The Role of Technology in Community Engagement
Tom Nesbitt, MD, MPHExecutive Associate DeanClinical and Administrative AffairsUC Davis Health System
Chancellor’s Fall RetreatSept 17, 2007
Overview of presentation
Rationale for the use of technology in the Health System’s community engagement activities
Define and describe telemedicine Impact of this program on current and
future academic activities One faculty member’s story
Shortages in Rural California
There is a shortage of physicians statewide
Nearly 200 California communities are located in the 109 rural health professional shortage areas
Rural areas often lack access to the full spectrum of health services
Many generalists will not practice in areas without specialty back-up
The University has significant expertise and resources that potentially address some of these issues
California’s Health Care Expertise State-of-the-Art, Yet Unavailable to
Millions
There is an explosion of new knowledge and
information that is ironically creating even greater disparities in
access to state-of-the-art health care
The Role of Technology
Advances in telecommunications and
information technologies can help overcome some
of these disparities by helping to redistribute
knowledge and expertise
Telemedicine
Interactive health care over distance using information or telecommunications technology
Telemedicine brings the expertise of a specialist to the point of care and allows that expertise to be customized to that patient
Telemedicine Improves Access to Expertise
UC Davis Telemedicine Services
Pediatric Critical Care Pediatric Sexual Abuse QA OB/GYN Pediatric Cardiology Surgical Oncology Allergy Occupational Medicine Child Development Burn Genetics Transplant Urology Pediatric Rheumatology Pulmonary Plastic Surgery Pediatric PM&R Podiatry Hematology Pediatric Urology Pediatric Gastroenterology Oncology Pediatric Hematology/Oncology
Surgery Cardiology Pediatric Endocrinology Pediatric Nephrology Gastroenterology Infectious Diseases Pediatric Neurology Pain Management Pediatric Genetics Nephrology Psychology Rheumatology Neurology Hepatology Otolaryngology Pediatric Obesity Orthopaedics Nutrition Endrocrinology Psychiatry Dermatology
Other Applications
Real-time emergency care
In-patient ICU and infectious disease consultation
Tele-pharmacy Tele-interpreting Diabetic retinal
screening
Remote Telepharmacy funded by California HealthCare Foundation
Telemedicine Training
Telemedicine Learning Center funded by The California Endowment
Organizations trained by the TLC 569Attendees 1,200Sessions at the UC Davis TLC 35Sessions off-campus 14
Makeup of Attendees:Clinical/Technical staff (59%)MDs (14%)Nursing (16%)Executives (11%)
Other states: AZ, FL, HI, IN, MA, MI, MO, NE, NY, OH, OR, TX, DC, WA
Other countries: Brazil, Mexico, Nigeria, Saipan
Telemedicine Learning Center at UC Davis
April 2007
UC Davis Telemedicine Programs Supported by Foundations in California
Sierra Health Foundation 1990-1992, Access to Prenatal Care in Northern California ($100,000) 1996-1998, Improving Access to Care in Rural Northern California ($500,000)
California HealthCare Foundation 2002-2004, Pediatric Telemedicine Outreach to Rural Underserved Emergency Departments
($290,000) 2005-2006, Pharmacy Consultation for Rural Hospitals ($400,000)
The California Endowment and California Telehealth and e-Health Center 1999- 2006, Telemedicine Learning Center ($2,000,000) 2003-2004, Telehealth via Portable Satellite Terminal: Conquering the Geographic and
Telecommunication Barriers ($250,000) 2004-2005, e-mental Health ($250,000)
William Randolph Hearst Foundation 1999-2005, The Northern California Rural Telemedicine Program for the Acutely Ill and Injured Child
(Rural Child Abuse and Pediatric Emergency Medicine) ($350,000) 2005-2007, Using Telemedicine to Provide Inpatient Pediatric Consultations ($250,000)
Children’s Miracle Network Pediatric Telemedicine for PICU care ($25,000)
Blue Shield of California Foundation 2007-2009, Store & Forward Telepsychiatry: A Cross Cultural Validation Study in Rural California
($500,000)
Robert Wood Johnson Foundation 2000-2004, Palliative Care in Assisted Living ($960,000)
Benefits for Research and Education
Greater than $40 million grants and contracts since 1997 Researchers
40 faculty members 15 have made telemedicine
a substantial part of their research 36 staff members
TM is a component of other UC initiatives Clinical Translational Science Center Betty Irene Moore School of Nursing Center for IT Research in the Interest of Society
Pediatric ER sites funded by California HealthCare Foundation
State Funding for Telehealth Nearly $500M currently
available state-wide $200 million to five
University of California medical schools to leverage telemedicine technology $36 million to UC Davis for
major new facility, statewide leadership role
$10 million for statewide community partners for technology for clinical TM and training medical students
Teleophthalmology with support from The California Endowment
California’s Proposition 1D Passes
“With Proposition 1D we will be able to connect our best hospitals and our best medical schools with clinics in remote areas all over the state of California.”
Governor Arnold Schwarzenegger 10/27/2006 UC Davis Pediatric Telehealth Colloquium
UC Davis Pediatric Telehealth Colloquium funded in part by William Randolph Hearst Foundation
A new model of collaboration through partnership in education,
research, and clinical expertise using Advanced Information and telecommunications Technologies
The Future: Rural Centers of Excellence
Education Research
Clinical
RURAL CENTER OF
EXCELLENCE
Summary
California is in the midst of a major transformation in the way that rural health care is delivered and rural physicians are trained
Technology and outreach are key elements in this transformation
Innovative models of community engagement by the University using technology played an essential role in setting the directions for this transformation
TM and the UCD TM network have contributed to other system-wide activities in the Health System