WP 50 Public Health Detailing: Building Partnerships to Improve Health Outcomes in a Rural State

Wednesday, September 21, 2016
Galleria Exhibit Hall
Susan Myers, M.Ed., R.N., Division of Public Health Services, Bureau of Infectious Disease Control, NH Department of Health and Human Services, Concord, NH

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.