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VCUHS TELEMEDICINE

VCUHS TELEMEDICINE. Caring for Inmates with HIV/AIDS. Jane Settle, FNP, MS, RN. Infectious Disease Clinic VCUHS. TOPICS. Technology of Telemedicine VCUHS Telemedicine Program Values and Limits of Telemedicine HIV Care for DOC Inmates Follow up Care. EQUIPMENT.

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VCUHS TELEMEDICINE

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  1. VCUHS TELEMEDICINE Caring for Inmates with HIV/AIDS

  2. Jane Settle, FNP, MS, RN Infectious Disease Clinic VCUHS

  3. TOPICS • Technology of Telemedicine • VCUHS Telemedicine Program • Values and Limits of Telemedicine • HIV Care for DOC Inmates • Follow up Care

  4. EQUIPMENT • Videoconferencing System • Hand held camera • Stethoscope • Computer terminal

  5. VCUHS Telemedicine network sites • Virginia Department of Corrections sites: • Augusta CC • Bland CC • Brunswick CC • Buckingham CC • Coffeewood CC • Deerfield CC • Dillwyn CC • Fluvana CC • Green Rock CC • Greensville CC • Haynesville CC • Indian Creek CC • Keen Mountain CC • Lawrenceville CC • Lunenburg CC • Marion CC • Mecklenburg CC • Nottoway CC • Pocahontas CC • Powhattan CC • Red Onion state prison • St. Brides CC • Sussex I state prison • Sussex II state prison • Wallenridge state prison • Virginia Correctional Center for Women • Outreach Program sites: • Rappahannock General Hospital • Riverside Tappahannock Hospital • Outpatient Telemedicine Clinic in Tappahannock • South Hill Community Memorial Health Center • Virginia Center for Behavioral Rehabilitation • Three Rivers Health District • Bay Aging at Colonial Beach

  6. Value of Telemedicine • Decreased travel • Decreased security issues • Cost effective • Access to specialty care • Regular interaction with nursing and medical staff who are providing primary care • Immediate problem solving

  7. Limitations • Difficult to visualize fine detail • Dependent on the skills of the person assisting with exam and presenting information • May see less than whole “picture”

  8. HIV Care • All inmates in DOC identified with HIV • Serve about 450 inmates • New patient or follow up care • More than consultant care – we prescribe HART and order labs (done through VCUHS) • Direct the treatment of HIV related symptoms and infections • Make recommendations as appropriate

  9. Themes • Clinical care • Immunizations • Diet and exercise • HIV education and prevention • Life issues – substance abuse, mental health, education, job skills, family issues

  10. Follow up Care • Planning for release • Medical needs – HIV and other • Seamless transition program • Housing and social support • Substance abuse and mental health issues • Virginia Center for Behavioral Rehabilitation

  11. Bridge Program • Need for improved psychosocial assessment in order to better understand behaviors • Goal (long term) to identify or design services to help individuals engage in medical care and access social support. • Target recently released inmates for detailed assessment and getting neuropsych testing done if needed

  12. Results of Neuropsych Testing • History of head injuries • Dementia • PTSD • ADHD • Depression • Anxiety • Social isolation

  13. Client Needs • Navigating social/financial systems • Mental health and SA services • Ongoing care for non-HIV related medical problems • Life skills • Financial assistance

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