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APHA Scientific Session and Event Listing

Recorded presentation

Charles M. Belden, BA, Mathieu Despard, MSW, Rae Jean Proescholdbell, PhD, and Frank M. Lombard, LCSW. Center for Health Policy - Health Inequalities Program, Duke University, 302 Towerview Road, Rubenstein Hall, Durham, NC 27708, 919-613-9356, mike.belden@duke.edu

Issues:

The Office of the National Coordinator for Health Technology (ONCHIT) has stated that informing clinical practice and interconnecting clinicians are two of the four main goals in the development of health information technology (HIT) in the US.

Description:

The Duke University Special Projects of National Significance team analyzed 10 years of process data regarding Electronic Health Record (EHR) implementation and the perceived needs of HIV clinical and ancillary providers in the urban-rural state of North Carolina.

Lessons Learned:

Results suggested that HIV clinicians should be interconnected with ancillary care providers to optimally inform clinical practice. Further, neither HIV medical providers nor case managers desired the exchange of the entire EHR, preferring instead the exchange of a small amount of specific data (i.e., viral load, CD4 count, medication adherence assessment, and next appointment date). Barriers to the implementation of EHRs include: competing demands for reporting clinical and administrative-level data for discretionary funded programs, disparities in information technology infrastructure between clinical providers and ancillary care providers and incompatibility between institutional EHRs and HIV-specific EHRs. Barriers to interconnecting clinical providers and case managers include: lack of medical provider trust concerning understanding and use of clinical data by case managers, varied capacity deficiencies among case management agencies, and lack of reconciliation between medical care and social service delivery perspectives.

Recommendations:

As regional health information organizations (RHIO) develop EHRs, further work must be accomplished to facilitate the participation of community-based ancillary care providers when such participation is expected to positively inform clinical practice.

Learning Objectives:

• Describe the potential benefits of linking HIV medical providers and community-based ancillary care providers.
• List the four kinds of information HIV medical and ancillary care providers wish to exchange.
• Articulate barriers to implementing Electronic Health Records.
• Articulate barriers to connecting HIV medical and ancillary care providers.

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation