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APHA Scientific Session and Event Listing

Recorded presentation

Beulah Perdue Sabundayo, PharmD, MPH, Jeanne Keruly, MS, CRNP, Greg Lucas, MD, PhD, and Richard D. Moore, MD, MHS. The Johns Hopkins University School of Medicine, Division of General Internal Medicine, 1830 East Monument Street, Room 8016, Baltimore, MD 21287, (443)287-6404, bsabund1@jhmi.edu

Background: The Office of the National Coordinator for Health Information Technology (ONCHIT) outlined 4 goals for health information technology (IT). Goal 1 is “inform clinical practice”. Audio computer-assisted self-interview (ACASI), an IT tool, provides more valid data than face-to-face interviews. We hypothesize that ACASI feedback to clinicians will inform clinical practice by improving clinician-patient communication, facilitating early identification of poor adherence, and promote timely interventions.

Methods: Patients enroll for 12 months and answer ACASI questionnaires immediately prior to clinician visits. Patients were randomized to have ACASI summaries relayed to clinicians just prior to visits or remain confidential. Clinicians are surveyed at 1 and 12 months to assess ACASI's impact on clinical practice decisions.

Results: 198 patients (58% male, 87% African American) enrolled and completed 1106 ACASIs (median: 6; range: 1-16). Median age is 43 years (range: 24-66) and 134 (68%) completed study. 33 clinicians completed 87 (1 month) and 58 (12 months) surveys. At month 1, 70% of clinicians reported that ACASI improved clinician-patient communication versus 74% at 12 months. Patient's self-reported adherence and reasons for missing doses were the most commonly cited helpful information at 1 (72%) and 12 (90%) months. Most frequent clinical management decisions included adherence discussions and strategies to improve adherence (1 and 12 months: 45% and 46%, respectively).

Conclusions: We enrolled primarily African Americans, a population that is generally under-represented in studies. ACASI was widely accepted by clinicians and viewed as a helpful IT tool to improve patient care, consistent with Goal 1 of ONCHIT.

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

• Describe how audio computer-assisted self-interview (ACASI) may be used in an urban HIV clinic population to impove clinician-patient communication.
• Identify helpful clinical managment decisions which inform clinical practice.
• Discuss clinician acceptance and satisfaction with ACASI.

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation