AETC Telehealth Training Centers Program Update: Technology
Best Practices Debbie Cestaro-Seifer, MS, RN Project
Coordinator
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Objectives By the end of this session, participants will be
able to: Identify three key telehealth program management
strategies that have proven helpful to the Florida/Caribbean
Telehealth Education Training Center (F/C TETC) in creating a
consistent, inter-professional, and interactive HIV learning
community. Discuss how the F/C TETC telehealth faculty and staff
use technology to create an interactive HIV learning environment
that focuses on the varying learning needs and styles of an
inter-professional and culturally diverse group of healthcare
providers.
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Expansion Telehealth Training Center Program Funding began in
2012 Deliverables 1.Develop a telehealth training program for low-
volume providers new to HIV treatment & care 2.Create a support
network and community of learning for providers new to HIV
treatment & care Project Background
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Florida/Caribbean Telehealth Education Training Center
1.Project initiation resources 2.Project initiation challenges
Project Timeline 1. Hire Project Coordinator 2. Identify available
faculty and staff 3. Determine technology equipment needs 4. Create
curriculum for new providers 5. Locate providers meeting
eligibility criteria Project Initiation
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Vision Develop an evidence- based engaging HIV- telehealth
educational curriculum that is easily accessible using short
didactics and HIV case- based learning Enroll 8-10 clinics located
within the region Project Vision/Mission Mission Clinic Eligibility
- not Ryan White funded (A & C) Provider Eligibility -low
volume providers having fewer than 25 patients in their practice
who are HIV-positive
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Clinic/Provider Identification 1.Faculty outreach/referrals
2.Florida Department of Health 3.Florida/Caribbean AIDS Education
and Training Center (F/C AETC) Local Performance sites (LPS)
Operationalizing the Mission
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Equipment Needs Webcams Headsets iPad Conference speaker phones
Internet connectivity speed Demonstration and site connection tests
Operationalizing the Mission
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1.Identify a consistent and diverse faculty representing a
variety of disciplines and geographical locations: infectious
disease, primary care, psychiatry, hepatitis, nursing, pharmacy,
medical case management 1.Schedule pre-session and post-session
session/faculty case reviews and quarterly faculty meetings
3.Provide faculty education on utilizing interactive learning
strategies to promote participant knowledge acquisition and
schedule faculty technology practice sessions Curriculum
Development: Recipe for success
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Faculty Location
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Faculty Challenges
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Case-based Learning Challenges We want more cases! Post session
evaluation surveys reported: Case discussions improved learning and
prevented providers from referring patients to HIV specialists One
clinic Medical Director requested that all of his providers
schedule themselves to present a case on a telehealth session I
really cant do it. Pre-session planning by Project Coordinator
resulted in many providers reporting: Im too busy. I dont have all
the answers yet. There is too much information needed. I dont have
the time.
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Project Challenges, Problem Solving, and Partial Solutions
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Case Presentation Form Version #1
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Case Presentation Form Instructions Version #1 1.Go to:
fctetc.org HOME page 2.Place your mouse/cursor over the
PARTICIPANTS tab (3 rd tab), then click TELEHEALTH SESSIONS 3.Once
on the TELEHEALTH SESSIONS page, click on the Case Submissions tab
(2 nd tab) 4.Then, click on the image of the form to open the PDF
case submission request form.
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Case Presentation Format #2
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Case Presentation Version #3 Patient Summary from February 18,
2015 (Session #48) 48-year-old Haitian female who originally tested
positive for HIV while living in Haiti during her first pregnancy
(2001). She delivered her baby in Florida. The baby was HIV
negative. The patient presents to our clinic with the following
health issues: 1.Elevated VL of 18, 705 copies/mL 2.Complaints of
poor sleeping due to dreams dizziness flu-like symptoms
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Open-ended Discussion Questions for Session #48 1.What are the
important medical issues to address during this patient visit?
2.What psychosocial concerns do providers have for this patient?
