Table of Contents Author Guidelines Submit a Manuscript
International Journal of Telemedicine and Applications
Volume 2011, Article ID 523161, 14 pages
http://dx.doi.org/10.1155/2011/523161
Research Article

Identifying Telemedicine Services to Improve Access to Specialty Care for the Underserved in the San Francisco Safety Net

1Global Health Sciences, University of California, San Francisco, 50 Beale Street, Suite 1300, San Francisco, CA 94143, USA
2Performance Improvement and Patient Safety Division, San Francisco General Hospital & Trauma Center, 1001 Potrero Avenue, Bldg 20, 3rd Floor, Suite 2300, San Francisco, CA 94110, USA

Received 13 May 2011; Revised 20 July 2011; Accepted 26 July 2011

Academic Editor: Velio Macellari

Copyright © 2011 Ken Russell Coelho. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Safety-net settings across the country have grappled with providing adequate access to specialty care services. San Francisco General Hospital and Trauma Center, serving as the city's primary safety-net hospital, has also had to struggle with the same issue. With Healthy San Francisco, the City and County of San Francisco's Universal Healthcare mandate, the increased demand for specialty care services has placed a further strain on the system. With the recent passage of California Proposition 1D, infrastructural funds are now set aside to assist in connecting major hospitals with primary care clinics in remote areas all over the state of California, using telemedicine. Based on a selected sample of key informant interviews with local staff physicians, this study provides further insight into the current process of e-referral which uses electronic communication for making referrals to specialty care. It also identifies key services for telemedicine in primary and specialty care settings within the San Francisco public health system. This study concludes with proposals for a framework that seek to increase collaboration between the referring primary care physician and specialist, to prioritize institution of these key services for telemedicine.