Telehealth AETC Appalachian Project (TAAP) Brochure

Goals of the Telehealth AETC Appalachian Project (TAAP)

• Expand capacity to address HIV, hepatitis and related issues in your client population at your clinic
  
  
• Deliver case-based educational consultation regarding specific patients or clinical issues
  
  
• Provide access to distance-based education for physicians, nurses, and other clinic staff
  
  
• Increase clinical team building, interprofessional dialogue and clinical decision making
  
  
• Enhance information on resources for persons with HIV, hepatitis and related conditions
  
  
• Disseminate information on the Affordable Care Act  and other issues that effect care

Membership in the TAAP Network of Community of Practice

Membership is exclusively for community health centers and hospitals in the Appalachian region of the US.  The focus of this educational intervention is to enhance service delivery for patients served by clinical teams in these specific health care settings.  

The project also aims to assist in expanding the capacity of clinicians and to enhance continuous quality improvement for persons with HIV, hepatitis and related conditions.


Focus of Educational Intervention

• Web-based 1 hour training targeted to physicians, nurses and other health care team members as a group or discipline specific.
• Web-based case based educational consultation on specific patients or clinical issues provided by a regional TAAP clinician in collaboration with the CHC.
• Web-based technical assistance on clinical, administrative, or health system issues or challenges.
• Periodic or as needed in-person educational training or consultation for specific issues tailored to the needs of the clinic.

Process for Increasing Comprehensive Care for Persons with HIV, Hepatitis and Related Conditions

The Telehealth Appalachian AETC Program (TAAP) is a healthcare educational training and consultation program developed to support healthcare providers in rural and underserved areas of Appalachia by linking them to treatment specialists. 

This program utilizes technology as a medium for specialists to provide case presentations, person-to-person consultations, needs-based didactic trainings and published resource materials to member providers.

The Health Resources and Services Administration (HRSA) supports this program to expand access to and improve healthcare and health outcomes for hard-to-reach, HIV-positive persons in medical care residing in rural areas within Appalachia.

The efforts of TAAP will enhance the capacity of clinicians and other members of the treatment team from other disciplines to provide quality HIV testing and treatment, and reduce professional isolation by enhancing co-management of treatment and care.

Topics for Educational Training and Consultation

• Acute HIV Infection:  signs, symptoms, intervention
  
  
• Cardiovascular: coronary artery disease, lipid disorders
  
  
• Dermal: fungal infections, seborrheic dermatitis
  
  
• Oral: thrush, aphthous ulcers, candidiasis, oral hairy leukoplakia
  
  
• Endocrine: diabetes II, hyper/hypoglycemia, lactic acidosis
  
  
• Exposure Prophylaxis: occupational and non-occupational exposure pre-exposure prophylaxis
  
  
• Gastrointestinal: diarrheal presentations
  
  
• Hemotologicical: anemia, eosinophilia, neutropenia, thrombocytopenia
  
  
• Musculoskeletal: osteopenia, HIV/NRTI related myopathy
  
  
• Medications: antiretroviral treatment, side effects, resistance testing
  
  
• Neurological: HIV-Associated/AIDS Dementia, neuropathy
  
  
• Oncologic: cervical dysplasia, Kaposi’s Sarcoma, leukemia, non-Hodgkin’s Lymphoma, rectal cancer
  
  
• Opportunistic Infections: candidiasis, cryptocococcal meningitis, Mycobacterium avium complex (MAC) Tuberculosis, Toxoplasmosis
  
  
• Pregnancy: initiation of ARV Therapy, ART in labor and delivery, breastfeeding
  
  
• Psychiatric: depression, anxiety, substance use & abuse
  
  
• Pulmonary/Respiratory: HIV/AIDS related pneumonia
  
  
• Renal: HIV associated nephropathy, ART related, renal failure
  
  
• Sexually transmitted infections: chlamydia, gonorrhea, syphilis, hepatitis A, B, C, human papillomavirus (HPV), herpes simplex
  
  
• Testing:  HIV, Hepatitis, current related laws

 
Process for Continued Involvement in TAAP

Although these are listed in a stepwise progression, variation in implementation may occur based upon need. 

• Step 1:  Site Visits
  
  These initial session(s) are aimed at learning about the specific patients served at your site and the educational needs of the staff. A needs assessment is conducted at this time which may include specific forms and interviews with key administrators, staff, and clinicians.
  
  
• Step 2:  Plan Developed
  
  An educational plan to provide educational training and consultation tailored to your clinic will be jointly developed by the clinic/hospital and TAAP staff and faculty. This may involve several site visits to complete this process.
  
  
• Step 3:  Agreement to Proceed
  
  Once we have jointly approved a plan, a memorandum of understanding will be developed that will be signed by appropriate officials at your site.
  
  
• Step 4:  Technology Assessment
  
  This session conducted by the TAAP technology expert will review your current needs for computers, software, and other resources necessary for the clinical team to participate. If needed, technical resources will be provided. 
  
  
• Step 5:  Identification of a CHC Coordinator
  
  In order to have a smooth and coordinated flow of information, we ask that the CHC/hospital identify an individual who will be the point of contact for the project.  
  
  In some cases, there may be more than one depending on the structure and needs of the clinic. A list of contact persons from TAAP will be provided to assure that communication is efficient.
  
  
• Step 6:  Initial and Periodic On-Site Training
  
  In order for the clinicians and other staff to become engage in the learning process, an on-site training may be offered initially and intermittently. This will achieve a number of objectives such as obtaining ongoing assessment of need, reactions to previous training, and the identification of new issues for consideration. 
  
  
• Step 7:  Begin Web-based Training
  
  Participating in webinars allows participants to increase their knowledge on a range of issues facing Appalachian health care settings including assessment, screening, prevention and treatment. This is supported with on-line access to the latest information available on the TAAP web portal. 
  
  
• Step 8:  Case-Based Discussion Session
  
  Via web, we will facilitate discussion on specific cases that we develop or that are provided by clinicians from your CHC or hospital.  
  
  The current relevant clinical standards, guidelines and competencies will be utilized to guide the discussion.
  
  
• Step 9:  On-Demand Consultation
  
  As the need arises, clinics/hospital involved in the TAAP network can obtain “on-demand” educational consultation and technical assistance as the need arises. This will be facilitated through requests from the CHC coordinator to the TAAP education coordinator who will arrange for the session to be scheduled based on the needs of the clinic.
  
  
• Step 10:  Community of Practice Dialogues
  
  One of the long-term goals is to enhance the collaboration between clinicians, administrators, and other team members within clinics and between similar clinics within the Appalachian region to increase communication, share best practices, knowledge of community resources. 
  
  
• Step 11:  Participation in Ongoing Evaluation
  
  Our HRSA funders are interested in learning best practices, successes, and challenges of this model to increase clinical capacity.   The TAAP staff obtain ongoing feedback and evaluation of the approach, specific intervention and outcomes of the program based upon your experiences.