AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #407 - Innovation in provider HIV education
Authors: Presenting Author: Dr. Michelle Iandiorio - New Mexico AIDS Educaiton and Training Center
Additional Authors: Ms. Tracy Tessmann, Dr. Karla Thornton, Mr. John Brown, Dr. Sanjeev Arora,
Aim: The 2010 National HIV/AIDS Strategy asked HRSA to work with AIDS Education and Training Centers (AETCs) to expand training for HIV clinicians and provider organizations to address provider-associated factors that affect treatment adherence. Additionally, the AETCs are in a position to assist with the goal of increasing the number and diversity of available providers for PLWHA. We implemented an innovative approach to HIV provider education.
Method / Issue: The New Mexico AETC has partnered with Project ECHO (Extension for Community Healthcare Outcomes) at the University of New Mexico Health Sciences Center whose goal is to expand access to specialized care for vulnerable populations and underserved areas. The NMAETC utilizes Project ECHO’s state-of-the-art telehealth technology to reach providers throughout the state who are treating HIV patients and assist in building capacity among community-based providers. PLWHA are increasing but few providers are choosing to pursue specialized training. As a result of this shortage more care is being provided by primary care physicians. Most rural areas cannot afford to deliver the broad range of disciplines and specialty medical training needed to treat patients infected with HIV. Underserved areas face issues such as limited funding, high provider turnover, and high provider to patient ratios HIV patients may have to travel to urban areas and academic medical centers for care. PLWHA in underserved areas may also face stigma, cultural issues, and limited training and knowledge of their providers. AETCs offer free training to providers to help bridge this gap and allow PCPs to feel comfortable treating HIV patients in their own communities. Local community based health centers and other providers are often the most culturally appropriate and accessible choices with the benefit of the ability to build relationships with patients. The access providers need to develop the knowledge and self-efficacy to deliver best practice care can be gained through the Project ECHO-NMAETC weekly clinics utilizing the ECHO model of telehealth consultation: 1) Use of technology to leverage specialized resources; 2) Teaching best-practices care; 3) Case-based learning, and 4) Outcomes monitoring. Community-based PCPs are able to treat their HIV patients, guided by expert consultation from the Project ECHO-NMAETC team, while gaining rapid learning of best-practices care and improving their self-efficacy to treat this chronic and complex disease.
Results / Comments: Project ECHO was first piloted in 2003 for the treatment of hepatitis C but has since expanded to 14 different healthcare clinics. The NMAETC, in collaboration with Project ECHO, began conducting weekly HIV clinics in October 2010. To date, there have been 48 clinics held, with 228 unique attendees and 1462 provider participation hours, representing 46 different professional credentialing areas, including medicine, pharmacy, nursing, counseling, social work, health education and community health workers. 62 unique patient cases have been presented. Provider outcome data has shown knowledge improvement in HIV care.
Discussion: Participation and feedback has been very good. New evaluation material to better understand the barriers to full participation is in the process of development. In the future, we would like to evaluate the patient outcomes from this training.
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