Project Background
According to a study, the demographics of the PLHIV are changing dramatically, with sex clinics in the UK now caring for increasing numbers of people aged 50 or over in 2021 compared with 25% in 2012.And in 2030 it will reach to 73%,so that’s what target audience we will be dealing with -people aged 50 or over live with HIV
sdue to the age ,the immune system of ageing people will decline naturally, coupled with the impact of HIV, may result in ageing people with HIV being more susceptible to other diseases, referred to as co-morbidities.Compared to the general elderly population. And the research shows 72% of people diagnosed with HIV have at least one other long-term health condition,
Due to the age ,the immune system of ageing people will decline naturally, coupled with the impact of HIV, may result in ageing people with HIV being more susceptible to other diseases, referred to as co-morbidities.Compared to the general elderly population. And the research shows 72% of people diagnosed with HIV have at least one other long-term health condition
As co-morbidities increase, so does the number of drugs available to the patient. As the number of drugs increases, so do the drug interactions. Older people need to take multiple medications at the same time to treat different conditions. However, interactions can occur between different drugs, which can not only have a bad effect on the treatment of co-morbidities but more importantly, can lead to resistance to HIV drugs, and More possibilities for co-morbidity allowing progressive development of aids
Current situation
In the current health care system for HIV patients, until 2012, all HIV treatment was provided at sex clinics because of the large number of new infections.
But since the new legislative changes in 2012 and subsequent developments reconfigured the commissioning model, HIV clinics are no longer funded to provide or coordinate non-HIV care.
The resulting situation is that they will now go to a sex clinic and to a GP for treatment of their condition separately, and when they first register into the sex clinic system, the nurse will advise whether to share the HIV patient's own condition status with the GP through them.
But the paradox exist is when you initially get diagnosed with HIV, you were asked whether to share information with GP, and it tick a box which connected to the systems, a lot if people don’t take that box ,and also people don’t come back and reticked,it is really a big systemic issues
Imagining, you are suddenly diagnosis, the positive result you get makes you life in a mess.Now every piece of information you take is you never get before, the decision-making is judged by yourself and relevant to how long you can live, you will be very sensitive,I even not tell this things to my parents why I need to let you to share it to someone know me before, it is weird right？
According to the interview The first group of patients are reluctant to share their HIV status with their GP due to the stigma that HIV brings to them, the fact that they do not trust the medical establishment 100% and the fact that they are not aware of the consequences of drug interactions due to lack of knowledge. More importantly, they may feel that "being asked to repeat a complex medical history to multiple health care providers can make patients feel that their case is not fully understood throughout the health care system, (a situation that is exacerbated by inadequate continuity of care between the GP and other health care providers).
the second group of patients, those who would otherwise be willing to share their condition, will slowly become reluctant to do so over time because they do not know who to trust in the face of the current fragmented health care system, where uncertainty about clinical responsibility undermines confidence in the care provided, and where medical decisions bounce back and forth between providers.They don’t know who to trust
Persona
And for the patient,This is milo a 50 year old hiv patient ,when Milo was young ,He had been a regular at the bar every weekend, leaving until it closed.but since he get diagnosed , everything has changed and he has become more discreet.Lets see his medication list ,he has hypertension, stomach acidity etc and will take 7 medications a day consistent with an overdose, according to his medication list
according to the liverpool hiv drug checker he takes four medications that are associated with serious adverse reactions to his hiv medication, of which the stomach medication omeprazole and multivitamins can easily be bought at a pharmacy without a prescription which means that the patients themselves lacked basic knowledge of drug interactions.I is horrible
Based on the above analysis, imagine it is a health issue that you can not get consistent advice on, As soon as co-mordities start arising, you end up being consistently treated in multiple ways by two different streams of care that aren’t talking to each other and in fact are conflicting
You're eager to figure it out yourself ,and you start to focus on some dietary product to increase your immune system, and you become next Milo with unknown side effects of the drug
Problem Definition
Stakeholder map
Depending on the stakeholders PLHIV comes into contact with throughout the journey. HIV consultant, HIV clinical nurse specialists social care coordinators, etc., engaged in it.
But again patients give a mixed bag of opinions, because the different roles are only partially responsible for providing support
So this is the key point I want to approach, If our service can bring all stakeholders together as a team to communicate with PLHIV, engage them in discussions about treatment, and give them confidence that they are valued, it will eliminate the difficulties that currently exist and reduce their risk of developing the disease.
it will be a patient-centred, rather than system-led, model. It involves an individualised, responsive case-based approach, centred around a care plan developed with patient involvement and communicated to all relevant providers, and a named person with responsibility for coordination of care, monitoring and follow-up
it will be a patient-centred, rather than system-led, model. It involves an individualised, responsive case-based approach, centred around a care plan developed with patient involvement and communicated to all relevant providers, and a named person with responsibility for coordination of care, monitoring and follow-up
Compare to the current healthcare system ,it provide a shared identity and purpose that encourages team members to collaborate with each other
Solution deliverable
Vitality is a health plan provider with a deep commitment to universal coverage and healthcare reform. They help clients better manage their healthcare and encourage them to adopt a healthier lifestyle.
It will be a carrier for multidisciplinary teams . Also due to the insurance contract, PLHIV do not have to worry about their information being compromised. Compared to the plans offered by Vitality, HIVE will add a multidisciplinary meeting approach to the original make a claim programme.
Lets see the new journey for our PLHIV,When he visit to the SC clinic for testing regularly
He will receive an updated version of the testing checklists provided by vitality at no cost to the hospital to help nurses better test milo's daily status, including co-infections and vaccinations, lifestyle, cardiovascular screening/, cancer screening and mental health. In exchange for value, the nurse asks milo for a recommendation to join HIVE insurance based on the guideline report.
When the patient decides to join, he will get a HIVE contract kit with a unique QR code, download the app, and when he has filled out and signed the contract, he will upload it online along with a photo of the checklist. After paying the monthly subscription fee and the guide will become part of his annual plan. It will also include optimised treatment for the patient, not limited to dental treatment, vaccinations
After downloading the app, patient can clearly see their schedule and set the time to take their medication, and the Drug interaction check function helps him to understand his medication detailed.
The vitality consultant will contact him to follow up on the contract and regularly check the annual plan to see the health status of him
Everyone’s plan is different depending on his detailed age and personal health. For the Ageing people with HIV we optimise that, it will be 10% higher than the common people over 50, but we also offer another plan for younger PLHIV, which is doing prevention. Their health is not influenced extremely, so the insurance price is lower and more works for them .
For the insurance companies, as long as PLHIV take their medication regularly, their condition can be effectively controlled and maintained. They can have the same life expectancy and future as people with normal disease.
At the same time, the intervention of multidisciplinary diagnosis will eliminate co-morbidities caused by the failure of AIDS medication due to the influence of multiple drugs. Their health would be no different from ordinary elderly people. At the same time, the two age groups of the plan are designed to ensure that the insurance company makes more profit. If now I attend in the plan，for next 20 or 30 years I will keep subscription.
