Background: In New Hampshire, 50% of people who are newly diagnosed with HIV infection develop AIDS within one year, indicating they have had the virus for a period of time. Additionally, some providers may be challenged with implementing appropriate treatment for sexually transmitted diseases (STD). During one quarter, over 60% of patients diagnosed with gonorrhea received inappropriate treatment. Early identification of HIV infection and implementation of the current STD screening/treatment guidelines will assure clients have access to appropriate care and linkages with prevention and partner services to reduce the likelihood of disease transmission.
Methods: The New Hampshire Division of Public Health Services (DPHS) launched a Public Health Detailing (PHD)Program in 2014. The goals are to: 1) Improve screening and management of infectious diseases, and 2) Build partnerships with primary care. A Public Health Nurse visits with providers to provide data and updated STD/HIV/Hepatitis C screening and treatment guidance.
Results: The PHD Program has evolved over a 15-month period. Of the 79 visits made, 57% (45) were in-person meetings with providers, while 43% (34) were drop-in visits. A total of 218 providers received education or technical assistance. Approximately 55% of providers are not routinely offering HIV testing and 65% are not routinely offering Hepatitis C testing to patients born between 1945-1965. These data underscore the need for provider-focused education on screening recommendations. Evaluation data for presentation will include satisfaction feedback from providers, percentage of providers with a knowledge shift, percentage of providers with intention to adjust practices and percentage of providers that have implemented change as a result of the visit.
Conclusions: The PHD model can be conceptualized to virtually any topic. In addition to education, the physician-focused intervention identifies opportunities for integration with primary care to align leadership, build community engagement and improve health outcomes.