in+care Campaign
Webinar
November 19, 2012
1
Ground Rules for Webinar Participation
• Actively participate and write your questions into the
chat area during the presentation(s)
• Do not put us on hold
• Mute your line if you are not speaking (press *6, to
unmute your line press #6)
• Slides and other resources are available on our website
at incareCampaign.org
• All webinars are being recorded
2
Agenda
• Welcome & Introductions, 5min
• Retaining Aging HIV+ Patients in+care, 30min
• Data Review and Discussion of Retention Strategies
Collected Through the Campaign, 15min
• Q & A Session, 5min
• Updates & Reminders, 5min
3
HIV and Aging
Presented by
Emily Tsuchida, RN, MSN, PHN, FNP-C
Center for AIDS Research,
Education & Services (CARES)
Sacramento, CA
Comprehensive Clinical Care
Medical
Psychiatry
Mental Health counseling
Case Management
Pharmacy
Clinical Trials/Research
Risk Reduction Counseling
Dental
Nutrition
Substance Abuse
Health Education
Laboratory Services
STD/HIV Testing
Prevention
Who We Serve at CARES:
 2600 HIV+ patients
 Over 74% are below 200%
of poverty level
 Approximately half have substance
abuse and mental health issues.
 African Americans are impacted
at an alarming rate.
 Young people are our fastest
growing group.
Audience Responses
What proportion of your caseload is aged 45
years or more?
25% of fewer
Between 26% and 50%
Between 51% and 75%
Greater than 75%
I have no idea / I do not have an HIV patient caseload
7
Audience Responses
PROVIDERS
In the chat room, tell us what you have done
at your sites to prepare for an aging
population if you serve HIV patients.
CONSUMERS / ALLIES
In the chat room, tell us what special concerns
you see as HIV+ people grow older and have
more complex health needs.
8
An Aging Population at CARES
Point# 1:
Important to get all ages
tested for HIV.
Point #2
Treatment for all as being over 45
is an indication for treatment.
Point #3
You must have expertise in
poly-pharmacy.
Point #4
Develop connections with
home care and skilled nursing
facilities.
Point #5
Elderly alone…
HIV+ people feeling alone…
The combination of the two.
Point #6
Need expert in geriatric patients
to assist with the care of these
aging patients.
Point #7
Nutritional needs for elderly are
different.
Audience Responses
PROVIDERS
In the chat room, tell us what you have found
most useful as training for Geriatric concerns
and Nutritional counseling.
CONSUMERS / ALLIES
In the chat room, tell us what special concerns
you can identify in terms of aging and
nutrition as they relate to People with HIV?
17
Point #8
Issues around dementia and
normal loss of cognitive
functioning.
Point #9
Assistance with insurance
coverage to maintain HAART
coverage: ACA provisions and
Medicare/Medicaid.
Point #10
Retaining people in care is
important for all ages but more
urgent for those with diseases
associated with aging.
In summary:
Woman infected at HS reunion.
86 year old woman from India.
Speaking from Experience:
Brief Peer Learning Exercise
Thinking about Emily’s 10
points and the resources
participants list in the chat
room, which resources have
you found to be the most
useful?
Are there are any resources
in the literature you
recommend?
Let us know your experiences LIVE!
22
Improvement
Strategies Exercise
Michael Hager, MPH MA
NQC Manager
24
in+care Campaign National Data Snapshot
December –
October Data
as of 11/16/2012
Measure 1:
Gap Measure
Measure 2:
Visit Frequency
Measure
Measure 3:
New Patient
Measure
Measure 4:
Viral Suppression
Measure
Dec
Feb
Apr
Jun
Aug
Oct
Dec
Feb
Apr
Jun
Aug
Oct
Average
Average
Average
Average
Average
Average
Sites
Sites
Sites
Sites
Sites
Sites
(Patients)
(Patients)
(Patients)
(Patients)
(Patients)
(Patients)
16.19%
(124,462)
207
16.15%
(130,231)
201
14.71%
(129,910)
206
15.03%
(116,888)
185
14.19%
(110,810)
171
15.79%
(108,669)
159
63.44%
(84,213)
155
65.74%
(87,068)
152
62.20%
(103,351)
175
64.20%
(92,495)
166
64.32%
(91,561)
159
62.32%
(89,541)
148
55.87%
(7,789)
194
58.25%
(8,802)
190
58.54%
(8,421)
195
59.67%
(7,220)
179
59.64%
(7,074)
169
58.95%
(6,931)
156
69.69%
(135,806)
199
69.46%
(147,223)
192
70.41%
(156,089)
198
71.87%
(139,967)
183
71.80%
(129,933)
167
71.49%
(127,207)
155
Coming Soon – new analyses at AGM!
