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Boldly Using Technology to Implement and Change the Culture around Routine HIV Screening Sin
Vergüenza (Without Shame) Angel Rosario, Clinic Testing
Supervisor
2
Topics • AltaMed Health Services Corporation • Electronic Health Record Development • HIV Training Modules • Sin Verguenza
AltaMed has delivered quality care to the underserved communities of Southern California for more than 40
years. Designated by the Joint Commission as a Primary Care Medical Home (PCMH), AltaMed prides itself in the
quality of its care delivered by its premier health care professionals. AltaMed serves the entire family with:
1) primary medical care 2) dental clinics 3) senior long-term care services 4) delivers disease management programs 5) health education 6) youth services, 7) specialty HIV/AIDS care for over 20 years 8) substance abuse treatment.
One of nation’s largest FQHC’s, with wrap-around IPA PCMH certified by TJC and NCQA 73% earn less than $44,700/year for a family of four Take all insurance types; 27% have no insurance 81% of our patients are Latino 1,900 employees across 43 sites 125,000 patients served; 930,000 annual visits 140 providers, mid-level practitioners 600 contracted specialists
Gilead Funded 2010
Los Angeles Three Pilot Sites: •East LA Commerce •El Monte •Pico Rivera
8,013 patients tested at pilot sites from January 2010-September 2011 •121,310 total eligible patients seen at AltaMed (all clinic sites) from January 2010 to September 2011, representing a penetration rate of 6.6%
28 HIV positive clients were identified
24 of the 28 (86%) testing positive were male, 4 were female. ***Lab Default
The Pilot
A Taste of Technology
This is all fine print for the graph above: Denominator: Patient must be 18 years old and above. Patient must not have undergone the screening in the past 12 months (1 year).
Numerator: Patient must be 18 and above that have received HIV Screening in the month selected. CPT Code: (86703, 8670392, NG083875, 19728)
Implementation of HIV Screen Lab Default
• In OC, from 10/1/2011 to 12/31/2012, 11,010 HIV screens performed and a total of 10 HIV+ individuals (newly identified and re-identified and linked into care)
• From 1/1/2013 to present, • Allowed us to focus efforts on routine
screening by developing infrastructure, visibility, and internal support
• Develop routine screening as a campaign
Into OC
Internal Barriers to Testing
• Changing the culture of AltaMed: – Support from senior leadership – Staff Support
• (Clinic workflows, lack of comfort with procedures)
– Staff training – Lack of patient education on routine testing policies – Lack of patient buy-in for routine testing
Using Technology: AltaMed University
• A learning management system (LMS) where staff gain access to training videos for personal/professional development and/or mandatory compliance trainings (occupational hazards, customer service, HIPAA, etc.)
Mandatory Training using AltaMed U
• Senior Leadership support for routine HIV Screening
• All clinical staff required to complete the entire set of HIV training by end of Q4 (October 1, 2012- December, 32, 2012)
• Over 700 clinical staff completed modules
Sin Verguenza
• Develop a culturally competent education tool to: – Disseminate HIV Prevention messages in an innovative,
non traditional, accessible manner – Engage communities in conversations about HIV – Educate on CDCs recommendations for routine
screening – Develop a script from the stories of our HIV+ patients
Increase HIV testing at our clinics
Sin Verguenza
• Developed an • Work with production company and casting
agency to hire REAL actors • Release Dates:
– World AIDS Day and bi-weekly release of webisodes on YouTube thereafter
• Worked with CSULB to develop an online survey linked to YouTube page
• As of April 2013: 120,000 > views
Current/Future Projects:
• “Together We Test” Campaign
• Preventions programs around Sin Verguenza
• Patient Narratives • Focus Groups • Documentary Short
Contact Information
Angel Rosario Clinic Testing Supervisor AltaMed Health Services Corporation [email protected] 714-500-0348