Published on March 14, 2017

New partnership launches Carolina Hepatitis Academic Mentorship Program

The state-wide program to help patients across North Carolina grew out of the successful doctor mentorship initiative led by Michael Fried, MD, Director of the UNC Liver Center.

The North Carolina Division of Public Health, Duke University Medical Center and the University of North Carolina School of Medicine have partnered to launch an innovative primary provider training program: the Carolina Hepatitis Academic Mentorship Program (CHAMP), which officially got underway on January 17, 2017.

The NC Champ program uses a telemedicine training model that links disease specialists to primary care providers in rural or otherwise difficult to reach locations. This training model allow providers to remove barriers to care and expand the provider network for people infected with hepatitis C.

“The objective of NC CHAMP is to expand access for people infected with hepatitis C virus by embracing an innovative training approach designed to remove barriers to care,” said Kimberly Psaltis MPH, RN, CDE, who oversees the program for the Communicable Disease Branch of the NC Division of Public Health.

In North Carolina, acute Hepatitis C has increased 400 percent since 2009. There are an estimated 110,000 people in the state living with chronic hepatitis C – a persistent liver disease that can lead to serious complications, including cirrhosis or liver cancer.

“Our intention is to build a North Carolina primary care workforce trained to diagnose, care for, and cure people infected with hepatitis C,” said Psaltis.

“What I like about this telemedicine program is that it is flexible, scalable, and sustainable,” said Heidi Swygard, MD, MPH, associate professor in the UNC School of Medicine and medical director of the viral hepatitis program for the Communicable Disease Branch of the NC Division of Public Health.

NC CHAMP provides an opportunity to train primary providers to deliver hepatitis C curative therapies and link those with more complicated needs to specialists at tertiary centers. To achieve this goal, the NC Division of Public Health approached leading experts at UNC and Duke to develop a peer training program for primary care providers to manage hepatitis C care and work towards eliminating the disease statewide.

CHAMP builds upon a successful mentorship initiative led by Michael Fried, MD, director of the UNC Liver Center. Beginning in January 2015, Dr. Fried began consultations about hepatitis C care with Rick Moore, MD, and Alison Bartel, MD, of the Rural Health Group in Roanoke Rapids, North Carolina. The remote training began with twice-monthly teleconferencing consultations about hepatitis C care. In its first 18 months, that effort produced extremely encouraging results in the treatment and cure of patients with hepatitis C.

“Doctor Moore and Dr. Bartel were very dedicated to treating hepatitis C, and that was reflected in the outstanding care that they provided to their patients”, said Dr. Fried.  “They demonstrated that this collaborative model could be highly effective to help deal with the growing burden of hepatitis C in North Carolina, especially in areas where there was limited access to specialty care.”

Concurrently, Andrew Muir, MD, Chief of the Division of Gastroenterology in the Department of Medicine at Duke University School of Medicine, directed a mentorship partnership with a practice in Virginia. The clinic is not able to care for patients infected with hepatitis C independently. Going forward, Dr. Muir will regularly host physician assistants and nurse practitioners from around the state at Duke clinics.

“I am very grateful for the leadership of the state and the partnership with UNC to help address hepatitis C around North Carolina,” Dr. Muir said. “Too many patients travel great distances for hepatitis C care and I am sure many never get the care they need if they live far away from academic centers. I hope I can help this program make a real difference in the lives of people living with hepatitis C.”

NC CHAMP is designed to train primary providers to diagnose and deliver hepatitis C care and curative treatments. Ideally, the training model will foster peer collaborations and referral networks in local communities and across the state through regularly scheduled mentorship meetings.

Clinicians begin the NC CHAMP process with an intensive, in-person “boot camp” to learn about hepatitis C diagnosis and treatment. Afterwards, those who enroll will meet by teleconference in small groups for approximately one hour every other week. During that time, they have the opportunity to present cases to their peers and mentor for review and feedback. 

Academic mentors are also available for additional consultations and as backup to manage more advanced or complex situations.  By establishing strong referral networks, such patients – those with advanced liver disease, for example – can be linked to a specialist to manage monitoring for liver-related complications of hepatitis C, including hepatocellular carcinoma (a form of cancer associated with liver disease).

The expectation for providers who attend the boot camp and enroll in CHAMP will be that they start implementing screening guidelines for hepatitis C in their clinical practice and begin delivering new curative therapies and reduce the burden of chronic disease care.

NC CHAMP is a collaborative program developed by clinical specialists and public health professionals. The program is sustained by the efforts and partnership of the following: 

UNC School of Medicine

Michael Fried, MD, Professor of Medicine and Director of the UNC Liver Center
Jama Darling, MD, Assistant Professor of Medicine, Division of GI/Hepatology

Duke University School of Medicine
Andrew Muir, MD Professor of Medicine and Chief, Duke Division of Gastroenterology

Rural Health Group (Roanoke Rapids, North Carolina)
Rick Moore, MD
Alison Bartel, MD 

Communicable Disease Branch, NC Division of Public Health
Evelyn M. Foust, MPH, CPM
Jacquelyn Clymore, MS
Heidi Swygard, MD, MPH
Kimberly Psaltis MPH, RN, CDE