Mixed-Methods Evaluation of a Telehealth Collaborative Care Program for Persons with HIV Infection in a Rural Setting

Geographic Access and Use of Infectious Diseases Specialty and General Primary Care Services by Veterans With HIV Infection: Implications for Telehealth and Shared Care Programs

“…Shared care relationships, with incorporation of HIV specialty care via telehealth, can provide accessible and comprehensive care for persons with HIV who live far from HIV specialty clinics . We have recently piloted a collaborative care program in VA that integrates HIV specialty care delivered by telehealth with primary care delivered by generalist health care teams in clinics serving rural areas . Our experience indicates that patient concerns over privacy and HIV stigma related to care in local primary care clinics can be overcome, and that satisfaction with “shared care” relationships of this sort is high.…”

Integration of Telehealth Services in the Healthcare System: With Emphasis on the Experience of Patients Living with HIV

“…The feasibility of implementing telehealth collaborative approach in a rural setting within the VA was established through this study; however, the generalizability of the results outside the VA healthcare system is uncertain. The study was also limited by the small sample size and did not measure HIV care outcomes 44. A study evaluating the implementation of the ECHO model of telehealth for the care of veterans with HIV showed limited uptake of HIV ECHO telemedicine programs.…”

The Continuum of HIV Care in Rural Communities in the United States and Canada: What Is Known and Future Research Directions

“…Telehealth encompasses a wide range of technologies and models, and is defined by the US Health Resources and Services Administration (HRSA) as “The use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration.” 96 Small studies in the United States suggest that interactive video visits allow HIV specialists to deliver care in remote settings, such as nonurban clinics and prisons, with high levels of patient satisfaction, acceptability, and care quality. 97–99 A pilot study in the VHA demonstrated the feasibility of a telehealth collaborative care model that combined HIV specialty care delivered using telehealth with primary care delivered in nonurban clinics. 97 A separate VA study showed that a telemedicine clinic was associated with reduction in missed clinic visits for patients with HIV infection, suggesting that telehealth may improve retention in HIV care in nonurban settings.…”

“…97–99 A pilot study in the VHA demonstrated the feasibility of a telehealth collaborative care model that combined HIV specialty care delivered using telehealth with primary care delivered in nonurban clinics. 97 A separate VA study showed that a telemedicine clinic was associated with reduction in missed clinic visits for patients with HIV infection, suggesting that telehealth may improve retention in HIV care in nonurban settings. 97 , 99 Studies evaluating the effect of telehealth models have found similar or even improved HIV and quality-of-life–related outcomes between individuals receiving telehealth HIV care and conventional HIV care.…”

“…97 A separate VA study showed that a telemedicine clinic was associated with reduction in missed clinic visits for patients with HIV infection, suggesting that telehealth may improve retention in HIV care in nonurban settings. 97 , 99 Studies evaluating the effect of telehealth models have found similar or even improved HIV and quality-of-life–related outcomes between individuals receiving telehealth HIV care and conventional HIV care. 100–102 …”