Programming Connection

Delegated public health follow-up process 

Vancouver Coastal Health
British Columbia

What is the Program?

In 2011, Vancouver Coastal Health Communicable Disease Control (CDC) developed a delegated public health follow-up process that has been integrated into the system of HIV care in Vancouver. The process was designed as a service to both patients and healthcare providers to facilitate HIV testing and follow-up services for patients with positive results.

The delegated public health follow-up process allows any physicians who order HIV tests to access support from public health for follow-up of positive results. A spectrum of support is available. At one end of the spectrum, support may consist simply of a phone call to the physician to plan follow-up care. At the other end of the spectrum, physicians can choose to rely on public health to provide all follow-up services to their patients on their behalf.

Public health follow-up services include: discussing the diagnosis and counselling the patient and their testing provider; providing HIV education for the patient and their primary healthcare provider, including information on available resources; ensuring that the patient is linked to HIV care and appropriate support services; and supporting voluntary partner notification services.

The goals of public health follow-up for HIV are to:

  1. facilitate early diagnosis of HIV
  2. support rapid linkage to treatment and care
  3. provide partner notification and care

HIV, like many other communicable diseases, is reportable to the Medical Health Officer in British Columbia. The requirement to report HIV diagnoses to public health has traditionally provided an opportunity for public health nurses to support testing physicians whose patients have new diagnoses, and these traditional forms of public health follow-up continue to be used by many physicians in Vancouver.    This case study focuses on the new process of delegating some or all follow-up responsibilities to public health, including discussing the diagnosis, counselling, education, linkage to treatment and support services, and partner notification.