How to Improve the Multidisciplinary HIV Care Model
How to Improve the Multidisciplinary HIV Care Model
Editor's Note: The multidisciplinary team approach to HIV care is widely seen as the ideal management strategy, but putting it into practice can be challenging. This issue was one of many topics discussed during sessions at the 8th International Conference on HIV Treatment and Prevention Adherence, held in June 2013 in Miami, Florida.
In an interview with Medscape, Michael A. Horberg, MD, Director of HIV/AIDS at Kaiser Permanente and Executive Director of Research and Community Benefit at Mid-Atlantic Permanente Medical Group in Rockville, Maryland, reviewed some of the key points raised during these discussions and looked at how clinicians across all specialties and disciplines might work together to improve outcomes for their HIV-positive patients.
Medscape: You participated in a panel discussion at the conference that focused on the role that different providers across different specialties can contribute to effective care of people living with HIV. Why is this such an important issue in HIV care?
Dr. Horberg: We have strived really hard in this country through various programs, such as private institutions, the Ryan White Care Program, and other settings, to develop systems for delivering high-quality care across the HIV care cascade. As large-scale health systems expand with the implementation of the Affordable Care Act (ACA), the challenge will be how to handle the ever-increasing influx of people needing care -- including those in primary care who need HIV testing, as well as HIV-positive patients who are newly diagnosed or who may have fallen out of care and are now reengaging in care.
How do we transfer these patients to a more primary care model? What level of involvement should an experienced HIV clinician have? Even if we are to shift more toward primary care, we need to ensure that we maintain our emphasis on quality and that our quality benchmarks are not lowered. So it's important that we not overlook the role of the experienced HIV physician within the overall HIV care team, and the experienced physician could probably serve as the leader of the care team.
For primary care physicians, the key focus will be on testing for HIV infection. Every patient visit is an opportunity to talk about safer sex and HIV risk, and to test for HIV infection as appropriate. If a patient has already been diagnosed as HIV-positive and the primary care physician is not completely comfortable providing the care, then he or she should have a referral system in place that transfers care to an experienced HIV clinician.
Keeping up to date is really critical. This is still a relatively young field of medicine, and there is new science and new clinically important data coming out all the time. Clinicians across all disciplines need to understand what is involved in treating an HIV-positive patient, and they need to know how to communicate to their patients how to keep themselves and their intimate contacts healthy.
Editor's Note: The multidisciplinary team approach to HIV care is widely seen as the ideal management strategy, but putting it into practice can be challenging. This issue was one of many topics discussed during sessions at the 8th International Conference on HIV Treatment and Prevention Adherence, held in June 2013 in Miami, Florida.
In an interview with Medscape, Michael A. Horberg, MD, Director of HIV/AIDS at Kaiser Permanente and Executive Director of Research and Community Benefit at Mid-Atlantic Permanente Medical Group in Rockville, Maryland, reviewed some of the key points raised during these discussions and looked at how clinicians across all specialties and disciplines might work together to improve outcomes for their HIV-positive patients.
Medscape: You participated in a panel discussion at the conference that focused on the role that different providers across different specialties can contribute to effective care of people living with HIV. Why is this such an important issue in HIV care?
Dr. Horberg: We have strived really hard in this country through various programs, such as private institutions, the Ryan White Care Program, and other settings, to develop systems for delivering high-quality care across the HIV care cascade. As large-scale health systems expand with the implementation of the Affordable Care Act (ACA), the challenge will be how to handle the ever-increasing influx of people needing care -- including those in primary care who need HIV testing, as well as HIV-positive patients who are newly diagnosed or who may have fallen out of care and are now reengaging in care.
How do we transfer these patients to a more primary care model? What level of involvement should an experienced HIV clinician have? Even if we are to shift more toward primary care, we need to ensure that we maintain our emphasis on quality and that our quality benchmarks are not lowered. So it's important that we not overlook the role of the experienced HIV physician within the overall HIV care team, and the experienced physician could probably serve as the leader of the care team.
For primary care physicians, the key focus will be on testing for HIV infection. Every patient visit is an opportunity to talk about safer sex and HIV risk, and to test for HIV infection as appropriate. If a patient has already been diagnosed as HIV-positive and the primary care physician is not completely comfortable providing the care, then he or she should have a referral system in place that transfers care to an experienced HIV clinician.
Keeping up to date is really critical. This is still a relatively young field of medicine, and there is new science and new clinically important data coming out all the time. Clinicians across all disciplines need to understand what is involved in treating an HIV-positive patient, and they need to know how to communicate to their patients how to keep themselves and their intimate contacts healthy.
Source...