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June E-learn Call Telehealth Project Update Deborah Cestaro-Seifer (Florida/Caribbean AETC) Natalia Martinez-Paz (Northwest AETC)

June E-learn Call Telehealth Project Update Deborah Cestaro-Seifer (Florida/Caribbean AETC) Natalia Martinez-Paz (Northwest AETC)

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  • June E-learn Call Telehealth Project Update Deborah Cestaro-Seifer (Florida/Caribbean AETC) Natalia Martinez-Paz (Northwest AETC)
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  • 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
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  • Next Call TBD (likely in August 2015)