About Us

In 2004, The University of Washington AIMS Center was founded, pioneering a Collaborative Care model representing an evidence-based approach to integrated care. Their model of integrated care was developed to treat common and persistent mental health conditions such as depression and anxiety.

The MIDUS program is based on the AIMS Center Collaborative Care model with the intention of identifying and treating depressive symptoms specifically among people living with HIV/AIDS. This particular audience experiences higher rates of mental illness (than the general population), increased rates of substance abuse, and are more likely to have experienced trauma within their lifetime.

 

Our Team

Ann Avery, MD

Ann Avery, MD // HIV Physician // Project Director // Principal Investigator

Dr. Avery provided administrative oversight and ensuring complete and appropriate implementation of the collaborative model. She currently oversees the Ryan White program for MHS HIV program and has been a prior principal investigator for a SPNS initiative, EnhanceLink. She is also the lead for the Greater Cleveland HIV Health Information Project (CHHIP) which has provided preliminary data to support the need for better depression treatment and will be used as part of the local evaluation. Together with Dr. Lavakumar, the collaborative model will be fully implemented, refined and evaluated.

 


 

Mallika Lavakumar, MD

Mallika Lavakumar, MD // Consulting Psychiatrist // Co-Director // Co-Investigator

Dr. Lavakumar provides mental health expertise and ensures safe and high-quality services are delivered through implementation of the collaborative model. Together with Dr. Avery, the collaborative model was fully implemented, refined and evaluated. Dr. Lavakumar provides weekly case consultation with the care coordinator and medical team. She is also responsible for capacity building of the medical staff through provision of education and training for medical staff. She works with Dr. Webel to develop and refine depression self-management tools for use as part of the algorithm.

 


 

Tracey Brichacek // Behavioral Health Care Manager

Tracy collaborates with the interdisciplinary healthcare team in the provision of patient care, working with HIV patients from the point of entry into care to ensure coordinated care across the full range of treatments and programs indicated. She maintains regular contact with patients to encourage full engagement through physician visits, education, lab tests, viral load monitoring, self-help activities, and peer group participation. As a BHM, she facilitates patient self-reports of depression symptoms, identifies depression severity, conducts further screens and full clinical assessments as needed, and develop the treatment plan according to protocol. She also performs a central role in integrated care for each patient, facilitating appointment scheduling and suggesting actions as needed, identifying problems as they arise, and working to resolve challenges. Tracy assumes some duties (such as assessment and chart documentation) that have traditionally been in the role of physicians, to improve workforce capacity by allowing a more strategic use of physician time. In addition, she facilitates interdisciplinary team meetings, suggest improvements, and works independently with Dr. Avery, other HIV primary care staff, psychiatrist, IS services, evaluator and data managers to ensure fully integrated care.

 


 

Mickie Chaney // Behavioral Health Care Manager

Mickie collaborates with the interdisciplinary healthcare team in the provision of patient care, working with HIV patients from the point of entry into care to ensure coordinated care across the full range of treatments and programs indicated. She maintains regular contact with patients to encourage full engagement through physician visits, education, lab tests, viral load monitoring, self-help activities, and peer group participation. As a BHM, she facilitates patient self-reports of depression symptoms, identifies depression severity, conducts further screens and full clinical assessments as needed, and develop the treatment plan according to protocol. She also performs a central role in integrated care for each patient, facilitating appointment scheduling and suggesting actions as needed, identifying problems as they arise, and working to resolve challenges. Mickie assumes some duties (such as assessment and chart documentation) that have traditionally been in the role of physicians, to improve workforce capacity by allowing a more strategic use of physician time. In addition, she facilitates interdisciplinary team meetings, suggest improvements, and works independently with Dr. Avery, other HIV primary care staff, psychiatrist, IS services, evaluator and data managers to ensure fully integrated care.

 


 

Webel_Allison

Allison Webel, Ph.D., RN // Consultant

Dr. Webel is an experienced clinical and HIV Educator. She was a clinical HIV educator at the San Francisco Department of Public Health and has expanded on this role as Director of Continuing Education in the Association of Nurses in AIDS Care. She regularly provides HIV education to nurses and students in Northeast Ohio. Her research focus is on self-management in adults living with HIV and has written over a dozen papers on this topic. For MIDUS, Dr. Webel drew on her years as a clinical educator to provide training to the MetroHealth HIV clinic staff on self-management. She used her research experience to conduct and analyze focus groups and interviews with the staff both prior to implementation of the proposed project, and after implementation to systematically learn how to improve the collaborative care model for depression in HIV primary care. She was also responsible for the development, dissemination, and education on the depression self-management tools.

 


 

Diana GurleyDiana Gurley, Ph.D. // Evaluator

Dr. Gurley is responsible for monitoring qualitative processes and quantitative outcomes. Her duties include participation in quarterly team meetings dedicated to discussions of process, workforce changes and adaptations, assignment of tasks according to complexity, and considering the efficiencies of staff training for depression and psychosocial assessments. She interviews patients and families, individually and in focus groups, to ensure ongoing patient contribution to the developing integrated system of care, and to enhance consumer satisfaction with care. Her analyses of process indicators and outcomes are included in annual program evaluations. Dr. Gurley also works with the data manager and consulting faculty from the Center for Healthcare Research and Policy (statisticians and economists) to examine quarterly trends in engagement with treatment through visits, medications prescribed, and lab tests; viral loads <200 copies/mL and undetectable viral loads; depressive symptoms and severity; and cross-tabulated health and behavioral health outcomes. She also works with the statistician, economist and data manager to produce estimates of the cost of care, and trends in healthcare costs compared to prior years and at the end of each year of the project.

 


 

Steve Lewis Steven Lewis, MS, MBA // Data Management

Steven Lewis works with the healthcare team and with Information Services developing new report templates for depression assessment and added psychosocial variables, creating queries to automatically extract key data from charts, and produces reports of univariate and stratified data on a quarterly basis, or as needed. He works with Dr. Gurley to design new analyses and reports, and with the team as a whole to review and monitor health trends.