Leading the Digital Transformation of Medicine

reprinted from Issue 22, Spring 2016 of Frontiers of Medicine (PDF)

Robert M. Wachter, MD

The practice of medicine is all about information: information collected and deployed to help patients become and stay healthy. Remarkably, until about a decade ago, most of this information was written on pieces of paper, stored in three-ring binders, supplemented by Post-it notes, and transmitted through fax machines.

In the past five years, medicine has transformed from a paper-based industry to a digital one. UCSF, of course, has been part of this trend, with electronic records, e-prescribing, and the like at all of our clinical sites. This digital transformation is making care safer and better.

But UCSF, and our department of medicine, can’t rest after simply adopting digital tools to improve care. Instead, it is in our DNA to be leaders, and leading in digital health requires a lot of new activities and competencies. It means becoming expert in analyzing so-called big data. Led by Atul Butte MD, PhD, director of UCSF’s Institute for Computational Health Sciences, we have developed a world- class program in big data and precision medicine, not just data collected at UCSF but across all five UC medical campuses. Leadership means promoting innovation in technology, and we are doing this, through the unique Center for Digital Health Innovation (our window to Silicon Valley) and our superb Clinical and Translational Science Institute (CTSI). It means integrating technology into our educational programs, as we are doing in myriad ways.

It also means celebrating the potential of technology without being blind to its dark sides. In fact, after witnessing a serious medical error at UCSF due to the complex interactions between people and computers, I devoted a year to writing a book entitled, “The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age.” One reader was the Secretary of Health of the United Kingdom, who has asked me to advise England’s National Health Service on its digital journey. Similar examples of leadership are emerging across our department – many of them described in these pages.

Technology is a tool – an immensely powerful one, but still just a tool. Our goal is to harness this tool toward the ends that we all seek: care that is safer, higher quality, more satisfying, more engaging, and less expensive. Education that is more tailored to the needs of students. Research that is more innovative and impactful. Increasingly, the ability of any academic health system to achieve its goals will depend on having world-class digital capabilities. Luckily, at UCSF, we do.


Robert M. Wachter, MD
Professor and Interim Chair, Department of Medicine
Lynne and Marc Beniof f Endowed Chair in Hospital Medicine

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