Jana Katz-Bell Assistant Dean, Interprofessional Programs

University of California, Davis

Leading Academic Health System Medical, nursing, NP/PA,

public health, informatics academic programs

Integrated clinical enterprise – 619-bed hospital, clinics – Primary care network – Regional cancer centers – Telehealth network

throughout California Comprehensive research programs

9,077 staff; 1,342 faculty and academic employees, 882 residents, fellows, 817 students

Practice Management

Group

Medical Center

Betty Irene Moore School

of Nursing

School of Medicine

History of telehealth at UC Davis

1996 – Video telemedicine implemented with three sites and

three specialties – steady growth with internal & federal funds

•2005-2010: – State biodefense training contracts – Proposition 1D (2006) $200M to UC – California Telehealth Network – $26M (FCC funding) – National disaster preparedness grant $5M

• 2012-2015: – Federal Broadband Technologies Opportunities Program

(BTOP) Grant for eHealth Adoption - $13.8M – Research grants (PCORI, HRSA)

UC Davis Telemedicine

Connecting to 100 sites/year 40,000 total consults to date

Applications at UC Davis Outpatient services ED services (stroke, trauma, ICU) Inpatient ward, ICU, NICU Remote Patient Monitoring (RPM)

Center for Health and Technology

Clinical Outreach Education

Innovation & Research

Activity Snapshot

Approx. 40,000 consultations across 44 counties to over 100 sites (does not include Radiology or Pathology)

Over 1,800 participants trained through Telehealth Education Program from 800+ organizations

Over 4,800 distance education

events • Over 1,600 grand round

sessions

Nearly 130 publications (journal articles, book chapters, letters to the editor, abstracts, limited submission pieces)

Pediatric Telehealth

The “Perfect Storm”

Caregiver Shortages

Aging and

Chronic Disease

Increased numbers covered thru ACA

•8 Increasing demand with no viable means of supply

We need more than improvement

…..We need transformation

•9

What Does Transformation Look Like?

Now Future Move patients to expertise

Move expertise to patient

Treat in institutions Treat in the home and community

Focus on “professional” caregivers only

Involve more family, friends, other informal caregivers, and patients

Reimbursed for Process Reimbursed for Outcomes

Use technology to support current process

Use technology to disrupt current process •10

TECHNOLOGY-ENABLED CARE IN THE HOME AND CHRONIC

DISEASE MANAGEMENT

Wearables

• The annual smart wearable healthcare market volume will grow from $2 billion in 2014 to $41 billion in 2020, a compound annual growth rate of 65%. (CDW Healthcare)

• Over 80% of consumers said an important benefit of wearable tech is its potential to make healthcare more convenient (PwC)

• 68% of consumers would wear employer-provided wearables streaming anonymous data to an information pool in exchange for lower health insurance costs. (PwC)

• The wearable band market grew by 684% on a worldwide basis in the first half of 2014 compared with the first half of 2013. (Canalys)

• 1 in 5 American’s own some type of wearable technology. (PwC)

•Language Xlater

•Blood

Press.

•Pulse Oximetry

•• Fashion addresses the stigma of care •• Patients: bearing greater costs of care •• Self care is a real possibility •• Approaches that address quality, productivity, efficiency and timeliness are needed.

•Cell phone as gateway

•Remote Care: Convergence of Sensors and Jewelry

•Body Aggregator

•Courtesy: Paul Wright

•The Handheld Telemedicine Kit includes the medical devices needed to conduct first-line patient exams, integrated with a tablet computer.

Handheld Cellphone-Based Otoscope

•15

•Health Chair incorporates a vast array of biosensors to measure basic vital signs:

Weight Blood Pressure Temperature ECG Auscultation of Heart and

Lung Sounds Blood Oxygen Saturation Motion Analysis Reflex Response Time

•Incorporates communication unit with remotely controlled camera

Smart Clothing

wii “Active” & Kinect “Your Shape”

• Scalable Sensor Technology for Telerehabilitation:(Kinect Research Projects)

Virtual Characters based on sensors (applications in tele-rehabilitation)

•Prof. Marcelo Kallmann (UC Merced)

•Dr. Jay Han (UC Davis)

Knowledge transfer & Collaborative Care Models

Virtual Tumor Boards

•UC Davis Academic Hub – Pain Specialists

•Community Clinic

•Community Clinic

•Community Clinic

•Community Clinic

•Community Clinic

•Community Clinic

•Community Clinic

•Community Clinic

• Weekly Video Conference Sessions

• Presentation on Core Pain Topic led by Academic Faculty

• Case Presentation by Clinic followed by group discussion

Synergy with the Triple Aim

Technology-supported, vertically-integrated systems of care Reduced duplication in services

Increased revenue streams for critical access

hospitals and safety net facilities Improved efficiency in achieving an effective

diagnosis and treatment

Advancing innovation in technology-enabled

clinical care, informatics research and health sciences education

Center for Health and Technology