Lessons Learned

1. Interactive Web Presentation April 11, 2006 8:00 A.M. Eliminating TB Case by Case A Case Series for Providers and Clinicians Joseph Gadbaw, Jr., MD Lawrence and Memorial Hospital New London, CT • TThe New England TB control programs invite you to participate in a case presentations of a patient with tuberculous meningitis and HIV infection. Access the TB Case Series at: www.mymeetings.com/nc/join.php?i=PG1678747&p=2006&t=c Toll free audio access: 888-552-9191 Password = 2006 # Accreditation: CME, CNE, CHES. This activity has been designated by CDC for 1 Category 1 hour toward the AMA physician's recognition award, 1.2 hours toward the ANCCCA nurse’s recognition award and 1 hour accreditation by NCHEC for educators. New Concepts in TB Control Internet-Based Strategies for Reaching Providers The New England Experience Mark Lobato,* Kathy Hursen,† Erin Howe,‡ Lisa Roy,¶ Judy Proctor,¶ Helen McCarthy,§ Subroto Banerji,* *CDC-DTBE, †Massachusetts Division of TB Prevention and Control, ‡Northeast RTMCC, ¶New Hampshire TB Program, §Rhode Island Office of Communicable Diseases Background New England TB, 2004 One size does not fit all Eliminating TB Case by Case NewEnglandTB.com • Providers present their cases • Designed to reach private providers • Created basis for distance learning • web-based • continuing education credit • Held 3 successful presentations • Need to market case series • Developed a team with expertise • Built a website to • Increase cohesiveness and visibility • Promote regional and state education • Exchange tools and materials Type of Provider (%), 2004 In 2005, the 6 New England TB programs started collaboration on a new approach to TB elimination by • Building program capacity on a regional level and • Identifying strategies for collective problem solving • TB cases • 486 cases • 3.4 / 100,000 (range 1.2-4.3) • Cases increased in 3 states • MA (9%) • RI (10%) • NH (59%) 90 • Maine, NH, and VT do not have outreach staff • Connecticut and Mass. are organized into health districts 80 70 60 CT A New Model of TB Control MA 50 ME 40 NH “The traditional model of TB control … is no longer the optimal approach.” CDC. “Controlling Tuberculosis in the United States,” 2005 RI 30 VT 20 10 0 HD Private Both Why Regionalization? Percent Foreign-born TB by State and Year New England Regional Plan Resources • The purpose of TB regionalization is to mobilize and coordinate broad collaborative actions • The approach uses existing infrastructure The regional plan revolves around 5 strategies • Communication • Education • Universal genotyping • Program evaluation • Consultation • State • TB programs/health departments • Schools of Public Health • Regional • TB Advisory Committees • RTMCC • CDC • DTBE • PHPS, Informatics 90 80 70 What can regionalization do for TB control? 60 2002 50 % 2003 • Expand expertise • Build on the diversity of experiences and practices • Involve stakeholders • Increase ability to affect health • Strengthen advocacy Genotyping Database 40 2004 30 • Work group defined data management capacity and needs • Planning for a web-based regional data set • Collaborated around CT cluster The Internet as a Regional Tool TB Education Objective 20 10 The Internet is a tool we have used for building program capacity. • Educational series “TB Case Series for Providers and Clinicians” • NewEnglandTB.com website To share materials and experiences • Genotyping database “Support and assist the Northeast RTMCC for the purpose of planning and promoting region-wide training and education of staff, providers, and patients using in-person or distance modalities.” 0 Lessons Learned CT ME MA NH RI VT State • The Internet is a useful tool for building program capacity • Modern TB control requires • Coordination • Collaboration across jurisdictions • Regional efforts offer benefits to state programs and to CDC