III. CLINICAL OUTCOMES: PROGRESS TO DATE Mount Sinai Brigitte - - PowerPoint PPT Presentation
1 III. CLINICAL OUTCOMES: PROGRESS TO DATE Mount Sinai Brigitte Buquez Natasha Toussaint 2 2 The Mount Sinai On the Ground Team Proje ject D Dir irector: Brooke Wyatt Ca Care Co Coordinators: Joy Cambe Brigitte Buquez Samara
Mount Sinai Brigitte Buquez Natasha Toussaint
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Proje ject D Dir irector: Brooke Wyatt
Ca Care Co Coordinators: Joy Cambe Brigitte Buquez Samara Washington Ashley Pichardo Natasha Toussaint Social W Work Ca Care Co Coordinator: Rachel Potter
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Dat ata M a Man anager ager: Celia Murnock Peer N Navi vigators: De Shaunda Page Glyn Singleton
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N %
Male 627 64.8% Female 338 35.0% Trans M/F 1 0.1% Trans F/M 1 0.1% Black 362 37.4% Hispanic/Latino 357 36.9% White 187 19.3% Asian 10 1.0% American Indian 3 0.3% Two or More Races 17 1.8% Other 2 0.2% Pacific Islander 1 0.1% Unknown 28 2.9% Manhattan 489 50.6% Brooklyn 178 18.4% Bronx 174 18.0% Queens 102 10.5% Staten Island 24 2.5% Age Mean 58
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(N=967) Gender Race/ Ethnicity Borough
29.1% 31.7% 19.2% 7.3% 12.6% 50 100 150 200 250 300 350 Internal Medicine Associates (CAM_IMA) Liver Medicine Practice (CAM_LMP) Faculty Practice Associates (FPA) Jack Martin Fund Clinic (CAM_JMFC) All External Sites
Number o
Enrol
Grap aph 1
Sinai ai P Proj
INSPIRE P Patients E Enrolle
Clinic S Site (N=967)
1.6% 9.8% 8.2% 28.7% 16.4% 23.0% 12.3% 5 10 15 20 25 30 35 40 Comprehensive Center for Health Practice (CCHP) Greenwich Village Clinic Beth Israel Roosevelt Ryan Center Clinic - 97th Street
Hospital- Liver Institute for Family Health Number o
Enrol
Grap aph 2
Sinai ai Proj
INSPIRE P Patients Enrolle
at External al Clinic S Sites (N= 1 122)
(69.2%) are on Medicaid and 16.1% are dually eligible.
Fee for Service and an additional 7.3% have Medicare Advantage.
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N % Medicaid 669 69.2% Medicare Fee for Service 67 6.9% Dually Eligible 156 16.1% Medicare Advantage 71 7.3% Other 4 0.4% Table 2. Mount Sinai Project INSPIRE Patients by Insurance Provider (N=967)
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91.3% 97.1% 99.7% 98.7% 74.2% 84.3% 72.9% 10.6% 3.4% 3.4% 100 200 300 400 500 600 700 800 900 1000 1100 Enrolled Complete Assessment Complete Referral Assessment Received Care coordination services Complete HCV Medical Asssessment Started Treatment Completed Treatment SVR @ 12 weeks SVR @ 24 weeks Stopped Treatment Relapsed Number o
lled
Grap aph 3
Treat atment C Cascad ade ( (N=967)
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N % 433 62.48% 137 19.77% 24 3.46% 22 3.17% 2 0.29% 3 0.43% 24 3.46% 11 1.59% 17 2.45% 9 1.30% 11 1.59% 693 100.00% Cleared Virus Transferred Care Ineligible upon further review Total Competing Medical Priorities Other Terminated from Program Deceased Declined Program Reasons for Discharge Completed Treatment Lost to Follow Up Incarcerated
Time t to
reatment - 53.5% of INSPIRE patients begin treatment within 3 months of medical evaluation. However, the median time to treatment is 77 days (11 weeks), indicating that the mean is skewed higher by a relatively smaller number of individuals who have taken significantly longer to start treatment.
iousl sly t treat ated p patie ients s - We have 77 patients who were previously treated but stopped that prior treatment without completing. As of now, 52 of them have successfully completed a full course of treatment and 41 have confirmed SVR 12
panim iments/ s/Esc scorts- 68 individuals have had INSPIRE staff accompany them to appointments. 38% of this group were previously treated and either stopped treatment or relapsed, as compared with ~24% of the overall Sinai INSPIRE cohort
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58% 84% 81% 82% 67%
100 200 300 400 500 600
Received Assessment Medically assessed and eligible for treatment Started Treaetment Completed Treatment Confirmed SVR
High Need ed cascade de
High need cascade N Received Assessment 524 Medically assessed and eligible for treatment 442 Started Treatment 360 Completed Treatment 296 Confirmed SVR 205
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35.6% identify as black, 40.7% as Hispanic or Latino.
Manhattan, while 19.6% live in Brooklyn and 17.8% in the Bronx.
with a mean age of 56.
Service and an additional 6.2% have Medicare Advantage.
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85.1% 96.7% 99.3% 98.2% 67.8% 60.7% 15.3% 0.9% 2.7% 5.4% 100 200 300 Enrolled Complete Assessment Complete Referral Assessment Received Care coordination services Complete HCV Medical Asssessment Started Treatment Completed Treatment SVR @ 12 weeks SVR @ 24 weeks Stopped Treatment Relapsed Number o
lled
Remain ainin ing MS INSPIRE Trea eatmen ment C Cascade de (N=275)
“I real ally appr appreciate y you an and d al all y you do do for me
Than ank y you forever, I I wish wish t there w was as mo more I I could sa d say o
do” If it weren’t for INSPIRE coordinators, as one patient explains, she would not have started treatment. The patient was prepared to walk away, but instead took heed to the information her coordinator shared and trusted that this was not the end of the
INSPIRE) the patient started treatment this past April- 6 months post enrollment. The patient also notes that if it weren’t for her coordinator during the first month, she would have stopped taking the medication due to the nausea and insomnia. This is pat patient st story, al although sma small in in st stature, e echoes t the l lar arger me message o
patients s share re p post t treatment; t ; that t they f y feel m more re c confident i in themselv lves, , energ rgized w with a h a better l r life a ahead. .
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