am. community enengage p.m. epidemioyelling approximate data and disease control. this strong base i lead to our over all strong department and city base for response. are you can see that almost halfor workforce have been deploy exclude part of the response the one point or another. we are will grateful to have been a part on the effort from from the early evaluate day in the upper left picture there. one of the questions as we go i will try to answer the good questions we are posed to meet on behalf of the division one question about covid-19 is how as a division will population health sfnld there is a new

variant that will require a different approach than our currently very excellent upon level vaccinations including boosters. that question is difficult to answer. it would depends on the characteristic are of a new rarnt or new circumstance wield be in. and certainly if there happened to be a variant that for it which the vaccines it tsdz across protection that would require a more of an effort and while pop layings help with the information and guidance tome in the task force trying to process the best approach. something would require a broad are response. again. within the division we have some of the expertise necessary along with others to assess what an

initial sponse motorbike. working with our state and federal colleagues. >> we are addressing our vacancy rate and want to hire. we are grateful for director chen and her team. happy to working with them and building on the accomplishments we wents out with the ways they upon have been hire for teams we hope to build on that. these are the percent vaccanceys and the different branchs. 91 of them are untouched. over all a 27% vacancy rate makes it challenge to do the work. sizes are in the shown year. oare has a couple. temperature is a mall branch.

keep are working with the director and leaders to try to if you recall these quickly as we can. focusing on the core leadership the department direct position. we don't have a community disease position director. a large aim went research branchs there are no reclassifications in civil service. that is where our contracted staff are work.

next slide. there are many accomplish am in phd and did submit i more full list that the directors had put together for your rehave you and krrgsz consideration comprehend i want to focus a couple the commissioners heard approximate wanted it dru you should attention to the cross division will way in which phd contributed to the lincoln center and our tome and doctor tener were instrumental in the initial start up as well as the community health promotion, our prescriptions team. and the office of 18 racism and equity. and of course w with the behavioral health with the network and other this is didment to taught the

contribution of phd to this effort. important for the department and the city and proud profit w they have done. why and implementification. in the midst of the pan dem exec vaccanceys and prud pedestrian clintibles this are gone live. travel and city and tv clinic were the first. we are excited about being link today the network over all. one. differences is that they employees serve some of the network and serve everyone in the city. their am goal is to reduce the burden of disease and so it is a city wide service. appreciate the it teams and ecic stole toek we this difference

buzz of this. some of the sensitive healing information the city rain being. q.ed to have the expert clan rigz with leaders and clinical leaders it is a wonderful thing. priorityings are aulgsz reevaluated and aligned. but spoken to should some of them 1 is the public health infrastructure. i'm grateful to the commission for approving the budget proposal. many focused on the idea of strengthning within the public health emergency appropriatedness and response

branch we learn from covid. needs to be large are than it is to support the city. when there is our next. major public healing emergency. as well as strengthening our data and epidemiology ain't to support the department and the city. i spoke about the leadership positions to condition building out. we are wing with the covid task force. with our partners we think there are good lessons learn when how we work and learn from community. we want to upon continue on build our ability to do that. we are working close low with the task force and the community exert bunkham within the task fore. we got our expert eat within pop

population health. >> we are looking forward to the conversations as we are thinking about next phases. >> our goal with all thankful as we sue in the 10 essential public healing services wheel is center everything with equity. look to director shepherd as our lead in population health w with doctor bennett and her teach we are now having our branch directors focusing on equity metrics looking at data broken out by race and metrics to be able to upon bed and improve our work in reaching all communities. and serving you will in san front.

why preparing for transition with the covid-19 task force. this is a critical piece of our work over the next the next 6 it 12 it 18 months most of the functions of the task nears have served city wise will come become in to population healing. you can imagine for testing and vaccine bigger than had we have done. this process is happening with leaders, task force leaders and the department's help in support thanksgiving work. >> next slide. upon just as an example i want to fwif you an example of how we think about future state. the areas you so in orange 50 if neat low in some of our existing

branches. our covid disease sponse unit hel the c it t is coming back. that whole cicd and tb, hiv as well >> at that timea reporting under dear part o center for dataancy and emcompetence surveillance under arches. those are going to be the sooner end of the time line and that strarnzification helped with close dice back to the demographic force. we are in the if process of wing with others to thing about the other groups under the blue lineful equity, test and guideness and vaccination to

