Specialty Care Safety Net Initiative (SCSNI)

CCHP’s three-year telehealth demonstration project connected forty-three safety net health centers across California with specialists at five University of California Medical Centers.

CCHP’s SCSNI project used telehealth to connect patients in rural and urban medically underserved communities with specialists in six high-need disciplines at UC Schools of Medicine. Public and private clinics provide a primary care “safety net” for low-income or uninsured patients in such communities, but there is no such safety net for those needing specialty care services.

The project acted as a laboratory to research several key topics:

  • The potential for California’s federally qualified health centers and nonprofit rural clinics to incorporate telehealth into their operations;
  • How to establish lasting relationships between UC Medical Centers and California safety net providers;
  • The policy, statutory, and practice pattern barriers that prevent widespread telehealth adoption and sustainability of telehealth services between participating providers; and
  • New and innovative ways to apply telehealth technologies in improving specialty health care.

Once completed, SCSNI clinics successfully referred over 3,000 patients for specialty care in offices as far as 600 miles apart from each other.

Lessons Learned

The SCSNI project revealed that incorporating telehealth specialty consultations can be disruptive for the clinics involved. Through this process, CCHP identified ten keys to success that help clinics to successfully establish, integrate, and use telehealth to increase patient access to specialty care. These ten keys are outlined in greater detail in the full report.

  1. Secure executive leadership support for a telehealth program.
  2. Perform a comprehensive needs and site readiness assessment.
  3. Designate a dedicated telehealth services coordinator.
  4. Standardize administrative processes associated with telehealth.
  5. Build an understanding and appreciation of telehealth technology.
  6. Secure active involvement of participating providers.
  7. Be selective when contracting for specialty care services.
  8. Anticipate disruption, and respond constructively to it.
  9. Increase mid-level practitioners’ roles.
  10. Demystify telehealth.