The Dallas VA Medical Center, a teaching facility for Southwestern Medical School, is a modern medical clinic facility that opened in November 1998. Located in a large urban area, is also serves 37 Texas and 2 Oklahoma counties. The mission of the medical center is to provide comprehensive health care to veterans, achieving excellence in clinical care, research, and education. In addition to 258 acute care beds, there is a transitional care unit, a long-term domiciliary program, and a large psychiatric facility. The Dallas VAMC research and development program expended $7,211,726 in FY 98, and has recently opened an inpatient clinical research unit (ICRU). Its laboratory is a reference laboratory for viral load, HIV genotypic resistance testing and CD4 testing.
HIV Program
The program has treated HIV-infected individuals since the mid-1980s. It is a rapidly growing program, with patient volumes in the top 10-15% nationally. Over 500 patients are currently enrolled in the VA HIV clinic. The racial breakdown is 46% African American, 47% Caucasian, and 6% Hispanic. The patient population is about 2% female, 375 of the patients are gay or bisexual men, 23% are Heterosexual, and 12% are IV drug users.
The HIV team offers multidisciplinary inpatient and outpatient care for the management of HIV infection and its complications, as well as educational and psychosocial support for individuals, their significant others, and their families. Through expert care, our goal is to empower each patient to manage their HIV infection, and enjoy a healthy and productive life.
Over 80% of patients seen at our clinic and placed on antiretroviral therapy have achieved an undetectable viral load, and 86% have a CD4 count over 200 (the highest percentage in the national VA hospital system). As a result, opportunistic infections are rarely observed. The focus of our practice and research efforts is therefore increasingly on the prevention and management of chronic complications from antiretroviral therapy, HCV and HBV co-infection and HIV itself.
The clinic is directed by Roger Bedimo, M.D., and is attended by three other ID physicians (James W. Smith, M.D., Clark R. Gregg, M.D., and Sanjay Revankar, M.D.) and two physician assistants (Mary Beth Kvanli, PA-C, Diana Turner, PA-C) In sum, these providers account for more than 80 years of experience in treating HIV disease. They are also all active in performing clinical trials. The staff also includes an HIV educator (Helen Lacy, RN) who is a nurse, and a social worker (Bettye White, MSW). Two HIV research coordinators (Holly Wise and Joyce Wagner) assist in the management of clinical studies.
Finally, the HIV program has a close collaboration with the Pharmacy program of the Texas Tech University Health Science Center which has a branch within the VA campus. One of the faculty, Anthony Busty, Pharm D, is integral part of the HIV clinic, assisting on antiretroviral and other drug issues. He also has research projects in collaboration with the program PI.
The service offers education and training in HIV medicine to physicians and other health providers in the outpatient clinic setting, and administers outreach education to the community via seminars, video conferences, and an annual regional training seminar.
Infection Control Program
The IC Program is an active, comprehensive program to prevent, detect, and control infections in patients, employees, medical and surgical staff, contractors, volunteers, and visitors. The program is directed by the Infectious Control Committee chaired by Sanjay Revankar, M.D., assisted by three IC nurses: Beverly Gray, R.N., CIC; Bernadette Arends-Taylor, R.N., CIC; and Kathleen Hartless, R.N., CIC. The IC Program is responsible for establishing policies and a surveillance program to identify and analyze important epidemiological events in the medical center. Infection Control policies are located in the Infection Control Manual (http://vhantxiis.dallas.med.va.gov/idsection/icmanual/IC%20MANUAL%203.htm).
