NORTHWEST AIDS EDUCATION AND TRAINING CENTER

Technology-Mediated Clinical Mentorship and Collaboration for HIV Brian R. Wood, MD Kent T. Unruh, PhD John D. Scott, MD, MSc.

Presentation prepared by: Kent Unruh and Brian Wood Presenter: Kent Unruh and Brian Wood Last Updated: 2/27/15

The Problem Is…

How to meet “National HIV/AIDS Strategy” goals? • in over 25% of US land mass

• with sparse access to Ryan White clinics

• in region classified as

healthcare workforce shortage area

Program Strategy is…

… to Build Capacity

• Leverage existing healthcare infrastructure (Community Health Centers)

• Identify community clinicians primed for mentorship

• Develop state-of-the-art HIV clinical training program: - Intensive weekly training sessions (146 sessions) - Longitudinal mentoring and training (30-40 providers/week) - Regional, peer-based HIV knowledge network (>100 clinicians) - Just-in-time clinical consultation (263 comprehensive consults)

…to Create a Pragmatic Training Delivery Model

Theoretical Base Situated Learning Theory Structure 1x per week VTC Clinical update Case Consultation Practical Benefits Just-in-time support Interdisciplinary Consultation CME

…to Provide a Rich, Virtual Learning Experience

…to Conduct Comprehensive Consultations

…to Perform Innovative Knowledge Assessment

…that Transforms Immediate Feedback into Teachable Moments

…to Catalyze a Robust Knowledge Network of Peers

…to Codify and Distribute Knowledge Asynchronously

What is the direct clinical impact?

Case 1

Homeless Unemployed Minimal Education

Latent TB Syphilis HIV+

Knowledge Sharing

Case 2

New immigrant Uncertain status History of viriological failure Known HIV drug resistance Provider told cannot access meds

Case 3

Active skier, mountain biker New HIV diagnosis Advanced disease Starts ART and prophylaxis New back pain Abnormal L-spine imaging