Georgia Leverages Telehealth to Expand HIV Care Management in Underserved Areas

Abstract

The Southeast U.S. and Georgia in particular are disproportionally affected by HIV. A major barrier in Georgia to meeting the goals of Ending the HIV Epidemic in the U.S is lack of proximity to HIV care. To address this and other barriers, Georgia implemented a comprehensive HIV telehealth system, including telemedicine to provide remote care through clients' local medical homes. In addition, a telementoring program (Project Extension for Community Healthcare Outcomes) was initiated to strengthen the HIV provider workforce in Georgia. A total of 60 telemedicine solutions have been deployed in Georgia, including 8 during the COVID-19 pandemic, to expand HIV care access in 12 of 18 Georgia health districts. Community providers were also able to access Project Extension for Community Healthcare Outcomes for remote training and consultation. Data were collected with CAREWare to assess HIV viral suppression among Ryan White HIV/AIDS Program Part B clients accessing telemedicine compared with Ryan that among White HIV/AIDS Program clients overall. In all, 6,977 Ryan White HIV/AIDS Program clients were seen during 2020. Of these, 1,041 had a telehealth visit, of whom 1,035 (99.4%) were prescribed antiretroviral therapy, and 951 (91.4%) were virally suppressed. Results were comparable with those of Georgia Ryan White HIV/AIDS Program Part B clients, overall. In Georgia, HIV telehealth has been successful at bridging gaps in patient care and in training local providers to offer comprehensive HIV care. Continuing challenges include integration of electronic health records with the telehealth platform, privacy and data security, equitable reimbursement, and lack of digital devices and Internet service access among some rural patients.