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Model eHealth Communities:
Transforming Healthcare through Broadband Dependent
Technology
Jackie Hausman, MPH, MPP UC Davis Center for Health and Technology
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Selection of Communities • Fifteen communities in CA. Selection
criteria included: Commitment to broadband-dependent
healthcare delivery History of community collaboration Inclusion of at least 3 CTN sites Engagement of broad range of
organizations
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Model eHealth Communities
• 15 Communities • 20+ counties • 70+ organizations • 100+ sites • Wide variety of eHealth applications
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Urban Model eHealth Communities
Goal: Improve access to specialty care for medically underserved. Alameda LA Venice
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Alameda MeHC
Partners: • Alameda County Health
Care Services • Oakland Children’s
Hospital • Alameda County Juvenile
Justice • Healthy Communities, Inc.
eHealth applications: • Providing primary care
and specialty consults to incarcerated youth
• Specialty care consults for medically underserved
• Tele-interpretation • School Based Health
Center planned
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Los Angeles Model eHealth Community
Project Partners: • LA Care (Lead Agency) • Asian Pacific Health Care
Venture • High Desert Health
System • LA Net • Tarzana Treatment
Centers Target Population: Medically underserved
Project Goals: To improve quality and efficiency and access to care by escalating adoption of telehealth technologies eHealth Applications: eConsult ER follow-up Remote Patient
Monitoring/Patient Education
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LA MeHC: Impact
• eConsult: Goal: serve 200 safety net clinics Currently 11 specialties Over 5,500 eConsults have been resolved
• Project Echo: 20 sessions held Over 20 Primary Care Providers participating
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LA MeHC – eConsult
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Venice MeHC
Partners: • Venice Family Clinics (Lead Agency) • Westside Family Health Center • UCLA Key Applications: • Specialty Care Consults at Primary Care clinics • Internal telehealth consults • School Based Health Center
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Rural/Frontier Model Communities
Goal: Increase access to specialty care for geographically underserved communities and reliable broadband. • Modoc • Siskiyou • Western Plumas • Southern Sierra Telehealth Network
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1 Canby Family Practice Canby, CA
Connecting to Care Grass Valley, CA
Far Northern Regional Center Chico, CA Modoc County Health Services Alturas, CA Modoc County Libraries Alturas, CA
Modoc Medical Center Alturas, CA
Shasta College Redding, CA
Strong Family Health Center Alturas, CA Surprise Valley Health Care District Cedarville, CA
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Cedarville
Alturas
Canby
Modoc MeHC
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Modoc MeHC
• Impact: Aggregated eHealth needs across Modoc health
providers to improve access to tertiary sites Built on existing collaborations between medical
providers to enhance eHealth applications across the county and specialty sites
Project Data 10/01/11 - 12/31/12
Telebehavioral Health Consults – 396 Telepsychiatry Consults - 933
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Siskiyou Model eHealth Community
Project Partners: • College of the Siskiyous
– Rural Health Sciences Institute (Lead Agency)
• Fairchild Medical Center • McCloud Health Center • Mountain Valley’s
Health Centers • County health
department • Tribal Health Clinics
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Siskiyou Model eHealth Community
Project Goals: • To expand access to healthcare for
rural/frontier Northern California. • eHealth Applications: Distance education,
Specialty care telehealth consultations • Impact: Increase in Distance Education of Providers Increase in specialty telehealth consultation
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Siskiyou Model eHealth Community
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Distance Education
# Grand Rounds provided via video conferencing
# who attended Grand Rounds
# CEU provided via video conferencing
# attended CEU sessions
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250
Telehealth Consultations
OutpatientSpecialty Consults
Behavioral Health Consults
Telepsychiatry Consults
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Western Plumas MeHC
Partners: • Plumas District
Hospital (Lead Agency)
• Seneca Healthcare District
Key Applications: • Develop high risk
perinatal telehealth program
• Specialty consults
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Southern Sierra Telehealth Network Partners: • Southern Inyo Healthcare
District (Lead Agency) • Big Pine Fire Protection
District • Clinica Sierra Vista • Kern Valley Healthcare
District • Ridgecrest Regional
Hospital • Southern Mono Healthcare
District • Tehachapi Healthcare
District Key Applications: • Specialty Consults • Distance Education for First
Responders
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Special Target Populations
Communities that defined themselves by target population, rather than geography • California Rural Indian Health Board • Redwood MedNet • San Bernardino • Sierra Nevada Cancer eHealth Community
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CRIHB • Project Goals: To expand telehealth specialty care
services Target Population: American Indian/Alaska Native peoples and communities living on or near tribal lands.
