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The Standard of Care Changed December 6, 2001: Now What?

President's Forum

Winter 2002

On December 6, 2001, the standard of care for HIV-positive patients in the United States changed. On that day the Academy began mailing over 5,000 HIV Specialist credentialing kits. Then exactly one month later California Governor Gray Davis proposed that the Academy's definition should be included in state regulations allowing access to HIV Specialists (see cover article).

A Brief History

It has been a busy time for the Academy as we put in place the pieces needed to define and credential HIV Specialists. We began by assembling 50 of the top treators and academicians from across the country as our faculty. They volunteered countless hours to create and develop the many Academy initiatives. The faculty started by defining the core knowledge an HIV health care provider should possess to define himself or herself as an HIV Specialist, which became our Core Curriculum. The Core Curriculum was then organized and developed into over 250 Educational Objectives. Next, the Academy's Board of Directors adopted an HIV Specialist definition based on the recommendation of our faculty and nationally accepted standards.

Credentialing was the next step, using the definition and the Core Curriculum. We designed a credentialing process and the elements needed for HIV health care providers to complete and attain the designation of AAHIVM HIV Specialist. This was the first opportunity HIV health care providers have had to be credentialed by a national professional association. Together, the Self-Directed Study Guide (described below), Core Curriculum Educational Objectives, and the credentialing kit will complete the AAHIVM Self-Directed HIV Medicine Education Program. So as you can see, 2001 was a busy year in developing the Academy's initiatives.

So, Now What Is Next for the Academy?

We gathered much input in creating the AAHIVM Self-Directed HIV Medicine Education Program. We hosted community meetings, public policy roundtables, and member meetings. We made literally hundreds of phone calls and sent about 50,000 letters. And we learned a great deal about the priorities of all HIV health care providers.

With the education program nearly in place, we now have a new question: "What are we going to do with all of these tools?" To answer this question, the Academy is beginning new initiatives and increasing our commitment to initiatives already in place.

AAHIVM Self-Directed HIV Medicine Education Program and the Self-Directed Study Guide

A Self-Directed Study Guide, a compilation of data and descriptions for all 250 Core Curriculum Educational Objectives, is now being written. This study package covers all of the Educational Objectives, supported with narratives, explanatory texts, tables, charts, illustrations, and key references that an HIV Specialist needs to maintain an up-to-date understanding of HIV medicine -- a valuable learning tool for HIV health care providers. In addition, the Self-Directed Study Guide will include Continuing Medical Education units (CME) for health care providers.

Continuing to Advance the Standard of Care

The Self-Directed HIV Medicine Education Program accomplishes several important changes in the standard of HIV health care on a national scale. By requiring HIV health care providers to maintain up-to-date HIV knowledge through the credentialing process, and creating a comprehensive listing of clinical data that an HIV Specialist should know, the Academy has created a new, unified minimal knowledge standard for HIV Specialists across the country. The program embraces treating the entire patient, not just the medical condition, and includes such comprehensive issues as interaction with the patient, prevention, special populations, and adherence. Because the program is created and maintained by a national group of HIV health care providers who care for over half of the HIV patients currently under care, it can be a valuable tool for advocating and measuring a better standard of care.

So now that we have met our initial goals of creating these tools, we must begin to use them to benefit our most important constituency -- PATIENTS! The announcements from California and New York demonstrate how public policy makers value and make use of the Academy's program. It shows how implementing the program has directly affected the quality of patient care. It is a strong starting place, and the Academy has learned a lot from the process.

One lesson we have learned is that we needed to clarify how we would use these tools. In December, the Academy put its intentions into words by announcing a new objective: advocate, support, and implement attainable, state-of-the-art HIV care. Our Public Policy Committee is beginning to gather input and choose initiatives to ensure that patients have access to the quality care outlined in the AAHIVM Self-Directed HIV Medicine Education Program.

Adoption of Our Credentialing Process and Definition by Providers

The Academy will continue to encourage states, AIDS service providers, and all health care organizations to recognize the Academy's standard of HIV care. We believe the AAHIVM Self-Directed HIV Medicine Education Program and the credentialing process are well thought out and of tremendous benefit to HIV patients and quality of care, so we will encourage as many groups as possible to adopt this minimum standard to ensure that practitioners in HIV medicine maintain the minimum standards of up-to-date knowledge.

Continue to Help Expand the Availability of Quality HIV Care

We will continue our initiatives to lower barriers for entering the field of HIV health care. We will also continue to help create efficient HIV practices through our Practice Management Committee. And we will continue our efforts to aid the patient community in understanding how to choose a qualified HIV Specialist.

Now What About You?

The successes the Academy has created took hundreds of volunteers, each putting in a many hours to help us. I hope YOU will choose to become a part of the evolution of HIV health care by applying for the AAHIVM HIV Specialist credential yourself and encouraging your colleagues to do the same. You can also encourage your clinic or the institution where you practice to adopt this new standard as well. Finally, we need to hear from YOU. What do YOU want YOUR Academy to do in the next year?

If you would like to help, please give us a call at 866-241-9601.

Back to The Nexus Winter 2002 contents page.

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This article was provided by American Academy of HIV Medicine. It is a part of the publication The Nexus. Visit AAHIVM's website to find out more about their activities and publications.