Technology-Enabled Health A Look Forward

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1 Technology-Enabled Health A Look Forward Jana Katz-Bell, Assistant Dean, Interprofessional Programs School of Medicine & Betty Irene Moore School of Nursing UC Davis Live tweet - #telehealth2014

2 If we could design the future, we would have information at the right place at the right time, but this will rely on our ability to escalate the intersection points of all the technologies in the field - Health Information Exchange, Electronic Health Records and Telehealth that are currently siloed. When a care provider can couple accurate, timely information through an EHR with a telehealth specialty consult about care decisions, the vision of technology-enabled health care is met. Tom Nesbitt, MD, MPH, Associate Vice Chancellor; Director, Center for Health and Technology; UC Davis Health System

3 Transformation Now Responsible for health of individuals Treat in institutions Focus on professional caregivers Accept fragmentation Use technology to support current process Future Responsible for health of populations Treat in the home and community Involve family, friends, other informal caregivers, and patients Drive integration Use technology to disrupt current process Steve DeMello, CITRIS Health 3

4 Live tweet - #telehealth2014

5 Telehealth Services at UC Davis (20 years) Allergy Burn Cardiology Child Development Dermatology Endocrinology Gastroenterology Genetics Hematology Hepatology (Hepatitis A-E) HIV/AIDS Infectious Diseases Nephrology Neurology Neurosurgery Nutrition OB/GYN Occupational Medicine Oncology Ophthalmology Pediatric PM&R Ophthalmology Pediatric PM&R Orthopaedic Surgery Pediatric Psychology Orthopaedic Surgery Pediatric Psychology Orthopaedics (adolescents) Orthopaedics (adolescents) Otolaryngology Pediatric Rheumatology Otolaryngology Pediatric Rheumatology Pain Management Pediatric Sexual Abuse Pain Management Pediatric Sexual Abuse QA Palliative Care QA Palliative Care Pediatric Urology Pediatric Cardiology Pediatric Urology Pediatric Cardiology Plastic Surgery Pediatric Critical Care Plastic Surgery Pediatric Critical Care Podiatry Pediatric Dermatology Podiatry Pediatric Dermatology Psychiatry Pediatric Endocrinology Psychiatry Pediatric Endocrinology Psychology Pediatric Gastroenterology Psychology Pediatric Gastroenterology Pulmonary Pediatric Genetics Pulmonary Pediatric Genetics Rheumatology Pediatric Hematology/Oncology Rheumatology Pediatric Hematology/Oncology Surgery Pediatric Nephrology Surgery Pediatric Nephrology Surgical Oncology Pediatric Neurology Surgical Oncology Pediatric Neurology Transplant Pediatric Obesity Transplant Pediatric Obesity Urology Pediatric Otolaryngology Urology Pediatric Otolaryngology (adolescents) (adolescents)

6 Looking forward: New models of knowledge transfer Catalyze state/regional projects that meet societal goals Live tweet - #telehealth2014

7 Examine Barriers to Scalability Specialty Care Safety Net Initiative To identify the barriers to long-term sustainability of UC based telehealth projects that provide service to safety net patients. Policy, statutory Practice pattern Financial sustainability To begin the process of developing models for sustainability for both the UC based specialty clinics as well as the primary care safety net clinics. And while you re at it. Introduce telehealth to rural and urban safety net clinics Provide support and technical assistance to the clinics throughout implementation and provide tools for long-term integration

8 SCSNI - Lessons learned and outcomes UC Providers were very satisfied with providing care for the SCSNI The way that UC Health Systems budget create challenges for any model other than year long, consistent blocks of clinician time. On-site access issues for specialty services create competition for clinician time for telemedicine clinics New models of care, such as asynchronous clinics and project ECHO, for some specialties have been developed by some departments as a way to meet the specialty care needs of the safety net clinics

9 Project ECHO Pain Management Clinic Clinic Clinic Clinic UC Davis Academic Hub Pain Specialists Clinic Clinic Clinic Clinic

10 Catalyze Statewide Telehealth Expansion Broadband Technologies Opportuity Program Sustainable Broadband Adoption Grant: $9.1 million awarded $4.7 million match $13.8 million total project

11 Components Low cost access to a state-of-the-art statewide managed, medical grade broadband network (CTN); Establish Model ehealth Communities Online community-based modular training program focused on broadband dependent technologies for organizations, consumers, information technology and health care professionals

12 Fifteen Model Communities selected throughout CA - 70 organizations and 100+ sites in 26 counties

13 Alameda Model ehealth Headline Prior to Initiative: Telehealth Knocking: Is Anyone Home? Today: Telehealth Takes Flight in the East Bay Project Partners ehealth Applications Health care access and quality Alameda County Health Care Services Oakland Children s Hospital Alameda County Juvenile Justice Healthy Communities, Inc. Provide primary care and specialty consults to incarcerated youth Specialty care consults for medically underserved Tele-interpretation School Based Health Center Consumer health and health literacy Outcomes Health workforce improves through distance learning, training and curricula capacity and engagement

14 Connecting to Care Modoc Model ehealth Headline Prior to Initiative: Modoc Patients Must Travel Four to Six Hours to Receive Needed Medical Care Out of Region Today: Modoc Patients Schedule Real Time Telehealth Office Visits with San Francisco Dermatologist at Their Local Rural Clinic Outcomes Project Partners Canby Family Practice Connecting to Care Connecting to Care Far Northern Regional Center Modoc County Health Modoc County Libraries ehealth Applications Expand specialty care Provide telebehavioral health and assistive technology services for regional center consumers Distance Learning and Professional Continuing Education Health care access and quality Consumer health and health literacy Health workforce improves through distance learning, training and curricula capacity and engagement Modoc Medical Center Strong Family Health Center Consumer health education and information Surprise Valley Health Care District

15 UC Davis Clinical Priorities

16 Tertiary and Quaternary Care Services

17 UC Davis Cancer Center Virtual Tumor Board Linking of NCI-accredited University Cancer Center with 4 community-based programs

18 Thank you

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