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Addressing Travel Barriers in Hemophilia Care: From Needs Assessment to Regional Satellite Clinic Implementation Sidney Glass, Elizabeth Hunt, Erika Martin. Virginia Commonwealth University, Richmond, VA, USA

Abstract

Background A 2020 statewide needs assessment conducted by the Virginia Bleeding Disorders Program identified distance and travel barriers as major obstacles to care for patients with inherited bleeding disorders. Over 66% lived more than 50 miles from their Hemophilia Treatment Center (HTC), and 73% of providers reported distance as a barrier for at least half of their patients. Among adults receiving care at Virginia Commonwealth University (VCU) HTC, one of only two lifespan HTCs in Virginia, 58% lived over 50 miles away, and over half of these patients were located in eastern Virginia. In response to these findings, VCU HTC conducted a targeted patient interest survey among adults in eastern Virginia to assess travel burden and gauge support for a satellite clinic. Based on strong patient interest and identified needs, VCU HTC launched a quarterly comprehensive adult satellite clinic in Williamsburg to expand access to specialized care in eastern Virginia. Its proximity to Children’s Hospital of The King’s Daughters (CHKD), a primary pediatric HTC referral source, strategically supports pediatric-to-adult transition by enhancing continuity of care for young adults. Objectives To assess patient interest, travel burden, and anticipated impact of a regional satellite clinic on access to care and appointment attendance; and to evaluate patient satisfaction following the first clinic session. Methods A five-question survey was administered via phone by clinic staff to adult patients (18+) with inherited bleeding disorders living in eastern Virginia. The survey assessed travel distance, visit frequency, challenges to care, and interest in a satellite clinic. Data were collected from 61 respondents out of 88 eligible patients. Additionally, a post-visit satisfaction survey was administered to patients attending the first clinic, offered in paper format or via an online link, and completed by 10 of 17 attendees. Results Among 61 respondents to the patient interest survey, 92% reported traveling more than 30 miles or over one hour for care, 88% expressed interest in a satellite clinic closer to home, and 66% anticipated improved appointment attendance. The most frequently reported barriers to care were travel distance (66%) and time off work or school (44%). After the first satellite clinic, 10 of 17 attendees completed a satisfaction survey. Results showed 90% were very satisfied, and all reported reduced travel burden with medical and support needs fully met. Coordination of care was rated excellent by 90% of respondents. Travel time to the clinic was substantially reduced, with 10% reporting travel time was less than 30 minutes, 50% reporting 30–60 minutes, and 40% reporting 1–1.5 hours. Additionally, 90% rated location access as easy or very easy. Conclusion This initiative addresses patient-identified barriers and marks a critical step toward equitable, lifelong hemophilia care in Virginia. Early feedback indicates strong support for the satellite clinic, with travel time reduced by about one hour, improving access and continuity. Its proximity to a major pediatric HTC facilitates transition planning and supports seamless care from pediatric to adult services. Ongoing evaluation will inform future expansion and resource allocation.

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