Dr Stella Safo Discusses the Impact of Value-Based Care on People Living With HIV

HIV care delivery has always had an ethos in it of really being based on a team-based approach, explained Stella A. Safo, MD, assistant professor of Medicine at the Icahn School of Medicine at Mount Sinai.

Transcript

With the shift toward value-based care and emphasis being placed on care coordination, are you seeing a positive impact on patients with HIV?

Yes. I would say that in the HVI world, we kind of had it figured out, and part of the reason why HIV, I think, is a wonderful beginning model for population health management—beginning I mean we were doing this 20 years ago in HIV delivery—is because patients were so sick and were struggling so much to get based services that HIV care always demanded a team-based approach. So, in order, for example, to get you patients back in the clinic, your medical assistants who might live in the neighborhood would reach out to the patient, for example, or whatever it took. HIV, I think, has always had an ethos in it of really being based on a team-based approach, and I think it’s only now that we’re seeing, as we’re using the language of team-based approach to manage other chronic illnesses, it’s only now that we’re seeing in the HIV world that we’ve already been doing this, and how do we pull it together as something we can then talk about to other folks.

One example of how we do team-based care at my practice and how they’ve always done it, is we have these huddles at least once a week, sometimes many times, and we’ll talk about all of the patients we’re worried about. When I say we, I don’t just mean me as a provider. I also mean if the front desk staff say a patient come in for routine labs, and that patient looked more disheveled than normal, or just didn’t seem themselves, the front desk staff will bring that patient up in our care team meetings and will say, “Hey guys, I saw Mr. X and he didn’t seem well. Can someone outreach and see what’s happening?” All members of our care team feel like we own our patients together, and that’s how it’s always run.

I think one of the wonderful things now in really thinking about population health delivery and team-based care being a really important part of proactive panel management, I think in HIV care, we’re just figuring out how we translate what we’ve always done into the language that’s being used now and help our colleagues in primary care, in chronic disease management, figure out how to do some of the work we’ve had.