Q&A with Michael A. Pfeffer, UCLA

Michael is responsible the overall health information technology strategic plan, the development and operations of the information systems, and the implementation of transformative and innovative technologies. Michael is also an Associate Clinical Professor of Medicine for the David Geffen School of Medicine at UCLA and continues to practice as a hospitalist. Michael is committed to medical student and graduate medical education and serves as the Associate Program Director for the UCLA Clinical Informatics Fellowship Program. Read his full bio.

Interview with Michael A. Pfeffer, UCLA

Q: In your roles as Assistant Vice Chancellor and Chief Information Officer of UCLA Health Sciences, you are responsible for the health information technology strategic plan. What emerging healthcare technologies do you anticipate will have the greatest impact on the strategic plan in the next 3 years or 10 years?

A: I think there are some really exciting technologies that will become more mainstream in healthcare. Artificial intelligence driven by machine learning algorithms will be transformative, and I believe we will start to see this more in the operational and population health spaces followed by clinical decision support at the point of care. This will also enable precision medicine as we discover more insights on how phenotypic, environmental, and genomic information combine to best determine treatment plans. I’d also expect AI to play a role in billing/claims/coding clerical work to unburden clinicians from this. Blockchain technology will likely make its way into healthcare around personal health data for patients. And I expect to see incredible advances in voice recognition technologies enabling the creation of a billable encounter note simply by listening to the clinician-patient interaction. There are many more but I think this is a good start!

Q: You are presenting in the session “Driving Toward Value-Based Care,” which has a major focus on interoperability. For a healthcare system that is building and extending interoperability throughout the enterprise, what are the biggest priorities and challenges? Where will the greatest benefits be reaped? Are there certain settings/specialties in which interoperability is particularly difficult to achieve?

A: We’ve seen tremendous advances in interoperability over the past few years, with the ability to exchange patient records in real time accelerating with collaborations like Care Equality. At UCLA Health, we exchange millions of records a year already with care providers from across the world on different platforms. I think this will continue to accelerate with more and more care providers joining national exchange networks, and hopefully we won’t need to talk about interoperability as it will be standard practice for optimal patient care. Challenges involve patient matching and the lack of a national patient identifier, which I believe is the only way for patients to truly have one medical record—one medication list, one allergy list, etc. I do not see one specialty over another having more challenges with interoperability, however there are significant challenges that remain for post-hospital care facilities, like skilled nursing facilities, to be able to have robust interoperability capabilities.

Q: Value-based care is largely evaluated on population metrics. Is there a way to evolve value-based care measurement to be more individualized? Who will drive this evolution?

A: Potentially, however significant research and pilots will be needed to determine if this is effective and the best plan for patients. For providers and health systems, it may disincentivize care for highly complex patients because it would look at the patient level rather than populations. We need to be very thoughtful and evidence-based on any changes related to value-based care.

Q: In addition to your leadership roles in health information technology at UCLA, you are a practicing hospitalist and serve as Associate Program Director for the UCLA Clinical Informatics Fellowship Program. What skill sets are important for Clinical Informatics Fellows to develop to be successful now and in the future of precision medicine?

A: Clinical informatics fellows are key to clinicians growing to meet the demand of informatics in medicine–which will be (and some would argue already is) necessary for all future advances in the care of patients. Successful fellows understand that the care of patients is first and foremost, and technology must not disintermediate patients from clinicians–that relationship is critical for health and healing. Fellows also must be great listeners, understand the principles of change management, and have a deep curiosity and creativity for the possible.