Researchers at the Center for Information Technology Research in the Interest of Society & the Banatao Institute (CITRIS) at the University of California are launching today Accountability, Coordination, and Telehealth in the Valley to Achieve Transformation and Equity (ACTIVATE), a public-private pilot initiative to bring telehealth services to underserved rural residents in Merced County, California. In partnership with Livingston Community Health, the University of California CITRIS network, technology distributors, community-based organizations, and government agencies, ACTIVATE aims to reach populations who are vulnerable to the worst outcomes of the COVID-19 pandemic with the technology, skills, and connections they need to access and utilize health care services.
ACTIVATE is co-led by Dr. David Lindeman, Director of CITRIS Health, and Dr. Katherine Kim, Associate Professor at the Betty Irene Moore School of Nursing and the School of Medicine at the University of California, Davis.
“The patients we’re serving with ACTIVATE are some of the most vulnerable members of society, and not only to COVID-19,” said Kim. “Many are low-income, undocumented, Latinx agricultural workers – these communities have the least access to quality health care services.”
California’s rural Central Valley faces some of the worst health disparities in the state and country. Many residents of the Valley lack access to basic health care, and service providers in the area have limited reach and coverage. The Robert Wood Johnson Foundation’s 2020 County Health Rankings recently ranked Merced County as among the “least healthy” counties with adverse health outcomes in California. Community health workers, public health activists, and local leaders are committed to progress on this front, focusing on investing in quality, affordable care that meets residents where they are and improves overall health outcomes in their community.
ACTIVATE will first launch at Livingston Community Health in Merced County, and is expected to rapidly expand throughout the state to other community health centers (CHCs) and clinicians that serve vulnerable populations. The goal of the pilot program is not just to provide the technology needed for telehealth and remote health monitoring, but also to ensure that patients are empowered to use it and see greater health outcomes as a result. To that end, program participants will receive health education and training in digital literacy as well as software and hardware (phones, tablets, and other remote monitoring equipment) needed to connect with health care providers and monitor chronic health conditions. Building on health education from community health workers and medical assistants based at the CHC, the program emphasizes training of primary care practitioners in CHCs. These critical health care workers are at the front lines of health care in the era of COVID-19. They are embedded in the communities they serve, and have the cultural and linguistic skills to break down barriers and help patients access physical and mental health services.
“The patients we serve are too often left out by traditional health system models,” said Livingston Community Health CEO Leslie Abasta-Cummings. “They live in rural areas and face financial, cultural, and legal barriers when it comes to accessing health care services. Working with these communities to embed and encourage the use of telehealth technology will empower patients to manage their own health and experience greater health outcomes.”
In collaboration with Livingston Community Health, the program will be implemented and evaluated by a coalition of experts through CITRIS’s University of California multi-campus network including experts from UC Berkeley, UC Davis, and UC Merced.
“Telehealth represents a safe and effective way for many populations, including rural and low-income communities, to access necessary health care services – especially during a pandemic,” said Dr. David Lubarsky, Vice Chancellor of Human Health Sciences and CEO of UC Davis Health. “UC Davis Health is committed to using our expertise to improve the health of those who live and work in our state. Through the ACTIVATE project, we will offer resources and expertise to identify the best ways to deliver telehealth services to providers serving the most vulnerable populations. Ultimately, we plan to provide a roadmap for both public and private partners, setting a gold standard in California and across the nation.”
The ACTIVATE team will evaluate the pilot program for achieving goals in technology implementation, outreach, adoption and utilization; successful use of community health workers to reach patients; and improved health behavior and health care outcomes. Working with the Center for Connected Health Policy, ACTIVATE will develop a roadmap for post-pandemic sustainability of health system reforms that incorporate telehealth. Ultimately, ACTIVATE aims to demonstrate that telehealth has the power to serve rural and vulnerable communities, and encourage telehealth solutions as cost-effective means of enhancing community-based health systems.
The Center for Information Technology Research in the Interest of Society & the Banatao Institute (CITRIS), based at the University of California, was created in 2001 to leverage world-class research to develop technology solutions to society’s biggest challenges. CITRIS’s UC experts have years of experience working on issues related to health care access and digital inclusion. Livingston Community Health is a Merced County-based clinic that serves mostly Latinx communities with primary and preventative health care services regardless of their ability to pay.