Office of Telehealth, Telemedicine, and Project ECHO, Georgia Department of Public Health, Atlanta, Georgia.
Division of Medical and Clinical Program Services, Georgia Department of Public Health, Atlanta, Georgia.
Am J Prev Med. 2021 Nov;61(5 Suppl 1):S55-S59. doi: 10.1016/j.amepre.2021.07.001.
The Southeast U.S. and Georgia in particular are disproportionally affected by HIV. A major barrier in Georgia to meeting the goals of Ending the HIV Epidemic in the U.S is lack of proximity to HIV care. To address this and other barriers, Georgia implemented a comprehensive HIV telehealth system, including telemedicine to provide remote care through clients' local medical homes. In addition, a telementoring program (Project Extension for Community Healthcare Outcomes) was initiated to strengthen the HIV provider workforce in Georgia.
A total of 60 telemedicine solutions have been deployed in Georgia, including 8 during the COVID-19 pandemic, to expand HIV care access in 12 of 18 Georgia health districts. Community providers were also able to access Project Extension for Community Healthcare Outcomes for remote training and consultation. Data were collected with CAREWare to assess HIV viral suppression among Ryan White HIV/AIDS Program Part B clients accessing telemedicine compared with Ryan that among White HIV/AIDS Program clients overall.
In all, 6,977 Ryan White HIV/AIDS Program clients were seen during 2020. Of these, 1,041 had a telehealth visit, of whom 1,035 (99.4%) were prescribed antiretroviral therapy, and 951 (91.4%) were virally suppressed. Results were comparable with those of Georgia Ryan White HIV/AIDS Program Part B clients, overall.
In Georgia, HIV telehealth has been successful at bridging gaps in patient care and in training local providers to offer comprehensive HIV care. Continuing challenges include integration of electronic health records with the telehealth platform, privacy and data security, equitable reimbursement, and lack of digital devices and Internet service access among some rural patients.
美国东南部,尤其是佐治亚州,受到艾滋病毒的不成比例影响。在佐治亚州,实现美国艾滋病毒终结流行目标的主要障碍是缺乏接近艾滋病毒护理的机会。为了解决这一问题和其他障碍,佐治亚州实施了一项综合性艾滋病毒远程医疗系统,包括远程医疗,通过客户当地的医疗服务提供远程护理。此外,启动了一个远程指导计划(社区医疗保健成果扩展项目),以加强佐治亚州的艾滋病毒提供者劳动力。
佐治亚州共部署了 60 种远程医疗解决方案,包括在 COVID-19 大流行期间部署的 8 种解决方案,以扩大 18 个佐治亚州卫生区中的 12 个地区的艾滋病毒护理机会。社区提供者还可以通过社区医疗保健成果扩展项目获得远程培训和咨询。使用 CAREWare 收集数据,以评估通过远程医疗接受治疗的 Ryan White HIV/AIDS 计划 B 客户与 Ryan White HIV/AIDS 计划总体客户的艾滋病毒病毒抑制情况。
2020 年,共有 6977 名 Ryan White HIV/AIDS 计划客户接受了治疗。其中,有 1041 人接受了远程医疗访问,其中 1035 人(99.4%)接受了抗逆转录病毒治疗,951 人(91.4%)病毒得到抑制。结果与佐治亚州 Ryan White HIV/AIDS 计划 B 客户的总体情况相当。
在佐治亚州,艾滋病毒远程医疗在弥合患者护理差距和培训当地提供者提供全面艾滋病毒护理方面取得了成功。持续存在的挑战包括将电子健康记录与远程医疗平台集成、隐私和数据安全、公平报销以及一些农村患者缺乏数字设备和互联网服务接入。