Boldly using tech and social media to change the culture in LA around HIV testing and HIV screening Sin Verguenza (without shame). English, Spanish. Health Communications. Using social media for public health. Telenovela and soap opera series educating patients about the importance of HIV testing

1. 1
Boldly Using Technology to
Implement and Change the Culture
around Routine HIV Screening Sin
Vergüenza (Without Shame)
Angel Rosario, Clinic Testing
Supervisor

2. 2
Topics
• AltaMed Health Services Corporation
• Electronic Health Record Development
• HIV Training Modules
• Sin Verguenza

3. AltaMed has delivered quality care to the underserved
communities of Southern California for more than 40
years. Designated by the Joint Commission as a Primary
Care Medical Home (PCMH), AltaMed prides itself in the
quality of its care delivered by its premier health care
professionals. AltaMed serves the entire family with:
1) primary medical care
2) dental clinics
3) senior long-term care services
4) delivers disease management programs
5) health education
6) youth services,
7) specialty HIV/AIDS care for over 20 years
8) substance abuse treatment.

5.  One of nation’s largest FQHC’s, with wrap-around IPA
 PCMH certified by TJC and NCQA
 73% earn less than $44,700/year for a family of four
 Take all insurance types; 27% have no insurance
 81% of our patients are Latino
 1,900 employees across 43 sites
 125,000 patients served; 930,000 annual visits
 140 providers, mid-level practitioners
 600 contracted specialists

6. Routine Testing Goals

7. 2006 CDC Revised
Recommendations Guidelines
For those aged
13-64:

8. Gilead Funded 2010
Los Angeles Three Pilot Sites:
•East LA Commerce
•El Monte
•Pico Rivera
8,013 patients tested at pilot sites from January 2010-September 2011
•121,310 total eligible patients seen at AltaMed (all clinic sites) from January
2010 to September 2011, representing a penetration rate of 6.6%
28 HIV positive clients were identified
24 of the 28 (86%) testing positive were male, 4 were female.
***Lab Default
The Pilot

9. A Taste of Technology
This is all fine print for the graph above:
Denominator: Patient must be 18 years old and above. Patient must not have undergone the screening in the past 12 months (1 year).
Numerator: Patient must be 18 and above that have received HIV Screening in the month selected. CPT Code: (86703, 8670392, NG083875, 19728)
Implementation of HIV Screen Lab
Default

10. • In OC, from 10/1/2011 to 12/31/2012,
11,010 HIV screens performed and a
total of 10 HIV+ individuals (newly
identified and re-identified and linked
into care)
• From 1/1/2013 to present,
• Allowed us to focus efforts on routine
screening by developing
infrastructure, visibility, and internal
support
• Develop routine screening as a
campaign
Into OC

11. What we had:

12. Internal Barriers
to Testing
• Changing the culture of AltaMed:
– Support from senior leadership
– Staff Support
• (Clinic workflows, lack of comfort with procedures)
– Staff training
– Lack of patient education on routine testing policies
– Lack of patient buy-in for routine testing

13. Using Technology:
AltaMed University
• A learning management system (LMS)
where staff gain access to training videos
for personal/professional development
and/or mandatory compliance trainings
(occupational hazards, customer service,
HIPAA, etc.)

14. Video Training Modules
Using Hollywood:

15. Mandatory Training using
AltaMed U
• Senior Leadership support for routine HIV
Screening
• All clinical staff required to complete the
entire set of HIV training by end of Q4
(October 1, 2012- December, 32, 2012)
• Over 700 clinical staff completed
modules

16. The Pop-up Alert
Streamlining Processes:
Continued EHR Development

23. Testing Alert Promotion

24. Testing Alert Promotion

25. Sin Verguenza
• Develop a culturally competent education tool to:
– Disseminate HIV Prevention messages in an innovative,
non traditional, accessible manner
– Engage communities in conversations about HIV
– Educate on CDCs recommendations for routine
screening
– Develop a script from the stories of our HIV+ patients
Increase HIV testing at our clinics

26. Sin Verguenza

28. Sin Verguenza
• Developed an
• Work with production company and casting
agency to hire REAL actors
• Release Dates:
– World AIDS Day and bi-weekly release of webisodes
on YouTube thereafter
• Worked with CSULB to develop an online survey
linked to YouTube page
• As of April 2013: 120,000 > views

29. Sin Verguenza

30. Current/Future
Projects:
• “Together We Test”
Campaign
• Preventions programs
around Sin Verguenza
• Patient Narratives
• Focus Groups
• Documentary Short

31. Contact Information
Angel Rosario
Clinic Testing Supervisor
AltaMed Health Services Corporation
arosario@altamed.org
714-500-0348