make sure we. investment best infrastructure that allows for support w that may be meedz said. and approximate make sure they we bridge in resources and as leadership to do this work. and thens we see how the pandemic is playing out and coming to i steady stay, we will will see how we will side each of the efforts as well. we always know we are torn prepared. when would we do if there was something knew and how we would. scale back up. i wanted give you an example the ways we are planning. there is, lot within and xun we are again in the work of stable

using and reimagining what this division can be. we got an am look of the ways it served the stay and how can you do more with focus on supportingor workforce and make sure we have xhekz so much we are workforce. we refect all levers. that is my last slide. i amed thank you for the time for the attention and the on going approximate commitment and support i feel and i not that rest of the of dinigz it has been a difficult 2 years for everyone. suspicion analyze feat that t. is gastifiy to work with all these arc maze pregnant people. i'm happy to answer questions.

external, you are muted. thank you for the presentation. secretary morewitz do we have public comment y. if you would like to make a comment press star 3 now. i don't see hahns. why thank you. doctor philip as you go every your chart i saw names of people i admired since before i served on the commission. thifrngs to you and where you are tome for your work. san francisco work population health a model forination and leadership hen i great source of provide for san francisco.

long before corid and more since. thank you to you your division for your excellent work. seeing no. comments. i think we can move on, then. why thank you, president bernal and commissioners. where thank you. why our next item is the d ph it update. we have our chief information officer eric rappen and as well as the rest of his team. >> good upon afternoon. joined today by jeff divorceiat director of ethics and albert the chief operating receive. headquarter for meching time for the quarter low updates. next slide.

where today's up in 2 pers we will talk about epic on the last update we spent a lot about it and then strategic information about did thea after y. take home message today. epic continues to adapt and spread you heard about the grace flirnlts bring to phd critics and sailor share with you a quick financial opinion update. financials are solid. and acquiring action knowledge to support our work. we are generating momentum and

have interests and great yes are are coming forward. you will hand it over to jeff. hello i'm jeff garcia. i have the privilege serving the protect for epics team here. next slide. we are excited finally move forward in when we call the get better safe. when we have i new tool we have to get red to put it in place and the betting familiar with this phase. and learning how to leverage the too much we are look forward to moving optimalization. we call it waves as we role out

to additional parts. >> as we look at a couple of poses opinion stewardship alling on our mine. let the numbers on the slide dot talking leave you with a message it is the number in bold we are projecting 95% on over all ehr project budget epic and nonepic venders that is in the gray side. the vender contacts or outside is on that. the left side of the graph. that is our internal if costs. >> i will take one opportunity hereby exit think i will echo

doctor spillip upon again. . our team will currently has a 30 if % vacancy rate that is one. our challenges finding the resource inside o poseed pentses with consult not that is one of you are children and wanted to call that out here as we celebrate our financial controls. >> call out upon mile stones. lots of work the big of the challenge i want to get cross thesorption that continuing to move forward with the projects. this amount of upon capabling epic is shaking it up a bit and

rearraning the room examine saying good cluck. to do this noughted the hahn tejic. . and yours that had epic go drive joining us this tunneler >> we're excited about the poont enemy of care and our campus that the condition newt is i benefit. did a great job highlighting the city temperature clint xivenlg all the residence deps cross our city. we are excited about the conveniences. online scheduling and access to results and immunization records. after. receiving the service. . and last thing we give focus

to the cal aims. upon enhanced care manage inspect program this is for the approximate chief team to meet the revving lagzs to pursue say prop voided by the tome and thes no money well is no approximate mission. pursuing that from the state is important. xhrp coming mile tones. the approximate sobering center we then and there by several nameless perform laelth right 360. rein upon rice. a new approximate center will be put n. place that is red to go. woeful have maturn child health prosdprchl women and children across our city they are know to

yoib us on monday for their epic go live and share director and left ly telehealth video like to take a bit of focus on the telehealth if option and talk about how in it we also focus on equity. our challenges is digital equity is i change. in the he's to upon number is as we sits online feeting its is not easy to get into them watch teleif health yours is it is. simple bleft, possible grugz everclugsz >> focus putting in i requests approximate we text. tw patients join the am have. there are no user names or don't

downloads employs

>> also focussing on remising our reminder system to increase the number of languages and equity focus ensure the reminders reach our patings in

cities 7 language and left ly the behavioral healing. epic transitiono have physical health ment will healing. at this point i will transis to the doctor it give you perspective of prosecute voiders when it come to epic. >> next one. all right. thank you. commissioners. these comments flex [inaudible] the amount of providers in the network side in how than i experienced epic using it. you see where well is texts or using video visits to support

telehealing services. accident the economies are fir low positives a whole in terms of users that are like in epic. noted earlier that even new user something live on epic xoit body had they are seeing and experiencing >> you want mow to go into one of doctor green's question? >> yea, go ahead. where one of the questions the commissioner green you raised about an example. and it is a great question xu know the commission. from the clinical service perspectivek rit data when we see a patient. we do have 2 technical epic design position in place.

