Winter 2007

Inside Gives Patients Access to Fetal Experts Online

The message to UCSF's online prenatal evaluation service came from Asia, sent by an American woman working abroad. She was worried enough about the state of her pregnancy that she was ready to hop on an airplane to head back to the United States immediately.

Nurse Jody Farrell reviewed the initial request, arranged for the transfer of medical files and images, and brought everything to the attention of the experts at UCSF's Fetal Treatment Center. They reviewed the case and were able to give the woman the good news: no need to rush back.

This is one of the many success stories behind Inside, the online consultation service that launched this year. The new online evaluation tool allows those not in the Bay Area to access the physicians with more experience in treating fetal defects than any group in the world.

Most patients find the Inside service through online searches. When a patient uses Inside, a notice is immediately sent to Farrell. If it is the kind of case in which UCSF can assist, Farrell sends the patient notification that she is accepted, and arranges to get all the patient's medical reports, scans, etc. sent to UCSF online.

Each case is evaluated by a team of nurse specialists, pediatric/fetal surgeons, radiologists and perinatologists. After evaluation, they write a final report and send it to the patient. All of these steps are covered by a flat $575 fee.

"Most people already have the medical information from their doctor and are ready to upload," says Colin Fahrion, web manager for Inside. Most files are in a form that is fairly easy to transfer, he says, but UCSF personnel will assist if complications come up.

The Fetal Treatment Center is now working to build the second phase of the project. This next phase will allow more involvement by the referring physicians, who will be able to upload files directly and see the interaction between UCSF and the patient.

Initial response to a patient's inquiry occurs within a maximum of 48 hours, but usually things happen more quickly. In one unusual case, Farrell got the initial materials and took them to Michael Harrison, M.D., and Roy Filly, M.D., who were about to go into a regular Tuesday roundtable. They took the case, talked about it and got back to the patient with a report. The whole process took half a day.

Patients can access the Inside service at

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