499. Washington State Satellite HIV Clinic Program: Delivering Highly Effective, Decentralized Care for Patients in Underserved Communities
Session: Poster Abstract Session: HIV Policy and Healthcare Utilization
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • Satellite Clinic Poster ID Week 2016_10-17-16_Wood.pdf (2.1 MB)
  • Background:

    In 2007 the University of Washington (UW)/Harborview Medical Center Madison HIV Clinic initiated a satellite clinic program to deliver HIV care to patients living in underserved and geographically isolated communities.  HIV-infected patients living at distance from their providers or who are out of care altogether due to a shortage of local HIV providers are at high risk of disease progression and of transmitting HIV.  Washington State residents living in underserved areas are particularly impacted given the geographic barriers within the region and the lack of efficient, affordable public transit connecting neighboring counties to Seattle.

    Methods:

    To address this problem, we established a unique partnership between the UW/Harborview Madison Clinic, individual community health care centers, and the Washington State Department of Health (DOH).  HIV clinic sessions are held one day per week per satellite, are staffed by HIV specialists and are integrated into the local health center.  This arrangement provides ready access to local specialty care and hospitals and to clinic-based primary care on non-HIV clinic days.  

    Results:

    To date the program has opened four separate clinics in partnership with four distinct community health clinics and has provided expert HIV and primary care to 616 unique patients during 5201 visits.  Eighty-two percent of all satellite patients maintained undetectable plasma HIV viral levels in 2014, significantly better than the national average of 68% for patients engaged in care (CDC, 2014). The rates of viral suppression were also higher among satellite patients compared with overall suppression rates within each county (Figure). 

    Conclusion:

    This unique collaboration between an academic medical center, our state DOH, and already established community health centers leveraged existing resources to rapidly increase HIV care capacity and gain the trust of both patients and local providers. This successful deployment of HIV care to underserved communities benefits patients, their communities and advances the teaching and care missions of our academic medical center by providing care to the most vulnerable while training the next generation of HIV providers.

    Brian Wood, MD1, Nina Kim, MD MS2, Shireesha Dhanireddy, MD3, Christopher Behrens, M.D.4, Shelia Dunaway, M.D.4, Javeed Shah, MD5, Christian Ramers, MD6, Pegi Fina, BSN7, Rhonda Bierma, BA8, Darren Layman, BA9, Richard Aleshire, BA10, Nadine Ramstead, BSN11, Ellen Arthur, BSN12, Christopher Bell, BSN7 and Robert Harrington, MD4, (1)Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, (2)Univ. of Washington, Seattle, WA, (3)Medicine, University of Washington, Seattle, WA, (4)University of Washington, Seattle, WA, (5)Division of Infectious Diseases, University of Washington, Seattle, WA, (6)Family Health Centers of San Diego, San Diego, CA, (7)Harborview Medical Center, Seattle, WA, (8)Harbourview Medical Center, Seattle, WA, (9)University of Washington Neighborhood Clinics, Seattle, WA, (10)Washington State Department of Health, Olympia, WA, (11)Community Health Centers of Snohomish County, Everett, WA, (12)Kitsap Public Health Department, Bremerton, WA

    Disclosures:

    B. Wood, None

    N. Kim, None

    S. Dhanireddy, None

    C. Behrens, None

    S. Dunaway, None

    J. Shah, None

    C. Ramers, None

    P. Fina, None

    R. Bierma, None

    D. Layman, None

    R. Aleshire, None

    N. Ramstead, None

    E. Arthur, None

    C. Bell, None

    R. Harrington, None

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