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The Denver Metro Health Clinic Service Integration and Evolving Standards of Care

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

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The Denver Metro Health Clinic Service Integration and Evolving Standards of Care

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  1. The Denver Metro Health ClinicService Integration andEvolving Standards of Care Kees Rietmeijer, MD, PhD

  2. 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

  3. Hospital Community and School Health Public Health Denver Health and Hospital Authority

  4. TB Program HIV Prevention Infectious Diseases Immunization Program STD Control Vital Records Epidemiology and Surveillance Health Promotion Public Health Preparedness Administration Denver Public Health Department Denver Health and Hospital Authority

  5. 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)

  6. 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

  7. Comprehensive STD Services • Free treatment for • Gonorrhea, chlamydia and associated syndromes (NGU, PID, Epididymitis) • Syphilis • Trichomoniasis • Bacterial vaginosis • Genital warts

  8. 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

  9. 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

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