1. Caring for Inmates with HIV/AIDS

2. Infectious Disease Clinic VCUHS

3. TOPICS Technology of Telemedicine VCUHS Telemedicine Program Values and Limits of Telemedicine HIV Care for DOC Inmates Follow up Care

4. EQUIPMENT Videoconferencing System Hand held camera Stethoscope Computer terminal

8. VCUHS Telemedicine network sites Virginia Department of Corrections sites: Augusta CC Bland CC Brunswick CC Buckingham CC Coffeewood CC Deerfield CC Dillwyn CC Fluvana CC Green Rock CC Greensville CC Haynesville CC Indian Creek CC Keen Mountain CC Lawrenceville CC Lunenburg CC Marion CC Mecklenburg CC Nottoway CC Pocahontas CC Powhattan CC Red Onion state prison St. Brides CC Sussex I state prison Sussex II state prison Wallenridge state prison Virginia Correctional Center for Women Outreach Program sites: Rappahannock General Hospital Riverside Tappahannock Hospital Outpatient Telemedicine Clinic in Tappahannock South Hill Community Memorial Health Center Virginia Center for Behavioral Rehabilitation Three Rivers Health District Bay Aging at Colonial Beach

11. Value of Telemedicine Decreased travel Decreased security issues Cost effective Access to specialty care Regular interaction with nursing and medical staff who are providing primary care Immediate problem solving

12. Limitations Difficult to visualize fine detail Dependent on the skills of the person assisting with exam and presenting information May see less than whole “picture”

13. HIV Care All inmates in DOC identified with HIV Serve about 450 inmates New patient or follow up care More than consultant care – we prescribe HART and order labs (done through VCUHS) Direct the treatment of HIV related symptoms and infections Make recommendations as appropriate

14. Themes Clinical care Immunizations Diet and exercise HIV education and prevention Life issues – substance abuse, mental health, education, job skills, family issues

15. Follow up Care Planning for release Medical needs – HIV and other Seamless transition program Housing and social support Substance abuse and mental health issues Virginia Center for Behavioral Rehabilitation

16. Bridge Program Need for improved psychosocial assessment in order to better understand behaviors Goal (long term) to identify or design services to help individuals engage in medical care and access social support. Target recently released inmates for detailed assessment and getting neuropsych testing done if needed

17. Results of Neuropsych Testing History of head injuries Dementia PTSD ADHD Depression Anxiety Social isolation

18. Client Needs Navigating social/financial systems Mental health and SA services Ongoing care for non-HIV related medical problems Life skills Financial assistance