The Big Tent

CTSI 2016 NIH Renewal Proposal Launchpad

Telemedicine and Translational Research

Primary Author: David Durand

Advancements in technology, greater acceptance of remote communication by patients and insurance providers, and a trend toward an  increasing demand for providers and cost effective approaches will ensure telemedicine will play a much large role in the future of healthcare delivery than it does currently.   T4 research on outcomes, efficacy, cost, quality of care, and patient satisfaction related to the various applications and potential applications of telemedicine has grown significantly over the past decade, and there are now two journals dedicated to telemedicine.   However, little research to date has been with the pediatric or diverse rural or urban underserved populations.  The Institute of Medicine recently published its report on advancing translational research among the CTSA programs and recommended a greater focus on both children and ethnic minorities.

Largely with federal funding, the California Telehealth Network has built an infrastructure of high-speed broadband throughout California.  With expertise in numerous pediatric specialties and diverse population populations and a progressive spirit, CTSI could be the hub of research at the forefront of telehealth research.

Studies on outcomes, patient satisfaction, cost effectiveness and ROI, and comparative effectiveness may be applied to timely topics such as but not limited to:


•             Tele-care coordination, home health 

•             Remote monitoring of persons nursing homes

•             Tele-care for persons in correctional facilities and other institutions

•             Telepsychiatry and behavioral medicine

•             Oversight of non-MDs if scope of practice bills pass (SB 491,SB 492, and SB 493)  

•             Access to specialty care in rural areas of California

•             Provider training


In addition to research on telemedicine, the utility of these new technologies within the research enterprise has barely been tapped. There are numerous applications and opportunities to both study and utilize new communication technologies within translational research to facilitate participant interaction and involvement and oversight more non-academic community research locations. 

A CTSI planning grant will allow a select group of researchers across partnering institutions to secure partners, define its goals, and narrow its focus.  Potential partners include the UCSF Telemed Dept., the CTSI Community Engagement Program, Children’s Hospital & Research Center Oakland, and the UC Davis Pediatric Telemedicine Project. Other potential partners include SF Bay CRN, UC Davis, UC Berkeley, and various organizations around the state.

A coordinated effort among and between UCs in California and community partners could serve as a national model and source of expertise for the study of telehealth clinical applications and the utility of telehealth applications within translational science. 


Most imperative piece is the identification of a long-term goal, with using the pilot funding to bring all the telehealth stakeholders to gain buy-in and develop a small,scalabile cohort study with metrics to support the initial pilot. 
  • How do we maximize impact and broad applicability of the proposal?
    • May be more specifically focuses. Beginning small and building on experimental success.
    • Transferability to other therapeutic areas. Scalability.
    • Where is demand coming from for this service?
    • Is this community need driven? Have we asked the questions to the partenrs?
    • Make certain that large institutions are all involved.
    • How do you loop in community provider?
    • Leverage the California bond; leverage the foundation.
    • Clinical service establishment; research examines the comparative effectiveness.
    • Narrow down; what is service/audience.
    • What is the research question? Clear who is targeted
    • Engage trainees throughout the process.
    • HIPPA compliant. What else is needed on other end? Translation
    • End users at the table.


  • What foundation exists on campus already that will ensure success of the initiative?
    • What is not on campus?
    • Infrastructure to perform research.
    • Practice based community health network.
    • Which partners would be beneficial at the table.  What current UCSF stakeholders should they engage?
    • Engaging David Durand
      • SF HIP
      • SFGH
      • Telemedicene department
    • Have a connector/facilitator connect the diverse stakeholders across campus.
    • Have the core set up infrastrucre; sharing SOP’s and allowing quick activation times.
    • Focus on specific area; specific performance metrics to measure success
  • What creative and/or innovative partnerships could be leveraged to ensure success?
  1. a.      Engaging local technology/industry companies. Apple, Google, Cisco, Facebook,
  2. b.      Learning lessons from Phase 4 Pfizer
  3. c.       Partner with ITA
  4. d.      Insurers/Payors
  5. e.      Schools
  6. f.        Cost effectiveness analysis
  7. g.      DPH- SF and Oakland
  8. h.      Collaboration across the state and CTSA’s


Chip Chambers

Courtney McFall

Cecily Hunter

Helen Loeser

Karen Hamblett

Kristin Chu

Nariman Nasser

David Haddick

Margaret Tempero

Michael Potter

Peter Becchetti

Jennifer Creasman
Era Whitaker 

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