VCUHS TELEMEDICINECaring for Inmates with HIV/AIDS

Jane Settle, FNP, MS, RNInfectious Disease Clinic

VCUHS

TOPICSTechnology of TelemedicineVCUHS Telemedicine ProgramValues and Limits of TelemedicineHIV Care for DOC InmatesFollow up Care

EQUIPMENTVideoconferencing SystemHand held cameraStethoscopeComputer terminal

Monitor

Multi-functionprinter/fax/scanner

PC Workstation

PC Workstation

Multi-functionprinter/fax/scanner

Monitor

Switch Switch

ATM/ VPN Link

POTS

DOC Remote site VCUHS Telemedicine center

e Stethoscope

Handheld Camera

e Stethoscope

Polycom

Polycom

VCU Medical Center

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

Value of TelemedicineDecreased travelDecreased security issuesCost effectiveAccess to specialty careRegular interaction with nursing and medical

staff who are providing primary careImmediate problem solving

LimitationsDifficult to visualize fine detailDependent on the skills of the person

assisting with exam and presenting information

May see less than whole “picture”

HIV CareAll inmates in DOC identified with HIVServe about 450 inmatesNew patient or follow up careMore than consultant care – we prescribe

HART and order labs (done through VCUHS)Direct the treatment of HIV related

symptoms and infectionsMake recommendations as appropriate

ThemesClinical careImmunizationsDiet and exerciseHIV education and preventionLife issues – substance abuse, mental health,

education, job skills, family issues

Follow up CarePlanning for releaseMedical needs – HIV and otherSeamless transition programHousing and social supportSubstance abuse and mental health issuesVirginia Center for Behavioral Rehabilitation

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

Results of Neuropsych TestingHistory of head injuriesDementiaPTSDADHDDepressionAnxietySocial isolation

Client NeedsNavigating social/financial systemsMental health and SA servicesOngoing care for non-HIV related medical

problemsLife skillsFinancial assistance