25
26
27
28
29
Improvement Strategies Discussion
Take Home Points – Interventions!
• HIV Testing
• Routine testing of all ages
• Treatment
• Treat all PLWH > 45 years of age with ARVs
• Training
•
•
•
•
30
Understand specific MH issues, social-psychology and cognitive impairment
Experience with treatment with multiple meds for multiple conditions
Experience in geriatric concerns, treatments and referrals
Experience in nutrition and nutritional counseling
Improvement Strategies Discussion
Take Home Points – Interventions!
• Connect
• Leverage Health Information Exchanges (HIE) / Regional Health
Information Organizations (RHIO) in your region
• Link your service to skilled nursing facilities / Visiting Nurse Association
(medical care) and Patient Navigation Systems (other supports)
• Patients with appropriate payer resources and systems to support PLWH
engagement (increasingly important with Affordable Care Act
implementation)
31
Submit Improvement Updates!
32
Announcements
33
Upcoming Events
•
Next Meet-the-Author Webinar: L.Gardner – Low-Effort, ClinicWide Intervention December 12, 2012 at 1pm ET
•
Next Partners in+care Webinar: Optimal Wellness for PLWH
December 13, 2012 at 2pm ET
•
Next Campaign Webinar: Sustainability of Retention Projects in
Unsure Funding Environments January 9, 2013 at 2pm ET
•
Campaign Webinar: Mental Health and Retention
Date Pending – to be announced!
34
Upcoming Deadlines and Office Hours
•
Campaign Office Hours:
Mondays & Wednesdays 4-5pm ET
•
•
•
•
•
•
Monday, November 19 - Open Space, no set topic
Wednesday, November 21 - National Holiday, no office hours
Monday, November 26 - Open Space, no set topic
Wednesday, November 24 - All Grantee's Meeting, no office hours
Monday, December 3 - Open Space, no set topic
Wednesday, December 5 - Sustaining Retention Projects Over Time
•
Data Collection Submission Deadline:
December 3, 2012
•
Improvement Update Submission Deadline:
December 17, 2012
35
in+care at AGM
Wednesday, November 28, 2012
12pm ET
Thurgood Marshall Ballroom South
36
MedScape Retention in HIV Care Series
• Technical Working Group working on articles for a new
Medscape Today News Series.
• We recommend that you subscribe to HIV/AIDS MedPlus
to be informed of new and exciting articles in this series!
• Published Pieces:
•
•
•
•
•
•
Monitoring Rates of Retention in HIV Care Across the State
How Health Departments Promote Retention in HIV Care
Improving Retention in HIV Care: Which Interventions Work?
Engaging in HIV Care: What We Learned from AIDS 2012
How Should We Measure Retention in HIV Care?
Retention In HIV Care: The Scope of the Problem
http://www.medscape.com/index/section_10285_0
37
Partners in+care
• Partners in+care Private Facebook Group is live!
• Share tips, stories and strategies
• Join a community of PLWH and those who love them
• Email michael@nationalqualitycenter.org for more details
• Partners in+care website is live!
• http://www.incarecampaign.net/index.cfm/77453
• Join our mailing list (a list-serv version of the FB Group)
38
Time for Questions
and Answers
39
Campaign Headquarters:
National Quality Center (NQC)
90 Church Street, 13th floor
New York, NY 10007
Phone 212-417-4730
incare@NationalQualityCenter.org
incareCampaign.org
youtube.com/incareCampaign
40