Reciprocal Innovation – Improving the Delivery of Complex Care to HIV Positive Patients through Guided Practice using the HIV AMPATH Tele-ECHO Platform2020-08-11T12:39:30-04:00

Improving the Delivery of Complex Care to HIV Positive Patients through Guided Practice using the HIV AMPATH Tele-ECHO Platform

Principal Investigator Adrian Gardner MD, MPH
International Collaborator(s)
Project Title Improving the Delivery of Complex Care to HIV Positive Patients through Guided Practice using the HIV AMPATH Tele-ECHO Platform
Priority Area Chronic disease
The Intervention The objective of this study is to understand the feasibility and effectiveness of implementing the Project ECHO® ‘s teleECHO clinic training model within the AMPATH network to improve the capacity of non-physician clinicians to manage patients on advanced ART regimens. The Extension for Community Healthcare Outcomes (ECHO) model™ was developed to improve access to complex chronic disease and specialty care in rural and underserved communities around the world. Project ECHO® (abbreviated ‘ECHO’) has successfully applied the inter- disciplinary expertise of specialty clinicians to the growing public health problems in treating hepatitis C virus and other chronic, complex diseases. TeleECHO participants not only gain expertise in disease management and treatment, they also come to rely on each other for expertise and support and develop a community of practice. The ECHO model is accessible and proven to be successful in HUBs across the world. Access to this type of education can be implemented in rural settings throughout the world, as well as the US.
Key Facilitators This intervention is being piloted in Kenya with support of the public health system run by the Kenyan Ministry of Health. The Indiana CTSI is developing a program focused on reciprocal innovation that seeks to support the indentification, adaptation, implementation, and evaluation of promising interventions developed at LMIC partner sites for use in Indiana. This infrastructure provides funding and other resources to adapt interventions to a US context. Additional support includes AMPATH-affiliated HIV clinics in collaboration with Indiana University and Moi Teaching and Referral Hospital in Kenya.
Target Population The intervention targets COs who are directly involved in the clinical care and management of HIV-infected patients at AMPATH sites will be surveyed to determine the effectiveness of the intervention, adult and child patients on advanced ART regimens will be retrospectively reviewed in AMRS to determine the proportions with viral non-suppression, and a diverse cadre of HIV care providers (clinical officers, nurses, social workers, nutritionist, and peer counselors).
Process to Implementation This project utilizes a 2×2 crossover design to implement an HIV-focused ECHO training curriculum across two matched groups of 12 AMPATH clinics each. In so doing, all major AMPATH sites will receive the intervention with the primary difference being the timing of when sites receive it.
Key Stakeholders Stakeholders include Indiana University and Moi University researchers and clinicians. We anticipate in transferring to the US that there would need to be similar stakeholders that would need to be engaged.
Scaled or Transferred? This intervention was scaled from the US setting, including Indiana, to sub-Saharan Africa
Type of Research Implementation science was utilized. TeleECHO clinics provides a guided practice model where primary care clinicians retain responsibility for managing the patient, operating with increasing independence as their skills and self-efficacy grow. Learning from providers practicing in similar settings and with similar barriers is facilitated by shared case management discussion and decision-making.
Published Materials The intervention has been proven successful and an abstract has been submitted to the AIDS 2020 conference
Year Funded

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