California TeleHealth Network has fail written all over it

California TeleHealth Network has fail written all over it

Summary: the California Telemedicine and eHealth Center at UC Davis, which hosted yesterday's demonstration, needs to get in touch with major EMR and PHR vendors stat.


With enormous fanfare California has launched the California Telehealth Network, connecting 800 health providers in underserved areas with the state's largest research institutions.

Since this is being done with government funds, it naturally is fronted by a big contractor, in this case AT&T.

It has fail written all over it.

  • It's a top-down design focused on state-owned facilities.
  • I see no commitment to coming standards like NHIN-Connect.
  • I see no effort to make this a true HIE, integrating with the state's private hospitals and insurance networks.

Maybe I'm missing something, but questions like this weren't asked by the reporters gathered around the Governor and other dignitaries.

Without standards that are applied uniformly, all you can possibly have is a two-way transmission of data which is heavily dependent on both sides of the line using the same formats.

The focus, according to Daily Wireless Report, appears to be on setting up broadband at rural clinics, with enough bandwidth to transmit things like x-rays and diagnostic test results. The promise seems to be that experts will participate when clinics have a tough case.

Fine, but what about routine use? What EMR formats are being supported? Are you going to send the complex stuff stat over this network and then wait for FedEx to deliver some paper? I don't think so.

As much as these clinics need fast broadband, in other words, they also need a compatible system of EMR software. Preferably something that understands open standards, maybe even open source.

The key to any hope of success is the California Telemedicine and eHealth Center at UC Davis, which hosted yesterday's demonstration. The center does have connections to the state's private health system.

A summary of the group's intentions is contained in a January, 2009 report, which calls demand a key component of acceptance. So where is the integration with Personal Health Records like Microsoft Healthvault or existing EMR systems like Kaiser's system.

Yet while Kaiser is linked to the VA, I could find neither institution mentioned at the California Telemedicine web site. Nor did I find the names of major EMR vendors, their HIMSS trade group, Microsoft or Google.

Someone needs to make some phone calls. Telemedicine cannot be divorced from EMRs.

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  • RE: California TeleHealth Network has fail written all over it

    [i]Someone needs to make some phone calls. [/i]

    Too many unanswered questions is an understatement.
  • Wong questions (AGAIN!)

    Starting (or finishing, or using) "logic" is just soooo twentieth century. Get back to conservative principles!

  • RE: California TeleHealth Network has fail written all over it

    Connecting all the data sources I agree is a challenge today and I keep saying we are over whelmed with gluts of software providers and the more software you need to connect, more code is required.

    You are right on the money at minimum for the PHR connection and I see that becoming even more important as time rolls on as it is the way a consumer can provide information and with all the various system and integrations taking place today, we might just all have to really fend for ourselves pretty soon with that PHR. Agree too that the EHR needs to be in the loop here too, thus more code for aggregation on the way I feel too. It's getting harder to make a decision today and feel good about it as something new pops up tomorrow and the next day which creates questions all the time.
  • RE: California TeleHealth Network has fail written all over it

    Dana I hear where you are coming from, but you are wrong. At this point PHRs are nice-to-haves. And the CTN doesn't need tight EMR integration to be successful. Don't blame CTN for not being able to leverage open EMRs or regional Health Information Exchanges - they still don't exist!
    How about this...via CTN the primary physician in a rural setting now has live video access to specialists to confer with on complex cases. The primary physician can share his desktop on which he can view any image, lab, note that he has in his system. Via live video a remote specialist now has instant access to the latest information without worrying about the EMR system at all. The only time data needs to be input into another system is when the patient is referred to see the specialist in person. By empowering the point of attack doctor with first; access to expertise and over time the expertise itself, the rate of transfer will be greatly diminished with the bonus of better outcomes (see Project Echo).
    Ok, let's take this one step farther. The next step in health care is home care. Let's see... who might just have a HIPAA compliant broadband backbone spanning the state of California that could possibly handle linking local municipal area networks together to provide such access? CTN! failure? - I think not...