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Elevating access to HIV care through telemedicine

Image: Telemedicine offers patients the option of completing appointments from the comfort of their own home.
Telemedicine offers patients the option of completing appointments from the comfort of their own home.

Technology helps patients connect with providers for fast, convenient care.

Telemedicine has improved access to health care by offering patients the option of completing appointments from the comfort of their home. This is especially beneficial for patients dealing with chronic care management. In 2017, UF Health Jacksonville received a grant from the Centers for Disease Control and Prevention to support telemedicine efforts for patients living with HIV. By using the hospital’s existing UF Health Virtual Visit program, patients of the UF Center for HIV/AIDS Research, Education and Service (UF CARES) have been able to complete appointments with their providers in a more convenient way.

Reetu Grewal, MD, medical director of UF Health Family Medicine and Pediatrics – Baymeadows and the grant’s lead researcher, has made significant progress with the program since 2017. Grewal and her team have increased the number of participating health care providers, increased usage among patients and expanded the number of presenting site locations where patients can more easily access the technology required.

“We know access to the technology or a strong Wi-Fi connection can be a barrier for patients seeking to use telemedicine,” Grewal said. “Almost all of our primary care practices are set up as presenting sites, and we have five community-based organizations that help us to reach more potential patients.”

All presenting sites are set up with a tablet to help patients connect with a UF CARES provider from a location convenient to where they live or work. Each site has staff trained in the UF Health Virtual Visit software to help with appointments. The site locations help patients reduce time spent commuting to and from their doctor’s office if they do not have the capability to connect at home. Patients can also choose to visit organizations they feel comfortable with, such as the Jacksonville Area Sexual Minority Youth Network, or JASMYN, to use the tablets and complete an appointment.

Grewal has made progress in her collaboration with UF CARES providers to increase the number of appointments the team completes. She eases concerns by sharing how virtual care has been successful for her and other colleagues to more efficiently manage clinic days and reach more patients.

Nizar Maraqa, MD, medical director of UF CARES and a pediatric infectious disease specialist, says the team has embraced the concept and with initial technical hurdles cleared, they are getting more comfortable with recommending and completing virtual visits.

“Overall, it has been a positive experience for our patients and providers as we have eased into telemedicine,” Maraqa said. “Providers and case managers are able to identify clients who would benefit from this technology and ensure they have a way to securely access it.”

Maraqa’s team values the flexibility telemedicine provides patients who are medically stable and not requiring significant additional services. It’s an opportunity to save time and reduce potential conflicts that may result in missing an appointment.

Dee Williams, a UF CARES patient, started virtual appointments in early 2019 to help save time.

“I enjoy the privacy and I would recommend it to anybody to try,” Williams said.

Williams said that other than being unable to take vitals, her provider makes the appointment feel personalized just like an in-office visit. Using her phone, she can connect securely and move on with the rest of her day.

“There is a lot to be gained by providing this type of appointment option,” Grewal said. “It is another tool we have as physicians to better serve our patients, especially to ensure those living with HIV can access the care they need to maintain a healthy and full life.”

In particular, UF Health Virtual Visit has been immensely successful for Grewal’s patients in chronic care management. Most three-month, follow-up office appointments can be replaced with virtual visits. Those using this service have become more compliant with their treatment plans due to the increased monitoring and oversight telemedicine provides. For both client groups, telemedicine eliminates the travel and time barriers of coming into the office. 

“I see telemedicine as a tool to improve access to care, especially for patients who would normally travel far distances,” Maraqa said. “As it becomes more streamlined to provide the multidisciplinary care that people living with HIV require, I can see how it will improve our ability to reach patients and keep them connected to care.”

Featured Faculty

Reetu Grewal, MD

Reetu Grewal, MD

Associate Professor
Clerkship Director

Nizar F. Maraqa, MD

Nizar F. Maraqa, MD

Associate Professor
Medical Director, UF Cares; Program Director, Pediatric Infectious Diseases Fellowship; Associate Program Director, Pediatric Residency