The FCC Rural Health Care Pilot Program: Improving Access and Quality of Health Care throughout California

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The FCC Rural Health Care Pilot Program
Improving Access and Quality of Health Care
throughout California

• Thomas Nesbitt, M.D., M.P.H.
• Executive Associate Dean, School of Medicine
• Director, Center for Health and Technology
• University of California, Davis

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The explosion of new knowledge and information in
the health sciences is ironically creating
greater disparities in the quality of health care
services.
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If we discover a cure for cancer, but only half
the people have access to it, we have only
discovered half the cure for cancer.

• Medical Science, no matter how good it is, is
  worthless if not applied appropriately to
  patients who need it

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Advances in telecommunications and information
technologies can help to redistribute health care
knowledge and expertise to where and when it is
needed
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These technologies can help facilitate a new,
more efficient model of care across the economic
and geographic spectrum.
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The role of information and telecommunication
technology in health care
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Telemedicine

• Interactive healthcare over distance using
  technology
• Telemedicine brings the expertise of a specialist
  to the point of care and allows that expertise to
  be customized to that patient

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UC Davis Telemedicine Services

• Pediatric Critical Care
• Pediatric Sexual Abuse QA
• OB/GYN
• Pediatric Cardiology
• Surgical Oncology
• Allergy
• Occupational Medicine
• Child Development
• Burn
• Genetics
• Transplant
• Urology
• Pediatric Rheumatology
• Pulmonary
• Plastic Surgery
• Pediatric PMR
• Podiatry
• Hematology
• Pediatric Urology

• Cardiology
• Pediatric Endocrinology
• Pediatric Nephrology
• Gastroenterology
• Infectious Disease
• Pediatric Neurology
• Pain Management
• Pediatric Genetics
• Nephrology
• Psychology
• Rheumatology
• Neurology
• Hepatology
• Otolaryngology
• Pediatric Obesity
• Orthopaedics
• Nutrition
• Endrocrinology
• Psychiatry

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Medical Peripherals
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Outpatient Telemedicine
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Outpatient Telemedicine
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Telemedicine in the Hospital Setting

• Hospitalized patients are much sicker than in the
  past
• Having the right expertise at the point of care
  24/7 is essential
• Access to specialty expertise is a significant
  challenge for smaller hospitals
• Telemedicine can bring that expertise to the
  emergency room or to the inpatient bedside

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Emergency Room Telemedicine
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Redistributing Expertise in the Inpatient Setting
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Requirements for a successful statewide
telehealth network

• Broadband connectivity
• Reliability
• Quality of Service (QOS)
• Security
• Privacy
• Equipment
• At specialty and remote sites
• A trained workforce

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Proposition 1D

• Proposition 1D K-University Public Education
  Facilities Bond Act of 2006
• the amount of 200 million shall be used for
  capital improvements that expand and enhance
  medical education programs with an emphasis on
  telemedicine aimed at developing high-tech
  approaches to health care.

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Californias Proposition 1D Passes

• With Proposition 1D we will be able to connect
  our best hospitals and our best medical schools
  with clinics in remote areas all over the state
  of California.
• --Governor Arnold Schwarzenegger 

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The California Telehealth NetworkA digital
health care highway
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Current State
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FCC Rural Health Care Pilot Program

• Dedicated over 417 million for 69 pilot program
  networks
• Encourages regional broadband health care
  networks with connections to national backbones

UPDATE!
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Consortium Members

• The Office of the Governor
• California Business, Transportation and Housing
  Agency (BTH)
• The California Emerging Technology Fund (CETF)
• The California Public Utilities Commission (CPUC)
• The California Department of Managed Health Care
  (DMHC)
• The California Telemedicine eHealth Center
  (CTEC)
• Rural Telehealth Networks
• The UC Office of the President
• University of California Davis Health System
• The Office of Statewide Health Planning and
  Development (OSHPD)
• California Health Human Services Agency (CHHSA)
• The Corporation for Education Network Initiatives
  in California
• The California Office of Emergency Services
  (OES) 
• The California Institute for Telecommunications
  and Information Technology
• The California Hospital Association (CHA)
• The California Health Foundation and Trust (CHFT)
  
• The California State Rural Health Association
  (CSRHA)
• The California Primary Care Association (CPCA)

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FCC Rural Health Care Pilot Program Californias
Goals Summarized

• Goal 1 Create statewide broadband network
  dedicated to health care with explicit QOS,
  privacy and security
• Goal 2 Link the California Telehealth Network
  (CTN) to a national backbone
• Goal 3 Leverage and build upon recent
  investments in telehealth
• Goal 4 Utilize CTN for ongoing disaster
  preparedness training

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Technical Goals

• Extend broadband connections to 300 rural health
  care providers in 3 years
• Address technical and cost constraints
• Facilitate use of state-of-the-art telehealth
  services
• Telemedicine
• Continuing Medical Education

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Current Status of the CTN

• Award of 22.1M from FCC
• California Emerging Technology Fund (CETF)
  providing 3.6M for 15 match and start-up funds
• Letter of Agency process (completed)
• Original goal was 319
• Nearly 1000 locations represented in the received
  letters of agency
• USAC has qualified over 730 sites
• RFP has been submitted for posting on the USAC
  RHCPP web-site

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Current State
MAYERS MEMORIAL HOSPITAL
FREMONT-RIDEOUT CANCER CENTER
UCDAVIS HEALTH SYSTEM
TAHOE-FOREST HEALTH SYSTEM
ROUND VALLEY INDIAN HEALTH CENTER
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Current Model
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California Telehealth Network
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California Telehealth Network
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This effort has not only led to the next
generation of telecommunication for under served
areas but has also led to a new focus on
telehealth in the State as well as a new level of
collaboration among stakeholders
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How will all of this benefit Californians?
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(No Transcript)
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The FCC Rural Health Care Pilot Program
Improving Access and Quality of Health Care
throughout California

• Thomas Nesbitt, M.D., M.P.H.
• Executive Associate Dean, School of Medicine
• Director, Center for Health and Technology
• University of California, Davis