CITRIS began working at the intersection of health and technology more than ten years ago to lead and support University of California research on healthy aging, telehealth, and health technology in order to create a thriving future for all Californians.
Pioneering telemedicine research. Offering older adults access to technology that helps connect them with their friends and loved ones. Providing telehealth services to agricultural workers in California’s Central Valley. These are a few of the areas of impact that CITRIS Health is tackling through its research, programs, and outreach.
After years of working at the intersection of health care solutions and technology research, CITRIS Health has learned two key lessons: successful technology innovation starts with user input, whether that user is a patient or a health care provider; and technology solutions should be designed with a sustainability mindset from conception to implementation.
“We are addressing the most difficult challenges affecting the health and well-being of society through the development of innovative digital health solutions,” said David Lindeman, director of CITRIS Health. “With a focus on improving the health and well-being of vulnerable populations—including underserved communities and older adults—CITRIS Health researchers and technologists are creating technology-enabled interventions that have immediate, real-world impact.”
Lindeman has served as the director of CITRIS Health since 2014. During his more than 40 years in the field as a health services researcher and gerontologist, Lindeman has conducted research related to health care technology, chronic disease management, healthy aging, disabilities, community-based and residential services, and family caregiving.
Lindeman’s current focus is working with CITRIS seed funding researchers and CITRIS Foundry entrepreneurs on the incubation, start-up, evaluation, and scaling of technology-enabled health care solutions. These projects include addressing critical health care challenges through mobile devices, sensors to track health, telehealth tools and access, assistive technologies, and artificial intelligence/machine learning. Technology-enabled health solutions offer tremendous opportunities to rapidly scale and have a broad, sustainable impact.
The Future of Telehealth and Healthy Aging
Long before the arrival of COVID-19, CITRIS Health researchers were pioneers in telehealth and remote medicine. In 2011, after years of groundwork, CITRIS announced a programmatic focus on health as part of its Big Bets. As part of its early work, CITRIS Health researchers consulted on the design of the California Telehealth Network, which still today provides critical access to healthcare for thousands of rural Californians, connecting clinicians to patients through broadband network services. CITRIS Health Faculty Director Thomas Nesbitt was an early advocate for employing telecommunications technology to deliver health-care services in underserved urban and rural areas. Nesbitt established the first telehealth link at UC Davis in 1992 and was instrumental in establishing the UC Davis PRIME programs and Center for Virtual Care.
“One of the major challenges facing California and the nation over the past 20 years has been disparities in access to high-quality health care,” Nesbitt noted. “With the strong background of our faculty in offering remote-patient care through telemedicine, CITRIS Health has long been poised to play a major role in the transformation in health care delivery that we see flourishing today during the pandemic.”
One way CITRIS Health plans to do that is by leveraging the power of telehealth through two public-private partnerships launched in 2020: ACTIVATE and Lighthouse for Older Adults. Both projects provide access to the internet and telehealth services to vulnerable populations. ACTIVATE seeks to support rural, low-income agricultural workers in California’s Central Valley. Lighthouse for Older Adults supports low-income older adults living in affordable housing communities in Northern and Southern California. Last month, ACTIVATE and Lighthouse launched mobile COVID-19 care teams to deliver vaccinations in collaboration with the nonprofits Livingston Community Health and Eskaton, respectively. Senior living facilities and the Central Valley both have high COVID-19 rates and insufficient access to vaccinations and testing. The CITRIS Health project teams are providing much-needed support by offering vaccine outreach and administration, testing, follow-up care, and general COVID-19 public health guidance.
“By working together, we connect the scientific and technical resources of the University of California with the trusted, local healthcare team at Livingston so that our Central Valley residents receive the best of both,” said Katherine Kim, associate professor at UC Davis and co-PI of ACTIVATE. “We want to make sure that we build the capacity to provide needed care to rural residents.” ACTIVATE is unique in its comprehensive approach to providing primary care through telehealth to persons in rural communities.
CITRIS Health also supports University of California research projects through the CITRIS Seed Funding program which provides funding to early-stage research that can lead to bigger funding and impact. SafelyYou is a company that got its start as a CITRIS seed-funded research project.
SafelyYou supports older patients with dementia and their caregivers by installing AI-enabled camera systems that detect falls in real-time. This system alerts caretakers and allows them to review when and how falls take place to identify patterns and prevent future falls. Non-fall video is automatically deleted within 60 seconds and no audio is recorded; only video of falls is saved for review. SafelyYou also provides consulting on preventing falls based on the videos. With the support of CITRIS Seed funding in 2015, SafelyYou tested its technology, developed a proof-of-concept, and created a business plan. CITRIS Health provided advising and mentorship to the founders and helped make connections to potential customers. SafelyYou is now headquartered in San Francisco and provides its fall detection systems in communities across the United States and Canada.
Preparing the Next Generation of Telehealth Practitioners
To expand access to telehealth training, CITRIS Health has partnered with First Affiliated Hospital at Sun Yat-sen University (SYSU) to offer an innovative American-Chinese Health Informatics and Data Science Methodology research program. The Health Informatics International Program was developed and led by CITRIS and University of California researchers and clinicians in collaboration with clinicians and researchers from First Affiliated Hospital SYSU.
The Lingnan Foundation–funded program launched this spring 2021 with a training program for 240 American and Chinese participants who will be the next generation of health data scientists. “The kick-off training was a huge success and brought together participants from dozens of hospitals, colleges, and universities in the US and China,” said Lindeman. CITRIS Health hopes to continue this training program on an annual basis.
CITRIS Health also provides telehealth training through its participation in the Transatlantic Telehealth Research Network (TTRN). TTRN was launched in 2011 and is dedicated to developing cutting-edge research and innovation within telehealth. In 2020, CITRIS Health held its first virtual TTRN-CITRIS International Summer Institute for doctoral students and post-doctoral trainees from across the globe. The program aims to build and support an international network of researchers dedicated to the creation of impactful research and innovation in health informatics and data science.
In 2021, CITRIS Health programs and partnerships such as the Health Informatics International Program, ACTIVATE, and Lighthouse will continue to grow, providing training and telehealth access to more patients who face barriers to accessing care. Plans are in development for the scaling of both ACTIVATE and Lighthouse throughout California and beyond later this year.
“In the years ahead, it’s clear that technology will play an even greater role in the future of health and health care delivery,” Lindeman said. “As we come out of the COVID-19 pandemic we have learned that precision public health, driven by next-generation technologies and data analytic solutions, will help improve quality of care and health outcomes, as well as empower individuals to take even greater control of their own health.”