trying to address what doctor green you are raising or highlight. viewing the medication list they [inaudible] in order for to yous close an encernel. i can't close my encounter unless i view the medation. we created provide are level dash boards both the lists for every encounter in any begin mont. i can see and ratifying and reviewing the medication list and my percentage rate from month it month. enable the behaviors imthey don't guarantee the accuracy of

both of the list problemer medication and the fact as a practicing physician, you know the ease of accessing political sum rows are serb with we see parent and this is just know on going daily w for every provider in every health system where a single pisht is touching multiple key across different environments. of with updating allergy, social history. in dynamic. hopeful that answers your questions how we show the data accurate. in a high quality manner. where you submitted

commissioners there was another question dr. from doctor green about where we spends most efforts extracting data and whether they are respects this allow to yous do this. i think we would share that or efforts are spent in 2 suggests. and this is -- providing california state specific reports. and ensuring our report this is node to go to the state meet the california >> the second ensure we don't look at dast naacp in a scyllo we blends it. homelessness in supportingly housing systems to credit the best full picture of an individual might be experiences and how -- we can help them and how our services may be impacting them. >> the question about what is developing the reports cost.

we gave you an update on the over all budget and the resources to create the reporting customizations are resource who is work here for the partial health and included in our budget projection. the last question. when are the upcoming go go lives we summarize with monday april 25th. we the sobering center on may 26. and the telehealth video business project first go live in may and roll out in clinics throughout year. we are look forward to a project as well. why turning it over to you for the strategic portion. thanks so much >> good afternoon again, commissioners. we are going to spend our time

walking through a quick update on our strategic initiatives. around improving with did thea. the first sthing that we are changed the name of our initiative. and why we changed our snail is this we learned the acronym for beingalable was homonym for a term in another language. and base a lot of discussion the best court was to come up with a new name. people working on developing the strategic plan for actual knowledge. come up with the followings the new name. d ph way to improving with did thea to enable and align

ownership idea. you will hear us calling it our idea team. xru might be asking, what is this term the d ph way? it is not a new idea. we are -- borrowing and adopting how conducts the strategic plan and work and which can in the past referred to the sfg way. we are working on the d ph way. to improve and enable and, line. and we can break down the 3 words. align. enable and imfrouf with regard to our strategic work.

>> first of all aligning. how we use our tool and thinking to walk throughout strategic planning process and the deploy am process i mean going out and wing to obsectives or goal and focusing our work with square under pinnings of lean tool and processes. enable selling i focus on people. it is everything from leading by example. with humility. upon down to in our case, thinking about developing our workforce a linkage back also to our other strategic initiatives. . hire and developingure

workforce. that means we'll spend a lot of time understand when it takes to make sure that everyone who need to use data to improve, is going to get that access. when they need it. focusing on our work to be a lean organization. but it starts with encouraging break through ideas. we improve because others who experience the flesz we use or benched how we work. often have wonderful ideas how to make it better. the frame w we use to take advantage of the etch great ideas a pdsa. what it is it is an experiment. about understanding this we can take a great idea. put a plan together and conduct

an evidence a project or pilot. evidence that. and study huwe did you who did we measure our success. improve with did thea. bring in in the focus of our eventual feel. things we are moving forward with -- that -- fit well with arc line, enable and improve are the following. for align am we are absolutely

usingure lean tool and lean thinking to -- not only develop our strategic plan using an a3 improve am charter but also using our other lean tools to able to look at how we are going to work with our colleagues to deploy. and experiments with the solutions we create. we are clearly in the middle between our planning work and deploy am work and will continue to update where you are commissions we move forward. opthing we don't have the white pages of all of the folks when do data for a living. we have parts of d ph this depends on did thea every day.

we don't have the community of data analysts. a group that can collaborate and reach out and depend on one another. rain and learn together. wloik ly focused on building i community of folk who is do data for a living and i partner with this the understanding you don't node to go to a data analyst to get your needs met. >> that'sune known as subservice analystics. when you need ton you should be able to go out and get the information yours.

