Catalina Island Telemedicine Center

Description

The island of Santa Catalina is just over 20 miles off the coast of southern California. Its one clinic and hospital does not house specialty physicians, so islanders had to travel to the mainland for primary care and mental health specialty services. In order to give the island's 4,000 residents quick access to specialty medical care from the mainland, Catalina Island Medical Center (CIMC) in Avalon, the island's only incorporated city, set up a telemedicine center.

In partnership with Loma Linda University Medical Center (LLUMC), the Los Angeles County Department of Mental Health, and a private psychiatry company, Santa Catalina island residents can now save a trip to the mainland by seeing specialists electronically.

This telemedicine center received support from a 2006-2009 Federal Office of Rural Health Policy Rural Health Care Services Outreach grant.

Services offered

The CIMC telemedicine services offered include:

• Distance-learning diabetic education
• Retinal imaging screenings
• Telepsychiatry therapy and medication prescriptions
• Bilingual telemental health therapy services through Licensed Clinical Social Workers

• Digital diagnostic imaging
• Endocrinology

The most recent service added is telemedicine pain management. All patients who are prescribed narcotics at CIMC are automatically enrolled in the program and are required to sign a contract committing to the program. Before writing a narcotic prescription, CIMC accesses California's Controlled Substance Utilization, Review, and Evaluation System (CURES) to see if the patient has filled a prescription at any other California pharmacy. Patients from other facilities are often referred to the program. A pain doctor meets with the patients through telecommunications to help discover the cause of the pain and determine a course of action. If an addiction is the reason for the narcotics, additional steps are taken to help the patient gain full recovery.

A separate grant distributed by the VA allows veterans who reside on Santa Catalina Island to connect to their primary care providers, neurologists, and psychiatrists located at the VA Long Beach Healthcare Services via telehealth.

Results

An analysis of the telemedicine program found that patients had measurable improvements, and that 90% of patients were pleased with the program and will continue to use it. Annual averages include:

• 12 patients receive diabetic education
• 41 patients receive eye screenings
• 12 patients per month receive telepsychiatry services

Challenges

California State Board of Pharmacy regulations restrict physicians from ordering controlled substances for patients over the phone. Therefore, CIMC invested in tamper-resistant forms and a security prescription printer to be able to print prescriptions for patients on-site. A psychiatrist on the mainland can now submit a prescription electronically to be printed on the CIMC printer and taken to a local pharmacy.

It has taken some time to find good specialists who are committed to serving long-term with the telehealth partnership. Many specialists have used the CIMC-telehealth relationship to gain experience and as a stepping-stone to other practices.

Recently, the specialist who provided pain management services no longer makes visits to CIMC. A search for a specialist via telehealth is currently ongoing.

Replication

Telehealth has provided a way to meet the needs of a rural community for a variety of specialty care services while overcoming the difficulty of recruiting and retaining an on-site specialist.

Contact Information

David Hamlin, Clinic Manager
Catalina Island Medical Center
310.510.5141
dhamlin@cimedicalcenter.org