Providing care for veterans with HIV in the U.S is top priority for the Veterans Health Administration. According to the November issue of the “The Rural Connection” www.ruralhealth.va.gov published by the VHA Office of Rural Health (ORH), the ORH supports care for veterans with HIV but has found that 18 percent living in rural areas delay entry into HIV care because of the distance needed to travel for care. With the delay entry into HIV care, these veterans very often receive care when they are at an advanced stage of the disease.
OHR supported the development of the Iowa City VA Healthcare System’s Telehealth Collaborative Care (TCC) program for rural veterans living with HIV. During the past two years ending May 2012, there were 32 veterans with HIV who lived more than a one hour drive from the Iowa City HIV clinic and who were geographically closer to a Community Based Outpatient Clinic.
Thirty of these veterans chose TCC over traveling to Iowa City for their HIV care. An evaluation found that TCC maintained high quality of HIV care in the Iowa City system and improved the average travel time for care.
The Iowa Department of Health (IDPH) has recently been actively involved in several public health programs. For instance, IDPH is expanding their newborn screening program to include screening for Severe Combined Immune Deficiency (SCID), a rare inherited disorder caused by a deficiency or absence of cells that help fight infections.
If untreated, most infants with SCID die before their first birthday. The incidence of SCID is estimated to be one in 50,000 to 60,000 live births. Nearly 40,000 Iowa babies are screened shortly after birth through the newborn screening program.
SCID screening began as an implementation pilot to ensure that the screening process met standards, ensure that all the babies were being screened, and any baby with an abnormal result would receive appropriate interventions.
In other screening news in the state, more than one million babies have been screened as part of Iowa’s Neonatal Metabolic Screening Program. With one small blood sample, more than 50 diseases can be detected. Most of these life-altering and life threatening disorders are completely undetectable at birth without the newborn screening.
The IDPH with funding from CDC has just launched their Environmental Public Health Tracking (EPHT) Network at www.idph.state.ia.us/EHS/EPHT.aspx. The tracking system is expected to be a valuable resource as counties develop their Community Health Needs Assessment and Health Improvement Plans. The data will help the state develop effective public policy.
Public health officials in the state have relied on the state’s Immunization Registry Information System (IRIS) at www.idph.state.ia.us/InmTB/Immunization.aspx?prog=Imm&pg=IRIS to ensure that patients at the recommended vaccines at the right times throughout their lives. Before clinic and hospital staff could only use certain computers that had been installed with special software. Recently, IDPH adopted new software for IRIS and now hospitals and clinics have immediate access to the database via laptops or tablet computers.
The state has taken another step forward so that in 2013, the Iowa Health Information Network (IHIN) will be established. In the meantime, Iowa is testing their direct secure messaging system. To prepare for the direct secure messaging pilots, Iowa e-Health at www.iowaehealth.org is partnering with the state’s HIE vendor, Xerox.
Xerox is working with several sub contractors including Informatics Corporation of America, Genova Technologies, and LightEdge Solutions. In addition, Iowa e-Health has conducted a webinar to educate providers about direct secure messaging in cooperation with Iowa Medicaid Enterprise, and Iowa’s HIT Regional Extension Center, Telligen at www.telligenhitrec.org. .
Once the direct secure messaging pilot projects are complete, enrollment will be open to all provider types and offered without charge to providers through 2012. Fees following this period will be assessed and published in the Iowa e-Health Business and Financial Sustainability Plan.