that work will likely rest urn our information program. and that's one of our other counter measures. ensuring that all the different divisions and branch and sections are part of and work within the umbrella of information. that is where we deal with everything from -- the definition of a person experiencing homeless tons huwe secure the transfer data from one organization to the another and development of policy and a data upon driven organization. the first bullets reside. why and finally another area where we'll like ly spend a fair amount of time is bring data together for multiple sources to support other priorities the best example is work we bring

together information to support our initiative -- to improve out come for people experiencing homelessness in scenario where the individuals are experiencing the behavioral everbhafrl health. we have start in the the work to bring data together frommure epic voirment, which you heardiest and albert speak to. our electronic health record. it has been there for i number of years but not yet on epic. to bring those 2 source together long with data you heard jefferreference from homelessness and supportive housing and all of the information we also get as a result of being connected to networks that feed us

information about other health care services this our patient and clines consume and together and in i dast store front amount place all of that information is matched up with the identities offer patient and clines so this we don't upon have to wonder as much about where and when the people we serve received health care services. hopeful low this is i good example on how we are working with our workforce to provide more data to support knowledge to drive our daily work. why we talk about improving. in addition to having that community of data analysts, we currently don't have a place where you with go and understands when is you will the data we have.

will we have on00 so much information in organizations. we don't have a catalog. the white page the community the yellow pages is the data catalog its. describes the different system we have and the dast available and the then often would include this definitions. the definitions are important. will baumz some of them improve over time. if we change the definition of i person experiencing homeless knows. it is important that all of d ph is able to see where this change was made. how it is made across the systems and so this if you node to use that data you can explain it effectively. as you use it it driveway your work. >> another thing we learn exclude doctor fill pips spoke

to this in her update. was this looking at disease surveillance. the lessons learned from our pandemic response. well is, lot of energy and momentum know improving our group will am approximate enengage how we can support the growth and enhancement of sdooes disease surveillance especially in tool and technology. and last but in the least. in another linkage to another will d ph initiative in this case hire and developing a diverse workforce. we don't have enough information approximator workforce from recruitment to retirement. cross that spectrum. and in order to do that, we realize we'll will have it make significant changes to how we

acquire information and how we use it. and so we are at this point break through ideas and gets inspire body when is possible. and so part of our idea w we very much begun efforts. to understand how other ergsz on both inside and outside of government and health care. use workforce management solutionless. . the epieng of hr information system. how other organizations are to theizing on the capants of the platforms to am help us understands trends in our organizations as well as how we are performing and how we can leverage the information we been our workforce to continue improve. i than was a lot.

i then and there we are at the upon end of our presently xagz so i like to thank all of you again for indulge us and hopeful low we have not made anything too technical and we are ready for your questions. why all right. thank you very much. secretary morewitz do we have public comment. where no one on the line. all right. i know this after thoughtful review or commissioners sent you questions in advanced thank you for address them during your presentation. i see vice president green. >> thank you so much for the presentation tell be interesting to see how this evolves. i mobile home quo can get update in which plants sprout.

i have a few concern busy data gathering and interested if it is in the in a presentliation to understands some of the did the awe will gather that is mandatory for organizations and various report being. you know i -- i before this i had gone in and looked up the word, addiction and there were 30. homelessness has 47. one concern is the optimal time to do it. i tloem is a uniformity of approximate choice. it is great people reviewing problem but the same problem can have differentiserations. it would be unfortunate if we can't gather dast to manage our population there are diagnose used for the same thing.

too many things. i would be interested in learning more and hoping that all of the clint iings it is a big number of people that make entry in this. and some people victim problems on their pressure problem list thisy olds. i will be interested in seeing how you navigate through some of those barriers and are in the unique to us but know approach trying to incorporate or population with a variety of different needs of behavioral and physical health and interested in seeing how you ends up gathering data and add sunrising everyone in the department to create uniformity and get data that are valuable.

thank you. we can keep you posts saids we get closer to bringing health service in epic. we are excite about theed benefits that the bring. points you rasz exist every in approximate health care. all right. commissioner chow. yes , sir. and thank you for the update and -- each time we get an update it is excite to see how let project is coming along. and so my first question was

related your time lines and the expenditures and the time lines now go out to 2024. obviously we were watchingly careful hoe and make sure that we were on schedule in the first blocks and those were pleasured well. and now the discrete areas including the behavioral health, which a story in 2023. so, i guess not having the -- detill on here i can view say that one we are on schedule and there is enough funding for this schedule that goes out to 2024. that is my first question. we are developing a lot of tools for clinicians theers side which