• eHealth Applications: Provider education, administrative purposes, specialty care (telepsychiatry, tele-endocrinology, genetics, addiction medicine, heptatology, cardiology)
• Impact: Launching new TH programs and expanding existing programs into satellite clinics.
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California Rural Indian Health Board (CRIHB) MeHC
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Redwood MedNet MeHC
Project Partners: • Redwood MedNet - Lead
Agency, Ukiah • Southern Humboldt
Community Healthcare District, Garberville
• Mendocino Coast District Hospital, Fort Bragg
• Healdsburg District Hospital, Healdsburg
• Palm Drive Hospital, Sebastopol
• Sonoma Valley Hospital, Sonoma
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Redwood MedNet MeHC
Project Goals: Expand existing telehealth programs at 3 hospitals Establish new telehealth services at 1 hospital
eHealth Applications: E-Nocturnist, e-Intensivist, e-ICU, e-Gerontology, e-Stroke Provider education
Impact: Expanded access to healthcare services
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San Bernardino MeHC Partners: • Community Hospital of
San Bernardino (Lead Agency)
• St. Bernardine Medical Center
• Mountains Community Hospital
• Community Health Systems, Inc.
• Inland Behavioral Health • Riverside-San Bernardino
Indian Health
• Project Goals and Target Population: Focus on people at risk for and living with diabetes
• eHealth Applications: Consumer health education and support; distance learning for providers; specialty consults; remote patient monitoring
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San Bernardino MeHC
• Impact: Launched consumer health education
sessions on topics related to Diabetes. As of 12/31/12 9 sessions have been offered. Sixty-five retinal scans provided from 1/1/12 –
12/31/12. 753 specialty consultations have been
provided since 1/1/12
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Connecting to Care Grass Valley, CA Eastern Plumas Health Care (EPHC) Hospital, Clinic & SNF Portola, CA Graeagle Medical Clinic (EPHC) Graeagle, CA Incline Village Community Hospital Incline Village-Crystal Bay, NV Indian Valley Medical Clinic (EPHC) Greenville, CA Loyalton Medical Clinic (EPHC) Clinic & SNF Loyalton, CA
Nevada Co. Health & Human Services Nevada City, CA Nevada County Libraries (5) Nevada City, CA Grass Valley, CA (2) Penn Valley, CA Truckee, CA Plumas Co. Health & Human Services Quincy, CA Sierra College Truckee, CA Tahoe Forest Health System (TFHS) Hospital, Clinic, Cancer Center & Learning Center
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SIERRA-NEVADA Model eHealth Cancer Community
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Sierra-Nevada Model eHealth Cancer Community Oncology Services
Anchor Site: Tahoe Forest Health System Cancer Center
Member of UC Davis Rural-Prime Program Uses broadband for eHealth services including Grand Rounds, Virtual Tumor Boards and CME
* Tahoe Forest Health System *Eastern Plumas Health Care
EPHC
Loyalton Clinic & SNF
EPHC* Portola
Hospital, Clinic & SNF
EPHC Graeagle
Clinic
EPHC Indian Valley
Clinic, Greenville
TFHS* Incline Village
Community Hospital
Hub Sites:
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Early Lessons
• Reliable broadband matters • Everything takes longer than you’d think • Equipment alone is not enough to ensure
successful implementation • Communication is critical