mission areas: education, clinical care, research and community engagement.
Education: Create world leaders in health and science
Training medical students today requires visualizing how doctors will be doing their jobs tomorrow - no easy task in the 21st-century world of unremitting and rapid-fire change.
"The practice of medicine will be quite different even five years from now," said Washington. One major factor driving this transformation is science - for example, deciphering the code of the human genome to enhancing disease prevention and treatment. Another is technology: Already, UCLA medical specialists are testing telemedicine tools such as special cameras and computers to expand their reach to patients and peers around the world.
Future graduates of UCLA's medical school will be trained not only as physicians but as tomorrow's leaders in medicine and science to meet the needs of society. Already proceeding in this direction are programs such as UCLA's Program in Medical Education (PRIME), which combines a medical degree with a master's degree in a related field along with community service projects that build leadership skills.
Washington said that the medical school will also place an increasing focus on inter-professional education: Students will spend more time in activities and practice sites where teamwork is essential to the care of patients, working alongside colleagues in nursing and other fields.
This approach more accurately reflects the real-life arenas in which doctors work. By fostering these relationships early in in the training process, Washington said, "we will ensure that medical students are ready, both from the perspective of knowledge and skill and from the perspective of understanding how to work with many types of people in many different settings."
Clinical care: Heal humankind one patient at a time
UCLA's hospitals are already ranked among the nation's best - Ronald Reagan UCLA Medical Center has been ranked as the best hospital in the western United States for 21 consecutive years. But "when you're driven by excellence," Washington said, "you know you can push toward even higher levels."
In a departure from the conventional health care model in which patients access services by making an appointment to see their doctor face-to-face in a medical office or clinic, UCLA is envisioning a system that will be more accessible, convenient and, ultimately, more patient-centered.
A major factor driving this change, Washington noted, is the rising population of aging baby boomers - some 78 million Americans born between 1946 and 1964 who are experiencing more health problems and entering the health care system in greater numbers at an escalating pace.
Expanding upon the one-on-one patient/doctor relationship, new kinds of health care teams using the latest technological advances will make patient care available 24/7. Under the leadership of a physician, teams will incorporate nurses, "physician extenders" such as nurse practitioners and physician's assistants, health educators and additional highly skilled health care professionals to serve patients, their families and caregivers. And while visits to the doctor's office certainly won't disappear, technology will make it increasingly feasible to receive certain types of care without having to leave home - whether by picking up the phone or logging onto the Internet.
"With the patient continuing to be the raison d'être for everything that we do," said Washington, "we want to develop a better understanding of what the patient really wants and desires - not just the clinical care that we provide in a medical office, but a whole complementary system of care."
Research: Discover the basis for health and cures for disease
Dr. Kodi Azari led a team that performed the first hand transplant in the western United States.At UCLA, one of the world's leading research universities, scientific discovery extends well beyond the medical campus - as does its impact. From breakthroughs in treating deadly diseases like cancer and AIDS to performing the first hand transplant in the western United States through the new Hand Transplantation Program, UCLA research continues to revolutionize health care.
"We are fortunate at UCLA because it's not just the David Geffen School of Medicine or the UCLA Health," said Washington. "We have a cadre of exceptional scientists across the campus - spanning molecular biology, computational biological sciences, clinical investigation, health services research and health policy."
Further pushing the envelope are a burgeoning variety of interdisciplinary efforts, from collaboration with UCLA engineering researchers to develop innovative surgical materials, to partnerships with social scientists to study human behavior in relation to health status.
 Even more closely linking scientific investigation to bringing about real-world change, many UCLA researchers are also looking at much broader expanses, such as epidemiological and population studies at the School of Public Health. By determining a community's health status based on rates of diabetes, cancer and other indicators, UCLA Health Sciences can address health problems on a much larger scale.
Community engagement: Optimize health through community partnerships
Some of the biggest challenges in health care - from obesity to smoking-related cancers - are best dealt with from the perspective of community, said Washington. UCLA Health Sciences has bold plans for partnering with multidisciplinary institutions to tackle high-impact problems on a broad scale.
One collaboration already under way is UCLA's recently created Clinical and Translational Sciences Institute (CTSI), an academic-community partnership designed to accelerate scientific discoveries and clinical breakthroughs to improve health in Los Angeles. CTSI brings together UCLA Health Sciences with Cedars-Sinai Medical Center, Charles Drew University of Medicine and Science and the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center.
Working from a more expansive perspective can make all the difference in dealing with many health care dilemmas, Washington said. Take the dangerous upsurge of obesity, for instance. "When we talk about tackling obesity, we're talking about nutrition, about eating behavior, about parks, about exercise. There has to be this kind of truly broad, cross-disciplinary, cross-institutional effort if we sincerely intend to make meaningful improvements."
In this and the many other bold aspirations Health Sciences holds for the future, "We have a rich legacy upon which to build," Washington said, "and are very strongly positioned to reach our goals."
"Shaping the future requires vivid imagination and gifted people," he said. "Fortunately, we are richly endowed with both in UCLA Health Sciences."



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