CIAQ Home About CIAQ

The Center for Innovation in Access and Quality (CIAQ) was established in 2007 to promote the creation and implementation of innovative approaches to improving quality care at Zuckerberg San Francisco General Hospital and other safety net systems.


Established in 2007, CIAQ accomplishes its mission by:

  • Providing content, data, evaluation and implementation support for projects that will both improve care in San Francisco and serve as models for other safety net systems.
  • Supporting transformation in our safety net as well as rigorous evaluation and dissemination of what we do/learn.
  • Leveraging and enhancing existing relationships among safety net stakeholders.



Delphine Tuot, MDCM, MAS - eReferral Director, CIAQ Co-Director

Dr. Tuot is faculty in the Division of Nephrology at UCSF with interests in chronic kidney disease (CKD), provider-patient communication, CKD awareness, and implementation science. Her research currently focuses on the development, implementation and evaluation of health systems interventions that: (1) enhance access to specialty care, (2) improve specialist-primary care provider communication, and (3) increase patient awareness, self-efficacy and self-management of kidney disease. Her long-term goal is to implement sustainable programs within community or public health settings that improve health outcomes among CKD patients, particularly among vulnerable populations, as they are at greatest risk of CKD-associated morbidity and mortality.  She is the Evaluation Lead of the Kaiser Specialty Care Initiative and the eReferral ratings project.

UCSF Profile

Elizabeth Murphy, MD, DPhil - eReferral Specialty Lead

Elizabeth Murphy, MD, DPhil, is Chief of the Endocrinology and Metabolism Division, Director of the Diabetes Center for High Risk Populations and Specialty Lead of the eReferral Program at Zuckerberg San Francisco General Hospital and a Professor of Clinical Medicine at the University of California, San Francisco.

As Chief of the Endocrinology and Metabolism Division at ZSFG, Dr. Murphy's work has focused on improving access and quality of endocrinology and diabetes care for low income, diverse populations in the San Francisco safety net.

UCSF Profile

Amanda Aguilar- eReferral Program Manager

Amanda Aguilar ensures smooth daily operations and functionality of the ZSFG eReferral program, including onboarding new clinical services, interfacing with ZSFG Information Services, and providing site trainings to staff across the SFHN. Amanda received her BA in Urban Studies and Planning from San Francisco State University, CA.

Iguehi James, MPH- Specialty Care Innovations Program Manager

Iguehi James is responsible for operational oversight and evaluation of the eReferral program as well as guiding expansion of telehealth initiatives with internal data and external benchmarks. She participates in strategic planning and grant writing as it pertains to enhancing specialty care access. Ms. James received her BA in Sociology and Anthropology from Occidental College in Los Angeles, CA and a Master's Degree in Public Health from the University of North Carolina Gillings School of Global Public Health in Chapel Hill, NC.

Francesca Long, MA - Specialty Care Data Analyst

Francesca Long supports the data and reporting needs for eReferral. She has a MA in International Development from the School of International Service at American University in Washington, DC and a BA from Brandeis University in Waltham, MA.

Alice Hm Chen, MD, MPH - CMO-SFHN, CIAQ Co-Director

Dr. Chen is the Chief Integration Officer, Director of the Center for Innovation in Access and Quality, Director of the eReferral Program at Zuckerberg San Francisco General Hospital, and an Associate Professor of Medicine at the University of California, San Francisco.

Dr. Chen's primary interest is in issues of health care access, particularly in how poverty, race/ethnicity, and policy intersect with healthcare delivery systems to produce barriers to care. Her work focuses on creating policies and programs to improve access to and quality of care for underserved communities.

UCSF Profile

Justin Sewell, MD, MPH - Evaluation Faculty

Dr. Justin Sewell completed his undergraduate, graduate (Master's in Public Health), and medical degrees at the University of Arizona in Tucson. He completed his Internal Medicine residency and Gastroenterology fellowship training at UCSF, and subsequently joined the GI faculty at Zuckerberg San Francisco General Hospital. Dr. Sewell is closely involved in clinical medicine, education of trainees (including medical students, residents and fellows), and health services research. Dr. Sewell's primary research interests are related to the interface between primary care and specialty care. He is specifically interested in the quality of primary-specialty care communication, and developing novel methods for providing specialty care. He is also clinically involved in primary-specialty care coordination. As director of the GI eReferral program, he reviews more than 2,000 patient referrals to the GI clinic annually. Dr. Sewell has been involved with CIAQ since its inception, and serves as an evaluator of CIAQ programs.

UCSF Profile

Hemal Kanzaria- MD

Hemal Kanzaria, MD MS is an Assistant Professor of Emergency Medicine at the University of California, San Francisco (UCSF). Dr. Kanzaria practices clinically at Zuckerberg San Francisco General Hosptial (ZSFG), where he teaches housestaff and helps direct emergency department lean improvement efforts. He is the Directory of Complex Care Analytics for the San Francisco Health Network (SFHHN), where he is part of the multidisciplinary team to improve whole- person care for the frequent users of emergent/ urgent medical, behavioral, and social services. Dr. Kanzaria is also an Adjunct scientist at RAND Health and affiliated with the Center for Innovation in Access and Quality at ZSFG, where his research and policy work focuses on methods to increase the delivery of high-value health care. Prior to his current appointment, Dr. Kanzaria was a Robert Wood Johnson Clinical Scholar at UCLA. He completed his medical degree and residency at UCSF- SFGH, during which he found Remedy at UCSF to recover unused medical supplies for socially responsible redistribution. The organization has provided medical equipment to underserved communities both locally and globally, and has been instrumental in several disaster relief efforts.

Interests: Health systems improvement, safety net care, social determinants of care, equity, population health, cost consciousness, high-value care, waste reduction, over-diagnosis, over-treatment, diagnostic imaging, shared decision-making, stakeholder engagement, interdisciplinary research and improvement efforts.

UCSF Profile