Three new studies, co-authored by UCSF Department of Family & Community Medicine (FCM) researcher Dr. Anjana Sharma, highlight innovative approaches to improving healthcare safety and access—particularly for patients in historically underserved communities.
Together, the studies underscore a central theme: health systems can be significantly improved by centering patient voices and addressing structural barriers to care.
Elevating Patient and Caregiver Voices in Hospital Safety
In a study published in the Journal of Patient Safety, Dr. Sharma and colleagues tested a novel mobile health tool that allows hospitalized patients and caregivers to report safety observations in real time via a daily text message received while they were hospitalized.
Traditional hospital incident reporting systems often miss many adverse events. This study found that patients and caregivers reported safety concerns such as communication breakdowns and near-misses.
The tool proved feasible among a diverse patient population in a public hospital setting, including English- and Spanish-speaking participants. Notably, all but one patient-reported observations were unique from those documented in staff reporting systems—highlighting the added value of incorporating patient perspectives into safety efforts.
The findings also revealed disparities in reporting rates among minoritized patients, emphasizing the need for more equitable engagement strategies in patient safety initiatives.
Bridging the Digital Divide in Telehealth Access
In a second study published in the Journal of General Internal Medicine, Dr. Sharma and collaborators examined how California safety-net clinics are implementing “digital navigation” programs to help patients access telehealth services.
Telehealth has expanded rapidly, but disparities persist due to barriers such as limited digital literacy, lack of devices, and unreliable internet access.
Through surveys and interviews across 36 safety-net practices, the research team found that 80% of clinics had implemented some form of digital navigation support—ranging from dedicated staff roles to partnerships with community organizations.
The study identified multiple models of digital navigation and highlighted key challenges, including insufficient infrastructure, limited staff training, and lack of sustainable funding. The authors emphasize that expanding access to devices, broadband, and reimbursement mechanisms will be critical to ensuring equitable digital healthcare access.
Expanding the Evidence on Digital Health Engagement
Dr. Sharma also contributed to a recent study in JMIR Formative Research examining how health systems screen for barriers to patient engagement with digital healthcare. The study highlights the importance of systematically identifying challenges—such as limited digital access or literacy—to better connect patients with the support they need to engage in digital care.
This work complements the digital navigation findings by emphasizing that equitable digital health requires not only tools and programs, but also effective ways to identify patients who need tech support in the first place.
A Shared Vision for More Equitable Care
Across these studies, a consistent message emerges: improving healthcare quality and access requires intentional design that includes and supports patients—especially those from marginalized communities.
“Patients and caregivers bring critical insights that can strengthen safety systems, while digital navigation helps ensure that innovations like telehealth are accessible to everyone,” said Dr. Sharma.
These findings contribute to a growing body of work at UCSF focused on advancing health equity through patient-centered innovation, implementation science, and community-engaged research.