Authored and Presented by LCDR Jonathan Owen PharmD LT Neelam Gazarian MS PharmD Quentin N Burdick Memorial Health Care Facility Indian Health Service Belcourt ND 12142017 Objectives ID: 756590
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How Belcourt Started a Hepatitis C Clinic
Authored and Presented by: LCDR Jonathan Owen,
PharmD
LT Neelam Gazarian, MS,
PharmD
Quentin N. Burdick Memorial Health Care Facility
Indian Health Service
Belcourt, ND
12/14/2017Slide2
Objectives
Describe use of tools to manage complex care of hepatitis C
patients, discuss workload capabilities.
Share resources of NICE Project with participants to help manage hepatitis C clinic.
http://www.hepatitiscentral.com/wp-content/uploads/2015/04/expenisive-hepatitis-c-medication.jpghttp://aph.org.ua/wp-content/uploads/2016/08/Bez-nazvanyya-4.pngSlide3
Who are we?Slide4
Prior to HCV ClinicSlide5
Inter-collaborative ApproachSlide6
Identifying Patients with Hepatitis CSlide7
EHR DocumentationSlide8
Consult TemplateSlide9
EHR Note TemplatesSlide10
EHR Note TemplatesSlide11
Hepatitis C Labs Order MenuSlide12
Hepatitis C Labs Order SetSlide13
Patient Management ToolsSlide14
Managing Patients
Hepatitis C Patient Panel ListSlide15
Managing Patients
Hepatitis C Patient Panel ListSlide16
Managing Patients
Snapshot of stage in treatment process drop down menus (these can be adjusted)Slide17
Patient PanelSlide18
Individual Patient DataSlide19
Appointment CalendarSlide20
Navigating Insurance/Prior AuthorizationsSlide21
Patient Assistance ProgramSlide22
Patient Assistance ProgramsTribal ID card
Income documents
Max income allowed differs by program
Proof of no insuranceAmerican Indians/Alaska Natives (AI/AN): Indian Health Coverage Exemption“American Indians and Alaska Natives (AI/ANs) and other people eligible for services through the Indian Health Service, tribal programs, or urban Indian programs (like the spouse or child of an eligible Indian)
don't have to pay the fee for not having health coverage. This is called having an Indian health coverage exemption.”Slide23
Time Investment and Workload (Minutes)Slide24
Current StatusSlide25
Patients Enrolled in ClinicSlide26
HCV Screening RateSlide27
HCV Screening RateSlide28
Cost Analysis: Cumulative
$
1,123,776Slide29
Next Steps
Leading efforts in the Great Plains, Bemidji and Billings Areas
Sharing experiences and resources with other service unitsSlide30
Next StepsSlide31
Success Story
Drop minimum
fibrosure
score requirements
No NS5A resistance test required unless prescribing
Zepatier
®
12-months abstinence requirements remains
ND Medicaid and ExpansionSlide32
Medicaid Letter – Balancing ActSlide33
Hepatitis ListservSlide34
Patient’s StoryFirst patient enrolled in HCV clinic summer of 2017, achieved SVR mid-November
“I have been waiting for this for so long. I know I have made some mistakes in the past, but I had started to turn my life around. I am very thankful to them for not being judgmental and for treating me with respect. I am finally able to start a family. God bless you!”
- First patient to attain SVR in HCV clinicSlide35
Recorded Webinars
http://www.npaihb.org/hcv/#
clinical-resources
How to create an iCare panelHow to create a quick order menu for required labsHow to use the NICE patient management tool
Hepatitis C clinic workflowMedicaid Letter, appointment cardsSlide36
AcknowledgementQuentin N. Burdick Memorial Health Care Facility Eliminate Hepatitis C Team:
LT Neelam Gazarian,
PharmD
. USPHS MS Pharmacology/ToxicologyLCDR Jonathan Owen, PharmD. USPHS. AE-C, CTTSThanks to:
Molly Steen, PharmD. Pharmacy Clinical Services DirectorCDR Tyler Lannoye, PharmD. USPHS, Chief of PharmacySlide37
Special ThanksJessica Leston , HCV/HIV/STI Clinical Programs Director for the Northwest Portland Area Indian Health Board
Brigg Reilley, National HIV/AIDS Program
David Stephens, BSN, RN, Case Manager for the Northwest Portland Area Indian Health Board.Slide38
QuestionsSlide39
Thank youContact Info:
Neelam.Gazarian@ihs.gov
Jonathan.Owen@ihs.gov701-477-6111 Ext 8426