is -- on a pating's side and patient information. and are we doing anything about that and as you talk about equity. and the ability to use the 7 threshold languages are they for administrative purposes for making appointments or are they going to be able to actually inkwoir in the language in and are they going to be able to look at their own data from the patient side. so -- i think that those are probably the and within the patient side i notices the systems give a med list and all. >> i guess you have spoken a lot about moving and doing a great yok and hoping the clinicians and so now i'm interested on the

sides of the patient. >> for your first question wore good. on schedule and budget. through 2024. behavioral health was original ly in the initial impelementation wave and moved forward and so as a result we have been budgeted and red to dot work and now the time is right. and we that with the great staffing -- recruitment exercise. wore feeling excited and confidence. but we are good from a budget perspective on that program. as well as -- the flam will00

although occur after which is working in the laboratory information system changes and jeff, happy to have you dive in on the paeshth access i provide feedback to the epic vendor the item i have been perhaps babying away is the equity point. aim languages in san francisco are noted the same as the entire population. i do provide a sense they are primary languages that they be add to the tools every chance i get.

we are purke our vendor to partner with us as well. where thank you. i know that and so -- i am actual ly excited. nationwide are important we

offer our edgeal materials in more languaging than just english and spanish we are w to inside the languages beyond. and -- think when you are bringing updates and present we should electronic down on the patient's side with how well we are ingrating the medical records to see and this is in the interest the equity and he i find that the initiative from the department has been revolve buzz when we are looking at the

data now. we can get them down in subgroups and understand better of the xhengz of the -- problems or diseases that were reviewing or the people that we are serving. i think this we should be able to also discuss the patients on >> report to getting out i think this would be helpful. thank you, again. for the presentification we will move to the next item. the d ph fiscal year 2020, betweenanual report. with health program planner. take it away.

can you see and hear mow? i so the presentation. where yes. looks good and you sound great >> good evening i'm max and i'm a healing program planner with the office of policy and planning hoar to present the draft of the department's annual year 20, 21 report. thank you for your feedback during the finance and planning on march first. and i want it note they have been incorporate in the this draft. you are, wear the report is required by the city code it prosecute voids the sum row of the accomplishments over the past fiscal year.

i revised design using colors and columns to the report's dablt. /to last year not highlights of activity this is occurred cross the department or population data. the report provides highlights documenting the elements of the d ph response to the covid-19 public helling emergency. why the annual report opening statements from the director of health. the message introduces the hospitaly 3 feature stories the departmenty department to covid-19. release of the equity objection plan and another healing transformation of mental health sf. >> the directory message is followed boy commission president bernal.

message discuss the response upon covid-19 >> and conditions such as mental health and hopelessness. messages -- discussed throughout the report. >> the next session prosecute voids know over vow of services cross the department. the sections start introducing the department tw divisions and role and protecting and promoting health of san front. next section true north. which is then followed by the organizational chart. part of the racial equity plan this year's report presents a disc in health commissioners and the department senior leadership. and this -- you want to note this information will be reportod in future reports. >> the left thing the section

focuses on the health commission the section prosecute voids know overue of function of the commission and bios for each commissioner. and the longerest section of the report prosecute voids or represents 3 main feature stories i noted early exert highlight the highest profile evaporate everefforts for the fitsical year. first an over view of beginning impelementation. the second discussions the release and racial equity action plan and theed last a review of response it covid. the article discussesents ridging from the vaccination roll out to transition to task force and a new normal. following the 10 highlights describing the response and i want to thank staff and others for their support in drafting the highlights the section

endses with theically indicators of the impact to the stele and the response efforts through theier. why doctor chow i want to thank you for your feedback and includes graph and highlight priority data points from the response. >> next the major section of the report focuses on data with the budget. budget did thea on the departmenty expenditures. revenues and investments the next highlights the san francisco health net w on rises. patient demographics and parent type cross the systems of care. thissier's data section as several important updates the first is the did thea on whole person intgritted care in the report for the first time. second in addition it patient visits counts are included in the table for areas of care and

descriptions of the level of care the network provided with notes that are long with notes for the metrics for the different yers. with the epic we are exploring ways to enrich the data in this report. why and left ly. each the 12 health commission resolutions adopted last year are included in the report. the report endses with know over vow of the service sites and condition transactors and maps of the primary care cites updateed reflect location changes and community contractors are provided. and left ly the report includes the d ph resources where more information can be found on the health commission. community organizations and of course, san francisco covid-19

response. so moving forward weluntil to explore ways to stream line the report and i'm happy to take question and comments. i want to thank you for your time y. no public comment. commissioners. clear clear