Dr. Gish has extensive experience with improving liver centers and liver transplant programs. He is able to oversee the implementation of an eConsult system, which is an electronic interface for clinics. Dr. Gish is also skilled in developing guidelines and protocols for managing liver patients and liver transplants that require complex patient management. These skills allow him to perform the CMS surveys needed to obtain certifications for liver transplant programs.
Dr. Gish improves the operations of liver clinics with care teams that include MDs, NPs, RNs and administrative assistants. He can also establish leadership roles for each member of a liver team and develop specific programs for liver cancer, artificial livers and non-alcoholic steatohepatitis. These improvements have reduced the wait times for appointments from four to five months to between four and five weeks. Dr. Gish can also implement an NP care program that allows NPs to operate independently of the MDs during follow-up care, which expedites patient discharges from clinics.
Additional improvements that Dr. Gish can make to a liver care program include the formation of an HCV clinic with an NP team that focuses on recruiting patients for clinical trials. This modification provides hepatology MDs with the time needed to manage complex patients such as those with ESLD. Dr. Gish's transfer center protocols have decreased the time needed to transfer patients to hospitals from two to three days to six hours. These reductions in transfer times increase inpatient service volume and improve patient survival to liver transplantation.
Dr. Gish's experience in diagnostics research includes developing anti-viral research centers that conduct multiple viral hepatitis trials simultaneously. He is also the principal investigator for three trials involving viral hepatitis and serves on a committee that establishes the priority for clinical trials. Dr. Gish develops global research consent forms to enter liver patients' information into a database, which facilitates research.
He also implements point-of-care tests for HBV and HCV screening for the eventual purpose of POC tests becoming the standard for group screenings. Dr. Gish defines the characteristics of group screenings to improve their efficiency and correlation with patient care. His screening methods have received research grants from the CDC for which Dr. Gish is the principal investigator.
Dr. Gish's development of therapeutics research includes enhancements to EPIC provider databases. These improvements integrate patient care with providers to streamline referrals to clinics and research programs. Dr. Gish's changes to research programs have increased patient satisfaction rates that were below 60 percent to above 90 percent within two years.
He has developed myChart patient communications, which allows patients to communicate with their providers via email. Dr. Gish also uses the UCSDLink system to make EPIC patient charts visible to external providers via electronic medical records. His Hepatitis Free program at the University of California at San Diego is the subject of multiple grant applications. Dr. Gish's contributions to pharmaceutical research include lectures, publications and collaborations in various research programs.