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dc.contributor.authorLeston, Jessica
dc.contributor.authorStephens, David
dc.contributor.authorMiller, Matthew
dc.contributor.authorMoran, Brad
dc.contributor.authorDeming, Paulina
dc.contributor.authorMera, Jorge
dc.date.accessioned2020
dc.date.available2020
dc.date.issued2020
dc.identifier.citationLeston J, Stephens D, Miller M, Deming P, Moran B, Mera J. Telehealth and hepatitis C treatment for indigenous communities in the United States. Rev Panam Salud Publica. 2020;44:e13. https://doi.org/10.26633/RPSP.2020.13en_US
dc.identifier.issn1680 5348
dc.identifier.urihttps://iris.paho.org/handle/10665.2/51901
dc.description.abstractTo the editor: In the United States (US), an estimated 2.4 million persons have chronic infection with hepatitis C virus (HCV). The number of deaths from HCV-related mortality is greater than that of HIV and tuberculosis combined. Treatment with direct-acting antivirals (DAAs), usually 1-3 pills a day for 8 or 12 weeks, can cure over 95% of patients. Successful treatment of HCV has been shown to greatly reduce liver-related as well as all-cause mortality. American Indian and Alaska Native (AI/AN) people have over twice the national rate of HCV-related mortality. The largest health care provider for AI/AN communities is the Indian Health System, a national network of federal (Indian Health Service), tribal, and urban health facilities, comprised mostly of rural primary care clinics. As part of the Indian Health System response to HCV, health facilities have access to tele-mentoring support such as the ECHO (Extension for Community Healthcare Outcomes) model, which has demonstrated excellent outcomes in treating HCV. The program connects rural clinicians (‘spokes’) to a specialist team (‘hub’). These participants meet regularly via low-bandwidth video conference technology. The format of case-based learning, supported by short didactic presentations, aims to scale up clinical capacity across a health network. Patient presentations entail a brief de-identified standardized form with a patient’s clinical history to assess liver disease severity and determine optimal HCV treatment. [...]en_US
dc.language.isoenen_US
dc.relation.ispartofseriesRev Panam Salud Publica;44, mar. 2020
dc.subjectHepatitis Cen_US
dc.subjectMortalityen_US
dc.subjectCommunicable Diseasesen_US
dc.subjectAlaska Nativesen_US
dc.subjectIndians, North Americanen_US
dc.subjectUrban Healthen_US
dc.subjectUrban Health Servicesen_US
dc.subjectHepatitisen_US
dc.subjectTelemedicineen_US
dc.subjectTelemedicine for Rural and Remote Areasen_US
dc.subjectHealth Services, Indigenousen_US
dc.subjectHealth of Indigenous Peoplesen_US
dc.subjectIndigenous Organizationsen_US
dc.titleTelehealth and hepatitis C treatment for indigenous communities in the United Statesen_US
dc.typeJournal articlesen_US
dc.rights.holderPan American Health Organizationen_US
paho.articletypeLettersen_US
paho.isfeatured0en_US
dc.identifier.doihttps://doi.org/10.26633/RPSP.2020.13
paho.source.centercodeUS1.1en_US
dc.relation.ispartofjournalRevista Panamericana de Salud Públicaes_ES
dc.relation.ispartofjournalPan American Journal of Public Health


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