the denver metro health clinic service integration and evolving standards of care
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The Denver Metro Health Clinic Service Integration and Evolving Standards of Care. Kees Rietmeijer, MD, PhD. Overview. The Denver Metro Health Clinic is the largest STD clinic in the Rocky Mountain Region In 2007: 16,687 Visits Diagnosed cases: GC: 726 CT: 1,878 Early syphilis: 27 - PowerPoint PPT PresentationTRANSCRIPT
The Denver Metro Health ClinicService Integration and
Evolving Standards of Care
Kees Rietmeijer, MD, PhD
Overview
• The Denver Metro Health Clinic is the largest STD clinic in the Rocky Mountain Region
• In 2007:–16,687 Visits–Diagnosed cases:
• GC: 726 • CT: 1,878 • Early syphilis: 27• HIV: 161
Denver Health and Hospital Authority
HospitalCommunity and School Health
Public Health
Denver Health and Hospital Authority
Denver Public Health Department
STD Control
TB Program
ImmunizationProgram
HIV PreventionInfectious Diseases
Vital Records
Epidemiology and
Surveillance
HealthPromotion
Public HealthPreparedness
Administration
Comprehensive STD Services
• Triage –Comprehensive visits
• Physical exam• Speculum and bimanual (women)• Routine STD tests (next slide)
–Express visits (asymptomatic patients)• No physical exam • Testing includes:
– CT and GC NAAT– HIV rapid test / qualitative RNA pooled testing– Syphilis (RPR)
Comprehensive STD Services• Tests: Routine
– Syphilis RPR– HIV rapid testing followed (for negatives) by pooled RNA testing– CT and GC NAAT
• Urine (males)• Vaginal swabs (females)
– Wet preps for yeast, trich, and BV
• Tests: On Indication– Gram Stain – Dark field microscopy– Urinalysis– FTA– HSV culture– HIV viral load and CD4 count
Comprehensive STD Services
• Free treatment for –Gonorrhea, chlamydia and associated
syndromes (NGU, PID, Epididymitis)
–Syphilis
–Trichomoniasis
–Bacterial vaginosis
–Genital warts
Service Integration
• HIV– Testing is routine, rapid & opt-out
– HIV RNA Pooling
– Linkage to Care
• Hepatitis– Hep C testing on indication
– Hep A and B immunizations available and free
• Family planning and birth control– Hormonal (routine and emergency) contraception
available
Emerging Standards of Care• Triage / Express Visits to enhance clinic
efficiency• Expedited Partner Therapy• Routine re-screening 3 months after CT or GC
infections• “Online” Services
– Testing– Results online– Text messaging for clinic reminders
• Client-centered counseling