Christian B. Ramers, MD, MPH
Assistant Professor / Clinical Advisor
Departments of Medicine (Infectious Diseases) & Global Health,
University of Washington
Medical Director, Northwest AETC ECHO

How do you build HIV workforce capacity with the dual constraints of limited resources and a geographic region that encompasses over 27% of the entire US land mass? It takes more than frequent flyer miles. It takes innovation.

In 2011, the Northwest AIDS Education and Training Center (NW AETC) was one of three organizations funded to develop an AETC Telehealth Training Center Program. We looked to the University of New Mexico Project ECHO model (http://echo.unm.edu) as a framework for developing this HIV telehealth program, given its immense success in bringing high quality specialty care and training to rural and underserved areas. Participants from established ECHO programs in New Mexico and Washington reported greater self-efficacy and less professional isolation, while achieving equivalent clinical outcomes. NW AETC ECHO aims to build the confidence and skills of rural, low-volume health care providers (HCP) and clinics in the Northwest region to provide high quality HIV care to patients. In line with the White House’s National HIV/AIDS Strategy, this program will increase access to care and reduce HIV-related health disparities by supporting HCP to take on HIV care in their rural primary care clinic settings.

Using interactive video, NW AETC ECHO will offer weekly online clinics, providing just-in-time clinical consultation between community providers and a multidisciplinary panel of HIV experts (Infectious Disease, Psychiatry, Family Medicine, Pharmacy, Nursing, Case Management). In each clinic session, HIV experts provide a short clinical HIV update and in-depth case consultations initiated by community clinicians from their community-based panel of HIV patients. Using this model, NW AETC ECHO fosters mentoring relationships between the HIV expert panel and participating HCP, as well as developing a peer learning and support network in the region.

With a region that includes Washington, Alaska, Montana, Idaho, and Oregon, the NW AETC serves some of the least populated states in the US. It is predominately a rural and frontier region with few urban areas. Notably, Alaska is larger than the three largest states in the lower US combined, is home to 220 remote villages where primary modes of transportation are small planes and boats, and has a population density of 1.2 persons per square mile. In such a remote region, HIV telehealth resources are a lifeline to HCP and an essential component of the NW AETC’s longitudinal training and mentoring model.

For information on the NW AETC ECHO program, visit our website: (http://www.nwaetcecho.org) or the main NW AETC site at (http://www.nwaetc.org).

Two other AETC Telehealth Training Center Programs were funded in 2011:  Pacific AETC’s HIV Learning Network and the Pennsylvania/MidAtlantic’s Telehealth Appalachia AETC Project.  To access further information on these two projects, please visit the NRC AETC Telehealth Training Centers Program page at http://www.aids-ed.org/aidsetc?page=ab-01-15