The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #64076

Peter Messeri, PhD¹, Rita Kukafka, DrPh², Mari P. Millery, PhD², Daniel Schluter, PhD³, and Rachel Ferat, MA². (1) Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 West 168 St, New York, NY 10032, (212) 305-1549, pam9@columbia.edu, (2) Center for Applied Public Health, Mailman School of Public Health, Columbia University, 722 West 168th St, New York, NY 10032, (3) Joseph L. Mailman School of Public Health, ETAC, Columbia University, 722 W. 168th Street, Room 1105, New York, NY 10032

HIV TIPS is a web-based, decision-support system for clinical management of HIV. TIPS has two major components. The first is an interactive clinical guidelines database that offers guidance for prescribing combination antiretroviral therapy. Among its features it warns of potentially dangerous drug-to-drug interactions and serious side effects associated with each medication. The second component creates patient tailored education material to improve the effectiveness of medication adherence plans. HIV TIPS is designed to support management of HIV patients in general practice clinics that serve poor and vulnerable population that have limited or no access to an HIV specialist. The attractive features of a web-based expert system for disseminating treatment guidelines to general practice providers are discussed. The system is expected to improve quality of care through reduction in suboptimal prescribing practices and increased patient adherence. A group randomized design will be implemented to evaluate HIV TIPS. Up to forty-two community-based medical care clinics receiving technical assistance and training from the AIDS Education and Training Centers Program will be randomly assigned to one of three experimental conditions: a nonintervention control condition, basic and enhanced intervention groups. The enhanced intervention combines the implementation of TIPS with agency feedback from an information technology needs assessment that is intended to motivate use of the system at both the provider and agency level. Major study outcomes on medication history, patient health status and provider use of the system are to be collected through medical chart abstraction and provider interviews. A cost analysis will also be conducted.

Learning Objectives:

Following this panel discussion, attendees will be able to: (
• identify four mechanisms by which IT interventions are expected to improve HIV-care delivery; (
• identify four methodological approaches in evaluation of IT interventions; (
• discuss challenges to implementation of IT interventions in community-based settings.

Keywords: Quality of Care, Information Technology

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.