3.What changes, if any, would you make to this patients ARV regimen
based on the objective and subjective findings? 4.Epilogue: So What
Happened? Medical, Nursing and Case Management Follow-up 5.What
further advice, comments or questions do participants have about
this patients treatment and care? Case Presentation Version #3
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Provider Engagement Strategies
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Provider Engagement Process 1.Introductory telephone calls and
emails 2.Clinic Site Assessments (pre-visit or on site) 3.Clinic
visits with administrators, healthcare providers and clinic staff
4.Demonstration of technology 5.Provider Learning Needs
Assessments-all disciplines Strategies to Promote Clinic/Provider
Participation
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Provider Engagement Process 6. Agreement of Collaboration and
Commitment 7. Ongoing communication via email and phone calls 8.
Creating a learning environment where providers and their
healthcare teams feel welcome and important 9. Identification of
special provider and staff learning needs, and patient needs 10.
Faculty availability for case discussions between sessions and
additional training as requested Strategies to Promote
Clinic/Provider Participation
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Letter of Agreement of Collaboration and Commitment
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F/C TETC Provider/Clinic Locations Florida Clinics U.S. Virgin
Island Clinics
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Utilizing Technology to Teach and Actively Engage Telehealth
Participants
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Welcoming and Engaging
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Types of questions: True/False Multiple Choice Short Answer The
Continuum of Polling Questions Timing/Placement of questions: In
the beginning of a session On demand Preplanned during a case
discussion or during a didactic
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Pre-didactic Polling Question Session #49 Adolescents
Transition to Adult HIV Care What are the challenges for
providers
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1.A Coordinator is paramount for clinic/provider linkage and
engagement 2.Obtain formal buy-in from administrators 3.Welcome
providers and clinics to each session making introductions of new
members 4.Utilize the short didactic and case learning format
5.Create a cohesive inter-professional faculty that mentors all
participants on each session and between sessions 6.Use technology
to its fullest! Summary Lessons Learned
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Your Questions
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For questions or more information please contact: Debbie
Cestaro-Seifer, RN, MS [email protected] 239-677-8011 Speaker
Information
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N ORTHWEST A IDS E DUCATION AND T RAINING C ENTER NW AETC ECHO
Natalia Martnez Paz, MA, MPA Program Manager, NW AETC ECHO
University of Washington Last Updated: 6/1/15
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Structure
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Structure- Clinical Team and Theoretical Model Infectious
Disease Pharmacy Psychiatry & Addictions Social Work Community
Clinician Nursing Theoretical Base Situated Learning Theory Force
Multiplier Effect Structure 1x per week VTC Clinical update Case
Discussion Practical Benefits Just-in-time support
Interdisciplinary Consultation
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Clinical Update 45 30 1 15
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Discussion and Case Consultation 1 30 4515 Spokane, WA Eugene,
OR Springfield, OR Pocatello, ID Vancouver, WA Medford, OR
Corvallis, OR Bozeman, MT Missoula, MT Vancouver, WA Anchorage, AK
Boise, ID
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Case Presentations
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Technology
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Zoom Technology
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Zoom System
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Alternate View
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Participation Presentation View
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UW Faculty View
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Interactive Polling
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All Clinical Updates Made Freely Available on Web Goal:
Establish Channel for HIV Knowledge
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Proprietary Processing System
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Stitching together the audio and powerpoint
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Remote presenters
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Interactive presentations
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YouTube Cross-Posting
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Lessons Learned
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Meeting a Professional Need Shift to teams in interactive
learning environment engaged in collaborative problem solving over
time ECHO = mentoring, not consultations
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Horizontal knowledge transfer Infectious Disease Pharmacy
Psychiatry & Addictions Social Work Community Clinicians
Nursing Pocatello Missoula Corvallis Billings
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Site Visits Goal: Build Relationships with Participants - The
importance of the face-to-face visit - Obtain baseline assessment
information - Assess clinic workflow and technology - Case review
in clinicians own environment - Meeting administrators helps to
encourage buy-in Slide courtesy of Drs. Brian Wood, Kent Unruh,
Christian Ramers
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Slide courtesy of Drs. Brian Wood and Kent Unruh Pre-existing
ECHO expertise jumpstarted launch Site visits essential Clinicians
in target group under enormous time pressures ECHO is a
full-service program Case consultation & 24/7 backup Clinical
skill building Knowledge dissemination Clinical mentorship Building
and expanding HIV capacity The overall goal: capacity building
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Questions?
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Contact Any questions about the presentation: Natalia
Martinez-Paz: [email protected]@uw.edu Deborah Cestaro-Seifer:
[email protected]@usf.edu