Academy Exchange

Hello Everyone, 

In the state of CT, it has become mandatory for the ED to provide opt-out HIV testing (which is great!) There has been more tests done in the ED since this mandate. I currently provide primary care to patients living with HIV in a clinic affiliated with the hospital/ED. We are getting a few positive test results and working on an appropriate work flow. I wanted to get your expert opinions to those who work in an HIV clinic in a hospital system affiliated with ED who have referrals for + HIV testing results.

1. Who discusses the results with the patient? What sort of counseling is provided in your ED? 
2. Who calls the patient to schedule a new patient visit to the clinic?
3. How have you delt with time to intake of care? We would ideally want to see these patients as soon as possible, but how do you get them in when the schedule is already booked up?

Any work flow/advise you may have is greatly appreciated. Thank you so much.

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Atsuko Yamahiro MD MPH
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you ask great questions.  We are doing HIV testing in the Ed - I wish they would test everyone but the providers there are reluctant - still working on getting them to test everyone.  This is how it goes in our ED:

1. someone tests HIV+ - the f/up provider usually calls me and lets me know that someone is HIV+.  We do not often know if it is a new HIV or old one.
2. I try to schedule the pt to come back to see me within the week.  The f/up ED provider calls the pt and lets them know of the appt and basically tells them that it is to f/up on results.  The ED usually does not provide the HIV test result - as they are not really skilled in this nor do they have the time.
3. The pt comes to see someone in the virology clinic and we tell them of their diagnosis.  It is very hard and emotional but it seems to be the best way to go as there is direct linkage to us.

I'd be happy to talk this process with you in more detail if you wish - you can email or call me.  

718-519-4976 (office) 

sara.back@nychhc.org 

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Sara Back
North Central Bronx Hospital
New York NY
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Original Message:
Sent: 05-28-2024 15:56
From: Atsuko Yamahiro
Subject: HIV Testing in ED and Intake

Hello Everyone, 

In the state of CT, it has become mandatory for the ED to provide opt-out HIV testing (which is great!) There has been more tests done in the ED since this mandate. I currently provide primary care to patients living with HIV in a clinic affiliated with the hospital/ED. We are getting a few positive test results and working on an appropriate work flow. I wanted to get your expert opinions to those who work in an HIV clinic in a hospital system affiliated with ED who have referrals for + HIV testing results.

1. Who discusses the results with the patient? What sort of counseling is provided in your ED? 
2. Who calls the patient to schedule a new patient visit to the clinic?
3. How have you delt with time to intake of care? We would ideally want to see these patients as soon as possible, but how do you get them in when the schedule is already booked up?

Any work flow/advise you may have is greatly appreciated. Thank you so much.

------------------------------
Atsuko Yamahiro MD MPH
------------------------------