The validity of clinic-based samples in approximating out-of-care HIV-infected populations.

Tremendous strides have been made in the diagnosis and treatment of human immunodeficiency virus (HIV); perhaps now the largest barrier to controlling HIV is retaining those diagnosed in care. Data on out-of-care populations are needed to develop effective retention methods, yet obtaining these remains methodologically challenging due to inherent difficulties in sampling. The purpose of this study was to evaluate whether individuals identified by two sampling methods commonly used to approximate out-of-care populations were significantly different from a sample of newly identified out-of-care persons.

Improved HIV-related outcomes associated with implementation of a novel public health information exchange.

Purpose: The purpose of this study was to evaluate HIV-related outcomes associated with use of a novel public health information exchange that was designed to identify out of care HIV-infected individuals seen within a large, integrated delivery network (IDN).

Methods: A novel, secure, bidirectional health care delivery-public health information exchange, the Louisiana Public Health Information Exchange (LaPHIE) was developed between a multi-geographical IDN and the Louisiana public health authority in response to the high proportion of out of care HIV-infected persons. The system provides real-time provider alerts when any HIV-infected person who has not had CD4 or HIV viral load (VL) monitoring in >1 year receives non-HIV care within the IDN, allowing immediate linkage to HIV specialty care.

Implementation of an innovative, integrated electronic medical record (EMR) and public health information exchange for HIV/AIDS.

Louisiana is severely affected by HIV/AIDS, ranking fifth in AIDS rates in the USA. The Louisiana Public Health Information Exchange (LaPHIE) is a novel, secure bi-directional public health information exchange, linking statewide public health surveillance data with electronic medical record data. LaPHIE alerts medical providers when individuals with HIV/AIDS who have not received HIV care for >12 months are seen at any ambulatory or inpatient facility in an integrated delivery network.

Disease management programs for the underserved.

Disease management has become an important tool for improving population patient outcomes. The Louisiana State University Health Care Services Division (HCSD) has used this tool to provide care to a largely uninsured population for approximately 10 years. Eight programs currently exist within the HCSD focusing on diabetes, asthma, congestive heart failure, HIV, cancer screening, smoking cessation, chronic kidney disease, and diet, exercise, and weight control.

Building a results review system: a critical first step in transitioning from paper medical records.

Electronic health records (EHRs) are valuable tools for efficiently delivering safe and effective care, yet the majority of providers continue to rely on paper based systems. Cost is a significant barrier to adoption. Providers unable to afford a comprehensive EHR may still be capable of taking a less costly first step toward improving quality and safety with less aggressive yet effective clinical information system strategies.