IMPLEMENTING AN HCV PROGRAM IN AN ESTABLISHED ASO DURING THEIR TRANSITION TO COMMUNITY HEALTH

Transcription

1 IMPLEMENTING AN HCV PROGRAM IN AN ESTABLISHED ASO DURING THEIR TRANSITION TO COMMUNITY HEALTH Amanda Goodpasture HCV Navigator Equitas Health, Columbus, Ohio Maria Brown, CDCA HCV Navigator Equitas Health, Dayton, Ohio

2 Disclosure : The HCV Navigation Program at Equitas Health is funded by a FOCUS Grant from Gilead Science Inc. Funds were used solely for the purpose of increased HCV testing and Linkage To Care. No funds were used in relationship to Gilead products.

3 FOCUS Grant Identify people living with Hepatitis C (HCV) using rapid antibody testing Connect Antibody positive clients to confirmatory testing Link HCV positive clients to medical care Help Equitas Health patients begin and complete HCV treatment

4 Getting up to speed: Onboarding HIV, HCV, STI 101 HIV Test counselor Training HCV Tester Training Phlebotomy Epic Training (EMR) Efforts to Outcomes (ETO) Training Certified Application Counselor Training

5 What we do : Community Based Testing Insurance Enrollment Linkage to Care Prior Authorization Patient Education Community Education Linkage to Community Support Services

6 Hepatitis C Antibody Testing Dayton HCV Testing 8/16-8/17 Columbus HCV Testing 8/16-8/17 Antibody Positive 28% Antibody Positive 21% Antibody Negative 72% Antibody Negative 79%

7 HCV Patient Navigation Overview Testing Community Based Rapid Antibody+ Onsite RNA Linkage HCV Navigation Testing, Education Outreach Events Referrals Equitas Health Patients LTC Visit Barrier Reduction Care Plan Barrier Reduction Treatment Access

8 Process If client needs assistance in followup for confirmatory, tester can link to Patient Navigator for assistance Linkage and Navigation Scenarios Preliminary Positive (Reactive) Test Positive Confirmatory (if necessary) Test counselor provides assessment, education, and short-term planning CLIENT HAS A PRIMARY CARE PROVIDER CLIENT WISHES TO SEE A MEDICAL PROVIDER CLIENT DOES NOT WANT TO SEE A MEDICAL PROVIDER Client is linked with Navigator/Linkage to make appointment with medical providers, answer questions, and identify barriers Tester/Linkage/Navigator educates client on health concerns, risk reduction, and preventative measures, conducts client assessment and refers to appropriate support services Client attends initial appointment. Creates care plan and develops goals as needed. Navigator works to support client success Client encouraged to schedule a follow-up; at subsequent contact, client may agree to see provider

9 Success: Partnerships

10 Challenge: Positive Confirmatory RNA Testing Ability to draw in the field Difficult blood draws Establishing relationship with lab Billing Concerns

11 Success: Integration into Medical Center Role Definition Linkage to Care- Internal & External Referrals Patient Navigation Epic: Communication and documentation Prior Authorizations

12 Challenge: Initiating Care Barriers Health Literacy Lack of Insurance Motivation to Enter Care Substance Use Other Socioeconomic Concerns

13 Challenge: Accessing Treatment

14 Case Studies

15 Private Insurance Case Study 40 year old woman, Ab+ at community-based testing event Requested help with next steps Wants care at Equitas Patient Navigation Program Created Care Plan Husband has strong mistrust of medical providers but wanted testing. Performed test/risk assessment on-site Antibody test was non-reactive Risk Assessment competed and f/u testing scheduled Patient attended all scheduled medical appointments with Navigator accompaniment. Began HCV treatment > 1 month after receiving reactive antibody test > SVR

16 Medicaid Case Study 38 year old woman, Ab+ a jail testing event Requests help with next steps Wants care at Equitas Linkage to Care Patient Navigation Program Created Care Plan at LTC jail Visit; Scheduled initial appointment Addressed Barriers: housing stability, insurance Attends initial medical appointment= Successful LTC Confirmatory RNA Testing/Tx readiness assessed Re-engaged with Primary Care/Comorbid Conditions addressed Patient attends all scheduled medical appointments with Navigator accompaniment. Currently unable to access treatment due to low fibrosis score

17 Pro Tips You Don t Know what you Don t Know Until you Know It Ability to communicate within EMR Access to skilled phlebotomists Balance Test Sites between those with high positivity and high opportunity for follow up

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19 Amanda Goodpasture Equitas Health 4400 N High St, Suite 300 Columbus, OH Ext. 333 amandagoodpasture@equitashealth.com Maria Brown Equitas Health 1222 S Patterson Blvd,. Suite 230 Dayton, OH Ext mariabrown@equitashealth.com