Creating A HIV Registry Steven Levine, MD June 2, 2010.
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Creating A HIV Registry Steven Levine, MD June 2, 2010
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Transcript of Creating A HIV Registry Steven Levine, MD June 2, 2010.
Creating A HIV Registry
Steven Levine, MDJune 2, 2010
Organizational Background
www.institute2000.org
The Institute for Family Health
15 Community Health Centers – 5 Bronx, 4 Manhattan, 6 Mid-Hudson Valley
8 homeless healthcare sites 1 School based health programs3 Dental centers2 Community Mental Health Centers2 Free Clinics
230,000 primary care visits 72,000 patients
The Institute has been fully paperless since September 2002 on Epic Systems (Verona, Wisconsin) Electronic Health Record and Practice Management System
In 2007 the Institute doubled in size with the acquisition of the Mid Hudson Family Health Institute. In the first month all 6 sites were live on the PMS. Six months later all sites were fully live on the EHR.
Background
Why develop an HIV registry?
• Aggregate view of HIV related outcomes;
• Timely accessibility of data; and
• Discover what interventions are needed and for whom.
Institute’s Strategy
• The Institute seeks to ensure that all patients with HIV/AIDS receive high quality care consistent with expert recommendations.
• We intend to develop an HIV/AIDS patient registry populated by electronic health record data.
Goals and Objectives
• To create and implement a guideline-based registry of patients with HIV/AIDS that can be used as a tool to improve quality of care across multiple care sites; and
• Develop a registry of HIV/AIDS patients that can be used to identify and address racial and ethnic disparities in care and outcomes by providing outreach to patients at highest risk of poor outcomes.
Development
Where to start?
• Plan
• Meet
• Design
Who is on the development team?
• The team should be multidisciplinary.
• Including members from all departments who interact and treat patients with HIV and EHR support staff and a report writer.
Team at the Institute
• John Weiser, MD• Steven Levine, MD• Kwame Kitson, MD
Medical Team
What standards should be considered?
• Identify the specific parameters.
• Share with project team
• Review a test run of the report
Documenting the specifications
Show screen shot of smart set
Preliminary Findings
HIV/AIDS Patients by Sex and Age
Males Females 13-19 20-25 26-45 46-64 65+0%
10%
20%
30%
40%
50%
60%
70%
80%
70%
30%
1%6%
45% 45%
4%
HIV/AIDS Patients by Race and Ethnicity
Hispanic 25.3%Non-Hispanic 74.7%
White 19.1%Black 45.2%Not collected 32.5%More than one race 2.2%American Indian/Alaska Native 0.4%Asian/Pacific Islander 0.4%Asian 0.1%Native Hawaiian 0.1%
Percentage of HIV/AIDS Patients Who Received Selected Screening over the Past 12 Months
0%
20%
40%
60%
80%
100%
41%
13% 12%
58% 55% 52%
20%25%
(n=807)
0.0%
5.0%
10.0%
15.0%
20.0%
0.6% 0.2% 0.0% 0.0%0.6%
4.8%
0.6% 0.5% 0.2%1.0%
3.2%
11.9%
15.0%
0.7% 0.5%
Percentage of HIV/AIDS Patients Screened for Syphilis in the Past 12 Months by Location
Number of Patients with Resulted Viral Load 400+ 50-399 Undetectable0
20
40
60
80
100
120
140
160
180
200188
164
23
1
Number of Patients Screened for Viral Load and Those Resulted
Final Thoughts
• User friendly• Time efficient• Ongoing and always current• Easily display trends• Identify needs quickly and • Effectively plan interventions
