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Provider Education and Training

Collaborative models of provider education show promise in connecting rural, low-volume HIV/AIDS providers and clinics. Patient care teams may be comprised of a diverse set of HIV/AIDS clinicians with different backgrounds and expertise.

Modeled after Project ECHO®, the Mountain West AIDS Education and Training Center (formerly the Northwest AIDS Education and Training Center) Project ECHO hosts weekly video conferences between HIV experts and healthcare providers in underserved areas. These interactive sessions provide an open forum for rural HIV/AIDS providers to gain clinical expertise, discuss complex cases, and receive recommendations in real time from expert faculty and their peers across the region.

Other AIDS Education and Training Center (AETC) interventions train primary care physicians in rural areas to care for people with HIV/AIDS, particularly when infectious disease physicians are not available. The AETC program is the training component of the Ryan White HIV/AIDS program. HIV/AIDS care providers, including primary care physicians, nurse practitioners, and physician assistants, can receive free clinical consultation, capacity building, and technical assistance training from the AETC's network of local and regional partners.

Examples of Rural Provider Education and Capacity Building Programs:

  • Project ECHO at the University of New Mexico is a telehealth-based education and training network that links HIV/AIDS expert specialists with primary care providers in local communities to enable knowledge sharing. As a result of this network, practitioners in geographically isolated rural areas can tap into a wider knowledge base to obtain specialized education and resources that they need to serve their community. Project ECHO hosts weekly video conference sessions for providers to participate in.
  • The Mountain West AETC ECHO Project is modeled off of the University of New Mexico's Project ECHO to build a network of content experts to share information on HIV/AIDS care and to build capacity for HIV care in underserved areas. Targeting clinics in rural and medically underserved areas in the Mountain West, the program provides high-quality HIV training to providers who then care for patients in their own communities. In weekly online sessions, HIV experts present 15-minute clinical didactics on HIV related topics and provide in-depth case consultations. When joining the program, clinics receive the appropriate equipment, such as a camera or microphone. A site visit may also be planned in order to better serve and address the needs of the clinic. Program participants are asked to attend at least two sessions per month. Clinical didactics are available online to the public. Additional resources are distributed on a weekly basis via email.
  • Southern Central AIDS Education Telehealth Training Center (SCAETTC), through the University of Kentucky, offers online and archived training materials and activities to educate primary care providers about treating HIV/AIDS patients in their community. Primary and family care providers as well as nurse practitioners and physician assistants who treat patients with HIV/AIDS meet twice per month for educational presentations and interactive telehealth sessions either using iPads or videoconferencing locations through a program called Kentucky TeleCare.
  • The Telehealth and Collaborative Practice Pilot Project is a telehealth program through the HIV Alliance that aims to improve access to care for people living with HIV/AIDS in rural Oregon. The program utilizes collaborative practice agreements that allow pharmacists at HIV Alliance to work with specialists or other providers and to work more directly with patients to monitor their treatment progress. The program provides patients with more direct and continuous access to trained pharmacists who can monitor their care through specially designed software that is installed on tablets or computers.

Considerations for Implementation

Collaborative models have the potential to build teams of providers caring for patients through a peer network. There are several considerations for building provider networks, such as the importance of having the right balance of staff and having the required technology and technology support. Using technology for provider education and training purposes requires access to specific resources that can be a barrier in smaller clinics and more remote rural communities. For example, broadband internet connections in some areas of the country may not be sufficient to allow for real-time presentations and telehealth sessions without interruptions and potential issues with quality of the images.

While the Project ECHO® model and adaptations of this model show promise for advancing care and bringing HIV/AIDS specialty care to more rural areas of the U.S., there are several considerations for implementation. Since the model allows providers in rural clinics to team up with urban providers to learn and share case studies, relationship-building and partnerships are an essential component of this model. Clinics that wish to participate in Project ECHO or an adaptation of the program need to apply to become a site, and providers need to attend a certain number of required sessions each month to continue participation. Since every clinical location is different and may see a different patient population, settings implementing the program will need to be able to adapt their training programs to the community as well as the backgrounds and needs of different providers. Flexibility during implementation is essential and programs will need to be able to adapt to changing needs of the care team. In addition, acquiring the right staff, sufficient expertise, and funding are all important components of a successful program.

Resources to Learn More

AIDS Education and Training Center Program (AETC)
Describes the role of AETC programs around the country and includes a variety of links to resources on HIV related services, data on HIV/AIDS impact, and updates from the Ryan White Community.

HRSA’s Ryan White HIV/AIDS Program Center for Quality Improvement and Innovation (CQII)
Resources on innovations in HIV care, specifically those coming out of the Ryan White Community. Recent updates and technical assistance are available.

TARGETHIV: Tools for HRSA’s Ryan White HIV/AIDS Program
A compilation of resources from across the Ryan White Community on HIV/AIDS programs implemented around the country. Includes recorded and upcoming webinars, guides, and news for community HIV/AIDS programs.
Organization(s): Target Center: Tools for the Ryan White Community