Medical AIDS Outreach of Montgomery - Sandra Percival


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Medical AIDS Outreach of Montgomery - Sandra Percival

  1. 1. Seeing Solutions: Telemedicine as a Means to Dissolve the Barriers to Care Faced by Consumers Living with HIV/AIDS Throughout Rural Alabama Sandra Percival Program Director, Telemedicine
  2. 2. Medical AIDS Outreach of Alabama (MAO) Mission Statement: Medical AIDS Outreach of Alabama provides community prevention education, quality services and compassionate care to those infected and/or affected by HIV/AIDS. Services provided include: social services, medical treatment, medication assistance, pharmacist consultations, mental health counseling, patient education, prevention education, HIV testing, food bank services and interpretation services for Spanish- language and hearing impaired communities.
  3. 3. Barriers to Care • Increasing number of HIV diagnoses • Poverty • Health Professional Shortage Areas • Stigma
  4. 4. Rates of Individuals Living with an HIV Diagnosis in Alabama • At the end of 2012, a total of 11,936 individuals were known to be living with HIV in Alabama. Of these individuals, 4,869 (41%) had progressed to the AIDS diagnosis. *HIV diagnosis per 100,000 population • It is estimated that an additional 2,000 to 4,000 individuals are living with HIV but unaware of their status.
  5. 5. Recent Trends: 2008 to 2012 The number of people living with HIV/AIDS in Alabama has increased 21% from 2008 to 2012.
  6. 6. Demographics Although only 26% of the state’s population is Black/African-American, 68% of newly diagnosed HIV cases and 65% of all persons living with HIV in Alabama were African-American/Black in 2012
  7. 7. Poverty Rates in Alabama Lauderdale Limestone Madison Out of Alabama’s 67 counties… Jackson Colbert Lawrence Franklin Marshall Cullman Marion • 46 counties have poverty rates that are higher than the national average. DeKalb Morgan Cherokee Winston Etowah • 23 counties have poverty rates above 20%. Blount Lamar Fayette Walker Calhoun St. Clair • 5 counties have poverty rates above 30%. Cleburne Jefferson Talladega Tuscaloosa Pickens Shelby Bibb Greene Chilton Randolph Clay Tallapoosa Chambers Coosa Hale Perry Sumter Elmore Lee Autauga Macon Dallas Montgomery Russell Marengo Choctaw Choctaw Bullock Lowndes Wilcox Barbour Clarke Butler Monroe Crenshaw Pike Henry Washington Dale Conecuh Escambia Coffee Covington Geneva Baldwin Mobile <10% 10-14.9% 15-19.9% 20-29.9% >30% •Wilcox County has the highest poverty rate in Alabama, with 38.5% of its population living below the poverty line. Houston • According to the US Census Bureau, the average household income in Alabama is less than 200% of the federal poverty definition. •Fully 17.1% (or roughly 1 out of every 6 of Alabama’s 4.8M residents) live below the federal poverty line
  8. 8. Health Professional Shortage Areas (HPSA) Lauderdale Limestone Madison • 62 of Alabama’s 67 counties are, either partially or whole, Health Professional Shortage Areas. Jackson Colbert Lawrence Franklin DeKalb Morgan Marshall Cullman Marion Winston Cherokee Etowah Blount Lamar Fayette Walker Calhoun St. Clair Cleburne Jefferson Talladega Randolph Tuscaloosa Pickens Shelby Bibb Chilton Greene Clay Coosa Tallapoosa Chambers Hale Perry Elmore Sumter Lee Autauga Macon Dallas Montgomery Russell Marengo Bullock Lowndes Wilcox Choctaw Barbour Clarke Butler Monroe Crenshaw Pike Henry Washington Escambia Baldwin Mobile Dale Conecuh Coffee Covington Geneva • For a general population of 4.8M there are only 57 ID Docs (most of whom are tasked to institutions) and approximately 5 AAHIVM credentialed physicians (voluntary). Houston Contains areas that are designated as HPSAs Entire County is designated as a HPSA
  9. 9. What is Telemedicine? •Telemedicine is a video chat environment between a doctor and a patient •High definition camera and video screen with 1080p capability •Bluetooth peripheral equipment •100% secure: telemedicine uses 128 bit encryption – twice the level of encryption used by the DOD •Transcends almost all of the barriers most PLWH/A face in accessing care Photo courtesy of David Kohn, Washington Post
  10. 10. Telemedicine - Beginning MAO created “spoke” telemedicine clinics in Selma, Sipsey, and Florence, Alabama, with corresponding “hubs" in Montgomery, Tuscaloosa, and Huntsville, Alabama. Using encrypted, high-speed data connections, spoke-site RN support, and high-definition video/diagnostic tools, our interdisciplinary hub-site providers are able to hold real-time encounters more frequently and more consistently, increasing both access to care and the fullness of care available to our rural HIV patients.
  11. 11. Telemedicine - Today Linking the hubs and beyond…… MAO expansion to Troy, Clayton and the Wiregrass area with a hub in Dothan
  12. 12. Outcomes Results of our work so far: • Retention rate of 92% per survey data •Positive response by consumers to the use of Telemedicine in their care • At their initial telemedicine appointment, patients are asked to rate their health • 74.49% of patients rated their health as excellent, very good, or good at that first interview. • After six months of telemedicine care, that number rose to 81.82% • After twelve months in the program, all 100% of telemed patients rated their health as excellent, very good, or good!
  13. 13. Contact Information Sandra Percival Program Director, Telemedicine and Distance Learning Initiatives MAO of Alabama, Inc. 2900 McGehee Road Montgomery Alabama 36111 334-280-3349 or 334-386-0857 Email: