The reality of modern medicine in the United States is often dictated by a map. In U.S. rural areas – 80% of which currently experience health care shortages – residents face a life expectancy nearly two years shorter than those living in metropolitan areas. Digital health has the potential to narrow that gap, but access remains uneven. In Arizona alone, 21% of the population doesn’t use the internet, according to the Arizona Commerce Authority, leaving those people at a disadvantage.

To address this gap, University of Arizona researchers are moving beyond traditional telehealth to launch Convergent Digital Health for Remote Access, or CoDiRA. One of six initiatives to receive funding as part of the Office of Research and Partnership’s inaugural Big Idea Challenge, the project seeks to provide a robust physical ecosystem of health care delivery across geographic and social barriers.

“It’s an unfortunate reality that the ZIP code you are born in can have a great impact on your health outcomes,” said Dr. Srikar Adhikari, a professor of emergency medicine and CoDiRA principal investigator. “People have died in front of me in situations where we could have saved their lives if they had presented earlier. The gap is really wide. Even if our project addresses a small part of that access issue, it would be a huge step forward.” 

The project unites 14 U of A researchers with expertise ranging from computer sciences and cybersecurity to advancing equity and promoting wellness. The multidisciplinary team is designing medical kiosks – powered by artificial intelligence – for rapid deployment in accessible locations such as pharmacies and community centers, grounding their work in community relationships, culturally tailored approaches and clinical practice.

“At the University of Arizona, we believe that the most complex challenges of our time, including a widening gap in health equity, cannot be solved in isolation,” said Tomás Díaz de la Rubia, senior vice president for research and partnerships. “CoDiRA is a prime example of convergence in action, bringing together our world-class expertise in AI, cybersecurity and medicine to build a robust, socially grounded ecosystem for care. By integrating advanced technology with deep community trust, we are fulfilling our land-grant mission to ensure that high-quality health care is a universal right, regardless of a patient’s physical location or social circumstances.”

A new care model

CoDiRA is designed to provide an alternative to standard urgent care and emergency visits, which often involve long travel and wait times, as well as to basic video platforms. CoDiRA uses cameras, audio and other sensing technologies to capture and analyze the subtle clinical signs that conversation alone might miss. The system is specifically designed to address common but critical complaints, such as urinary tract infections or elevated blood pressure, providing personalized advice and detailed assessments that prevent potentially unnecessary trips to the emergency room. 

The system operates within existing medical and regulatory frameworks, with built-in escalation and human oversight for situations that require clinical judgment. Trained partners, such as health workers, will help patients navigate the system.

Scaling the concept

With an initial seed-funded period of two years, which began in 2025, the project also is focused on establishing community collaborations that will encourage adoption and investment. Leaders at Mariposa Community Health Center met with the researchers to discuss how CoDiRA could support residents in Nogales, Arizona, and provided an endorsement for a grant proposal, Adhikari said. The team is also working to engage tribes, clinics and other trusted organizations to help guide CoDiRA development and deployment strategies.

This community-centric approach extends to the training of the AI itself. The team is refining the models using two streams of data: feedback from focus groups and surveys of potential end users, and the direct clinical intuition of the research team. Adhikari, who has 25 years of clinical experience, is working closely with data scientists to encode the specific ways providers gather information and narrow down diagnoses, essentially teaching the software to think with the nuance of a veteran clinician.

Safety and privacy remain at the forefront of the project’s mission. The CoDiRA ecosystem includes dedicated experts responsible for ethical AI infrastructure, regulatory compliance and cybersecurity to address patient concerns regarding the handling of sensitive health information. By building a model that is both technologically advanced and socially grounded, the researchers hope to create a global standard for care in low-resource and rural environments.

As the team moves toward a tested and vetted model, the researchers will need both a prototype and preliminary data to secure a partner and test CoDiRA with patients. Adhikari believes the system can play a distinct role for a business or government sponsor, providing integration, oversight and readiness beyond what a standalone product offers. 

“As of now, the majority of the technologies – even the ones which are FDA approved – have not been readily accepted and implemented,” Adhikari said. “We need to build trust and educate patients on why and how they can interact with these models. That's what we believe will separate us from any existing technologies.”