Background & Goal
The Mount Sinai Primary Care Hepatitis C Clinical and Research Program (Hepatitis C Program) was designed to address the needs of an underserved patient population with a prevalence of chronic hepatitis C infection nearly 5 times the national average. An integral component of the academic primary care practice at the Icahn School of Medicine at Mount Sinai, the Hepatitis C Program serves patients who are drawn primarily from the surrounding communities of East and Central Harlem and the South Bronx.
In addition to progression of their liver disease, the patient population most affected by hepatitis C has become increasingly chronically ill as they have aged, and requires closer and more specific follow up. Historically, social determinants of health resulted in this patient population being plagued with co-morbidities, behavioral health issues, social concerns, and substance use. These negative health factors, together with inadequate therapeutic agents, impaired the successful treatment of hepatitis C. Up to 75% of individuals with hepatitis C are unaware of their diagnosis. The goal of the Hepatitis C Program is to educate and screen at risk members of the community, link patients with chronic hepatitis C infection to care, deliver effective care and treatment through a holistic interdisciplinary practice that simultaneously addresses social determinants of health, and to transition patients to better care and improved population outcomes.
In 2002, Dr. Gardenier designed a holistic and longitudinal program to meet the needs of patients, most of whom were ineligible for treatment by the standards of care at the time. Dr. Gardenier purposefully took a harm reduction approach, using a patient-centered, relationship-based nursing framework which engaged patients and offered assistance with any issue, either concurrently or as a lead-in to treatment. The program’s outreach team targets high risk populations in the community through linkages with community-based organizations and other care providers. The team seeks to educate, screen, and then link those in need of care to appropriate resources.