>>Related story: UC med centers' improved margins shore up med schools amid declining state support

By Alec Rosenberg

PRIME-LC graduate Sarah Lopez finds out where she will serve her residency.

Four UC Irvine students made history this year, becoming the first graduates of an innovative education program that aims to help meet the needs of medically underserved communities in the state.

Launched five years ago, the Program in Medical Education for the Latino Community (PRIME-LC) was the first medical education program in the country addressing the unique health care needs of Latinos. Anna Altshuler, Sarah Lopez, Gabriel Rivera and Carl Smith were the first to complete the program.

"Our first class of students embodies the very best of PRIME-LC," said Dr. Charles Vega, PRIME-LC director. "They are diligent, empathetic and highly motivated to become physician-leaders, and they are certain to succeed in this goal."

University of California medical student enrollment has risen for the first time in more than 30 years, thanks to PRIME programs, which have grown to include 193 students at all five UC medical centers. That's a highlight of UC Health's annual report, which was scheduled to be presented at the Regents' meeting today (Nov. 19) but was postponed because of a busy agenda. The report, part of UC's 2009 Accountability Report that tracks the university's progress in meeting key performance and policy measures, outlines UC Health's activities, challenges and initiatives, from PRIME to telehealth to the financial performance of UC medical centers.

"The report shows the exceptional breadth and depth of quality across the UC health sciences teaching, research and clinical care programs," said Dr. Cathryn Nation, UC associate vice president for health sciences and services.

"We want to serve as a model for this nation in terms of what a system can bring to the health of its communities," added Dr. John D. Stobo, UC senior vice president for health sciences and services, who is responsible for UC Health's systemwide coordination, strategic planning, policy development and advocacy.

Where future doctors come to learn

With 16 health professional schools and 10 hospitals on seven campuses, UC Health runs the country's largest health sciences training program. UC, which awards 625 medical degrees a year, trains 60 percent of medical students and nearly half of all medical residents in California and is trying to help fill the state's demand for doctors: California faces a shortage of up to 17,000 physicians by 2015.

UC Regents have approved a new medical school at UC Riverside — the university seeks $10 million in startup funds from the state to help open it — and UC Merced is developing plans that could lead to a medical school. Meanwhile, PRIME programs already are beginning to help.

At UC Irvine, PRIME students are starting a health assessment program in the Duroville mobile home park, a community near the Salton Sea of poor, mostly Latino farmworkers with little access to health care. Other PRIME programs address rural health and telemedicine (Davis), diverse disadvantaged communities (Los Angeles), health equity (San Diego) and urban underserved (San Francisco).

"Although the program is still in the ‘launch phase' — with goals for a total steady state enrollment of 300-350 students systemwide — its potential impact shows great promise," Nation said. "Our obvious challenge stems from California's budget crisis and the fact that state support for PRIME students has not been provided for the past two consecutive years."

UC PRIME students are diverse: Fifty-five percent are Latino, African-American or from other groups traditionally underrepresented in medicine. Overall, about 20 percent of UC first-year medical students are underrepresented minorities, which exceeds the national average of 14.5 percent.

UC Health also is making its mark in areas from telehealth to research.

Telehealth

UC Davis and the UC Office of the President are managing the developing California Telehealth Network, which will use technology to bridge the distance between specialists and patients and communities that lack such access. The effort, which includes $22 million in funding from the Federal Communications Commission, will lead to the creation of a statewide broadband network, or "digital highway," for health. The network, which will build on UC's steadily expanding telemedicine programs, is expected to connect more than 800 sites but could reach more than 2,000 if UC can secure federal stimulus funding.

Breast cancer treatment

In September, UC launched the ATHENA Breast Health Network, a systemwide initiative to accelerate advancements in breast cancer prevention, screening and treatment.

Two other initiatives in the works are a learning object repository and health sciences academy. UC hopes to launch the repository, a digital multimedia library for health sciences education materials and resources created by UC faculty, by late spring 2010. The repository would showcase contributions by UC faculty and broaden access to educational materials, Nation said.

The academy would focus on recognizing, advancing and supporting educators as well as improving teaching. UC plans to have an academy kickoff event and systemwide planning meeting next spring.

Saving money

UC Health also is working to create systemwide efficiencies. The system negotiated higher systemwide clinical payment rates this year, resulting in additional revenue of about $100 million. Another $7.1 million in systemwide savings was achieved related to pharmaceutical, medical supply, laboratory and IT expenses.

UC also achieved systemwide improvements in patient safety, reducing blood stream infections by more than 20 percent in the second half of fiscal 2009.

Improving systemwide quality and cooperation will continue to be priorities for UC Health. Looking forward, two other critical issues stand out: How can UC hospitals maintain their financial vitality and how can UC health professional schools address work force issues (diversity and quantity) amid higher fees, decreasing state support and a changing health care environment.

"We are very concerned about rising fees and debt loads for UC health sciences students and the ramifications these burdens impose relative to both access to UC for students and the career choices that admitted students will make upon graduation," Nation said. "UC remains committed to the highest standards of excellence in education and in the face of eroding state support will need to develop new revenue streams and new strategies for containing costs. Raising new money for scholarships for our students will be increasingly important for assuring access and helping to reduce debt loads. We know that maintaining quality, while preserving access and affordability, will be essential for the success of our ongoing efforts to meet state needs."

Alec Rosenberg is the health communications coordinator in the UC Office of the President's Integrated Communications group.