Telehealth at UC Davis began as a telefetal monitoring connection with Colusa Community Hospital in 1992, and evolved to become the Center for Health and Technology in 2000. The telehealth program was established in an effort to reduce health disparities by bringing clinical care and educational resources directly to communities in need of specialized services.
We've lead a number of monumental initiatives focused on improving telehealth technology, equipment access, broadband networks and education for medical students interested in caring for rural communities.
History of UC Davis Telehealth
Under the leadership of Thomas Nesbitt, M.D., UC Davis began providing perinatology expertise in 1992 to family medicine physicians in Colusa through a simple analog connection. In 1996, we implemented video-based, telehealth service, connecting three specialties with three remote sites. UC Davis received its first grant from the Office for Rural Health Policy and another one from U.S. Department of Agriculture Rural Utilities Service Distance Learning and Telemedicine Program in 1997, which enabled us to expand telehealth services to rural hospitals.
Telehealth Education Curriculum
UC Davis established a formal telehealth educational curriculum in 1999 with funding from The California Endowment (a California-based health foundation). This program provided education for health care providers, technical specialists, and administrators on how to launch and/or expand successful telehealth programs.
Creating the Center for Health and Technology
In 2000, UC Davis executive leadership approved the creation of the Center for Health and Technology as a formal center with a broader mission around clinical service, research and development, industry relations, and education. The center’s role further expanded in 2004 as a resource for the State of California when it received a biodefense training and preparedness contract for the state focused on the use of telehealth and related technologies. Since the mid-2000s, UC Davis has expanded clinical offerings and revenue streams, developed a broad telehealth research portfolio, and focused on strategic partnerships to advance the field.
Selected Special Initiatives
UC Davis, leading a partnership of funders, educational organizations and local communities, implemented a $13.8 million program in the early 2000s to increase adoption of broadband-enabled eHealth technology and to sustain California’s Federal Communications Commission-funded broadband network. Federal funding of $9.1 million was matched with $4.7 million of local funding to support California’s innovative and far-reaching eHealth Broadband Adoption Initiative.
Not only did the initiative include broadband and equipment upgrades, but it also included training sessions, leadership to manage organizational changes, and sustained education strategies for consumers and health care professionals. To ensure success, the initiative supported three main strategies, including:
- Low-cost access to a statewide managed, medical grade broadband network through the California Telehealth Network.
- Online and community-based training programs focused on broadband-dependent technologies for organizations, consumers and health care professionals.
- Model eHealth Community Project support for equipment and implementation of eHealth applications.
Model eHealth Community Project
Model eHealth Community funding was intended to support the full utilization of telehealth equipment and CTN connectivity to accomplish a broad array of services including specialty consultations, distance education, online education, patient education, online support groups and other services. Fifteen Model eHealth Communities were funded based on readiness, need and capacity for success. Dispersed throughout California, the Model eHealth Communities included 70 organizations and 100 sites in 26 counties. Funded projects include: urban eHealth projects with a goal to improve access to specialty care; rural eHealth projects working to attain reliable broadband and increase access to care for residents of remote areas; and special population projects to address unique needs among underserved populations.
Model communities and their partners implemented more than 25 clinical services using new connectivity and equipment. Telehealth visits totaled almost 40,000 over the two-year period. In addition, digital exchange of health information and e-prescribing totaled almost 100,000 encounters. View a list of the communities and a map.
A project compendium was compiled to capture overarching themes, lessons learned, and the initiative's contributions to improved health and health care.
Comprehensive online eHealth training sessions were developed in 2012 as part of an innovative collaboration between academia, community-based educators, instructional design experts and tribal representatives. The training curriculum, developed with grant funding from the American Recovery and Reinvestment Act, was designed to support the transition to technology-enabled health care. Here are samples of some of the course modules.
California Telehealth Network Orientation
This course provides an overview of the California Telehealth Network, including services and membership.
- A Brief History: Telehealth Network in California
- The Benefits of the California Telehealth Network
- Getting Involved: Membership in CTN
This course is designed to assist sites in starting and expanding telehealth programs. The course examines strategic planning, technical and clinical details, as well as legal and regulatory information related to telehealth programs.
- Establishing a Successful Telehealth Program Infrastructure
- Aspects of Designing the Clinical Elements of a Telemedicine Specialty Care Program
- Team Composition: What Makes a Great Team
- Technical Overview and Needs Assessment
- Outcomes and Next Steps
- Clinical and Operational Logistics (Panel Presentation)
- Technical Troubleshooting
- Contracts and Telemedicine
- Chronic Disease Management
- Nutrition Care in Telehealth
- Technology in the Intensive Care Unit
- Disaster Preparedness
- Telehealth in Eye Care: Review of Relevant Program and Issues
Consumer Health Informatics
This course explores the development and implementation of telecommunications applications and interfaces designed to be used by health consumers.
- Health Information Technology: Physician and Patient Perspectives
- Is the Internet a "Third Person" in Today's Doctor/Patient Relationship?
- Consumer-Focused Applications and Devices
This course explores the theories and approaches to change management from the organizational as well as the community lens. The focus is on what is required to attain systems change – partnership, cross-system impacts of eHealth adoption, and multi-layered change at the staff, organization, consumer and community levels.
Community Change Management
- Understanding the Need for Change Beyond the Organization: Systems Change to Improve Community Health
- Developing a Vision and Plan for Successful Implementation
- Implementing a Systems Change / Change Management Process
- Sustaining Change - Outcome Measurement and Quality Improvement
Organizational Change Management
California voters approved Proposition 1D in 2006 to help fund all levels of higher education, including construction and renovation of facilities to enhance the university’s telemedicine programs. UC Davis Health used funds from the bond measure to establish a telemedicine equipment loan project, which provided videoconferencing units and peripheral medical equipment, such as specialized cameras, to health care sites located within the health system's 33-county service area, which reaches from the Oregon border south to Merced County.
Sites selected for the Proposition 1D loan equipment program include:
Please Note: The equipment loan program is a separate initiative from the eHealth Broadband Adoption Initiative. As an infrastructure bond, Proposition 1D supports the construction of buildings and purchase of equipment. The eHealth Broadband Adoption Initiative, funded by the Federal Communications Commission and guided by an advisory council of various stakeholders, supports the deployment of broadband technology. While the two programs complement one another, each has different criteria for inclusion.
Rural-PRIME is a combined, five-year M.D. and master's degree program focusing on developing physicians who can become leaders and advocates for improving health care delivery throughout the state's smaller, more isolated communities. The program offers an innovative curriculum, specifically geared towards students from rural backgrounds who have a strong desire to make a difference in communities like the ones they were raised in.
A significant feature of Rural-PRIME is the integration of telehealth training, leveraging UC Davis health' expertise in this area to offer quick access from remote areas to specialty care at UC Davis Health.
The Center for Information Technology Research in the Interest of Society (CITRIS) was formed in 2001, when researchers within the University of California system — including the Center for Health and Technology — realized that real opportunities lay not just in developing new and innovative technologies, but in applying them.
Today, CITRIS and the Banatao Institute at UC Davis work to create information technology solutions for society's most pressing challenges by engaging diversified groups of students and faculty, and facilitating partnerships and collaborations with other Northern California UC campuses, as well as industrial, public, and government partners. The CITRIS Health Initiative specifically focuses on developing transformative, scalable and sustainable information technology solutions to improve health and wellness. The Center for Health and Technology helps develop and test new hardware and software solutions.