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APHA Scientific Session and Event Listing

Recorded presentation

Jane Herwehe, MPH¹, Nathan Daigrepont¹, Manya Magnus, PhD, MPH², Laura Gibson, MBA¹, Tanya Brown, BA¹, Jeffrey Bawner¹, Newton E. Hyslop, MD³, Steven Styron, MBA³, and Michael Kaiser, MD¹. (1) Louisiana State University, Health Care Services Division, 8550 United Plaza Blvd., 4th Floor, Baton Rouge, LA 70809, (225)922-3230, jherwe@lsuhsc.edu, (2) The George Washington University, School of Public Health and Health Sciences, Department of Epidemiology and Biostatistics, 2300 Eye Street, NW, Ross Hall 120b, Washington, DC 20037, (3) Tulane University, Tulane Adult Infectious Disease Section, 1430 Tulane Avenue, SL-87, New Orleans, LA 70112

Background. Technology has the potential to improve health-related outcomes. In 2002, an HIV-specific interactive information technology intervention (ITI) was implemented at Louisiana public hospitals. The purpose of this study was to assess clinical and utilization outcomes associated with its use in a cohort.

Methods. Clinical and utilization data entered or viewed by clinicians between 5/6/2003 and 8/26/2005 were included. Generalized estimating equations (GEE) were used to identify associations. Predictors included use of health maintenance tracking tool, provider type (high vs. low ITI user), and per patient ITI uses. Outcomes included time between visits, diagnosis of PCP pneumonia, prescription of PCP prophylaxis for patients with CD4 < 200, and prescription of antiretrovirals for patients with CD4< 350. Models were adjusted for patient gender, baseline CD4 count, and number of visits in the system. A Bonferonni correction (Ą=0.0125), independent correlation matrices, robust estimators of variance, and Stata 9.0 were used.

Results. Between 5/6/2003 and 8/26/2005 there were 287,264 uses for 6,137 patients, by 63 users. The majority was for patient data (46.9%), diagnoses (14.7%), labs (11.1%), medications (10.7%), and health maintenance/screening information (8.7%). Health maintenance use was associated with increased prescription of antiretrovirals (p<0.001) and PCP prophylaxis (p<0.001). High use was associated with reductions in PCP pneumonia (p<0.001) and decreased average time between visits (p<0.01).

Conclusions. Use of an HIV-specific ITI was associated with improvements in medication prescription, retention in clinic, and reduction in PCP risk. This study suggests that electronic tools may be an important adjunct to care for HIV-infected patients.

Learning Objectives: Upon completion of this session, participants will be able to

• Discuss how an information technology initiative (ITI) can inform and connect clinicians.
• Describe how an HIV-specific ITI can improve health-related outcomes.

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation