227. Remote Mentorship and Consultation to Support HIV Providers in Geographically Dispersed Underserved Areas: Data from NW AETC ECHO
Session: Poster Abstract Session: Clinical Practice Costs, Informatics, and Telemedicine
Thursday, October 8, 2015
Room: Poster Hall
  • ID Week 2015 NW AETC ECHO poster 227_Wood.pdf (4.2 MB)
  • Background: Based on the Project ECHO model, we designed a longitudinal HIV distance mentorship and consultation program using real-time video to connect community HIV providers to a multi-disciplinary care team including academic specialists.  The goals of this analysis are to: 1) evaluate changes in participants’ self-assessed HIV knowledge and confidence to provide essential HIV care and 2) report the type of clinical problems for which community HIV providers most frequently request remote consultation.

    Methods: At baseline and every 12 months, participating providers completed assessments in domains of self-efficacy, community of practice, and knowledge.  We compared means within domains using a paired-samples t-test to assess change over time and examined the relationship between each survey item and level of participation (based on number of sessions attended) using analysis of variance.  We prospectively tracked the clinical problems for which providers sought ECHO consultation. 

    Results: 45 providers completed a baseline and at least one repeat assessment. Results demonstrated a statistically significant increase (p<0.05) in participants’ self-reported confidence to: counsel patients to reduce transmission, screen for viral hepatitis, screen for mental health issues, select initial ART, manage ART side effects, assess for drug interactions, and provide other components of HIV care.  Significant increases in participants’ perceptions of feeling part of an HIV community of practice and feeling professionally connected to academic faculty also occurred and were significantly associated with level of engagement in the program. The most frequent clinical scenarios for which community providers sought ECHO support include: changing ART, evaluation of acute symptomatology, and mental health issues.

    Conclusion: Telehealth innovation has potential to increase providers’ self-efficacy and knowledge, while decreasing professional isolation. Community-based HIV practitioners most frequently seek support on clinical topics for which no strict guidelines exist, such as changing ART or managing mental health disorders. Increased education for providers in these domains will help to build capacity of the HIV workforce.

    Brian Wood, MD1,2, Kenton Unruh, PhD1,2, Mary Annese, MPA2, Natalia Martinez-Paz, MA, MPA2, Christian Ramers, MD3, Lisa Kimmerly, MSW4, John Scott, MD1 and David Spach, MD1,2, (1)Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, (2)Northwest AIDS Education and Training Center, Seattle, WA, (3)Family Health Centers of San Diego, San Diego, CA, (4)Data Trends, Bellingham, WA


    B. Wood, None

    K. Unruh, None

    M. Annese, None

    N. Martinez-Paz, None

    C. Ramers, None

    L. Kimmerly, None

    J. Scott, None

    D. Spach, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.