Researchers receive $23.8 million from CMS to improve HIV prevention and care

Researchers at the George Washington University (GW) were awarded a grant estimated to be funded at $23.8 million from the Centers for Medicare & Medicaid Services (CMS) to study a new model that aims to improve HIV prevention and care while lowering healthcare costs. The project will test a system that relies on mobile technologies, home testing and an integrated care system in order to prevent HIV infection and provide better care for those who already have the virus that causes AIDS.

The Milken Institute School of Public Health at the George Washington University (Milken Institute SPH), together with the Rodham Institute of the GW School of Medicine and Health Sciences (SMHS), collaborated with more than 20 community partners including outreach organizations, clinical care systems, hospitals, managed care organizations, technology firms, the DC Department of Health, and DC Health Care Finance in order to successfully compete for and win the three-year award. The project will develop a shared Information Technology (IT) system that will provide Medicaid participants in the District of Columbia with preventive and chronic care services that are integrated across a range of settings, says Freya Spielberg, MD, MPH, who is the principal investigator on the project, an associate professor of prevention and community health at Milken Institute SPH, and an associate professor at the GW SMHS.

"This project offers an exciting opportunity to massively reduce the transmission of HIV and other sexually transmitted infections (STIs) in Washington, DC," says Spielberg. "We hope to create a new health system that uses mobile technologies, home testing, integrated information technology systems and community health workers to make sure that DC residents have been educated, tested and treated successfully."

The research team at GW, along with the community partners, will use mobile health education, home testing, and an integrated prevention to care IT system, in the hopes of making it easier for DC residents to find out more about their HIV and STI status or put in place services that can keep them healthy and prevent complications of HIV infection and unnecessary trips to the hospital.

As part of the project, researchers will provide patients with mobile health tools to support health literacy, risk reduction and home testing; and community health workers will receive mobile tools they can use to better coordinate care for HIV infected people who have detectable viral load, missed clinic appointments or medication refill visits. The integrated information technology system will detect when patients are not receiving the support that they need in order to prevent health complications and costly crisis care.

"This award represents a commitment to innovative, community-oriented care at its finest, especially in the District of Columbia where AIDS transmission rates are alarmingly high," says Lynn R. Goldman, MD, MS, MPH, the Michael and Lori Milken Dean of Public Health at Milken Institute SPH. "As the only school of public health in the District, we look forward to collaborating with our many partners here to hopefully increase success rates and improve the lives of those in need."

The grant is part of the Health Care Innovation Awards announced recently by the U.S. Department of Health and Human Services and CMS, which has awarded a total of $360 million to 39 awardees, including the research team at GW, which received the largest award to date. The CMS awardees will all be testing novel models that are designed to provide better health care at lower cost.

"The prevention of HIV and STIs and treatment of those with these infections are important areas of research and focus for GW. Through this research partnership, we hope to positively affect the incidence rate and treatment of HIV and STIs in Washington, D.C. and beyond," says Jeffrey S. Akman, MD, the Walter A. Bloedorn Professor of Administrative Medicine, Vice President for Health Affairs and Dean of the GW SMHS. "Providing new pathways for patient adherence to medication and disease prevention will enable health care providers to deliver care and ensure better patient outcomes."

The model will also help community health workers and/or patients create comprehensive care plans that can be integrated into electronic medical records. With such a care plan, providers will be able to easily check on a patient's medical history and provide supportive care that is aimed at preventing infection in the first place or keeping viral loads in check.

After three years, the team hopes to have created a model system that could be adapted for other conditions and used in other places, especially cities where the rates of HIV infection and other health disparities are high.

The GW team leaders include Principal Investigator Freya Spielberg who is taking the lead on innovation; Julia Hidalgo, the co-principal investigator and lead of finance reform; Jehan El-Bayoumi, the lead of provider education and dissemination; W. Douglas Evans, the lead of social marketing; Kathleen (Katy) Roche, the lead of mixed methods quality improvement; Jeffrey (Bart) Bingenheimer, the lead of quantitative quality improvement analysis; Cherise Harrington, the lead of health disparities innovation; Samuel Simmens, the Biostatistics lead; Caroline Sparks, the lead of behavioral health; and Don Strong, the lead of community engagement.