Academy Exchange

How do u apply it at your clinic?

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I practice in Decatur, GA. We have a Rapid Entry Coordinator who schedules newly dx or out of care >6 months with medical provider same day or within 3 days of enrollment. Newly dx pts. are seen most rapidly, same day most cases. Those out of care >6 months are seen within 3 days. Delays may be related to medication access and provider availability. There is usually not a delay in ARV start for newly dx or those with health insurance same day, but may be for those who have been out of care and un/underinsured. ADAP approval is less than 2 weeks, PAP may not be available if pt. accessed before. Therefore, Rapid Start is pt. receiving provider visit and ARV therapy on same day of dx, or return to care within 3 days of enrollment.

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Hermeyone Bell
Ellenwood GA
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Original Message:
Sent: 03-01-2020 00:54
From: Dennis Myers
Subject: Rapid start: what is your definition of rapid start?

How do u apply it at your clinic?

Sent from my iPhone

I practice in center city Philadelphia at a large HIV practice and see the majority of new dx patients. Rapid start for us is starting Meds at first visit. We get new dx 2 ways:

1) thru our own counseling and testing department which goes to 35 locations throughout the city and any patient that rapid tests positive is seen either same day or the following business day. Although for those patients we only have a rapid test I offer ART to all patients and get labs and follow up in 5-7 days. 

2) we have patients who are referred to us from other offices or self refer after getting a positive HIV test. Anyone that our scheduler identifies as a new dx is given an appt time within 2 days. They are asked to bring labs but if they don't have them we repeat. Again all patients are offered meds same day. 

we are an office that accepts pharma samples so we always have symtuza, biktarvy and dovato on hand. 9x out of 10 people start same day. Sometimes people want to wait for labs in which case I have them return in 5-7 days to review labs and decide on regimen. 

I have on site case management who see them on visit 2, on site mental health who will see them day 1 if needed, but many times I find patients are overwhelmed visit 1 so I try not to bring too many new faces in until they are a tad more comfortable. 

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Angela Kapalko
Physician Assistant Chairperson for AAHIVM
Philadelphia FIGHT CommunityHealth Centers
Philadelphia PA
akapalko@fight.org
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Original Message:
Sent: 03-01-2020 00:54
From: Dennis Myers
Subject: Rapid start: what is your definition of rapid start?

How do u apply it at your clinic?

Sent from my iPhone