Model eHealth Communities:

Transforming Healthcare through Broadband Dependent

Technology

Jackie Hausman, MPH, MPP UC Davis Center for Health and Technology

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

Model eHealth Communities

• 15 Communities • 20+ counties • 70+ organizations • 100+ sites • Wide variety of eHealth applications

Urban Model eHealth Communities

Goal: Improve access to specialty care for medically underserved. Alameda LA Venice

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

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

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

LA MeHC – eConsult

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

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

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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Alturas

Canby

Modoc MeHC

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

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

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

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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Telehealth Consultations

OutpatientSpecialty Consults

Behavioral Health Consults

Telepsychiatry Consults

Western Plumas MeHC

Partners: • Plumas District

Hospital (Lead Agency)

• Seneca Healthcare District

Key Applications: • Develop high risk

perinatal telehealth program

• Specialty consults

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

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

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.

California Rural Indian Health Board (CRIHB) MeHC

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

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

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

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

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

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:

Early Lessons

• Reliable broadband matters • Everything takes longer than you’d think • Equipment alone is not enough to ensure

successful implementation • Communication is critical