Increasing rapid HIV testing in the Emergency Department through the implementation of a provider-driven testing model

Background: 40% of NYC's HIV/AIDS cases are within our hospital's service area. To respond to community need, an HIV counselor conducted rapid HIV tests on Emergency Department (ED) patients. This method was successful in testing 200patients/month. Our goal was to routinize HIV screening and testing for all ED patients age 13 and older by implementing a provider-driven rapid HIV testing model in the ED. Methods: All ED patients age 13 and older are screened at triage for their self-reported HIV status and their desire to be tested. This response is entered into a mandated field in the patient's electronic medical record (EMR). HIV literature and a consent form are provided to the patient. The patient requesting testing appears in a queue in the EMR. A nurse ensures that the consent form is signed and draws blood for the test. The result is entered by the lab into the EMR within one hour. The physician gives the patient his/her result. If the result is positive, an HIV counselor links the patient to HIV primary care. Results: Provider-driven rapid HIV ED testing resulted in screening 100% of eligible patients with a 100% increase in patients tested/month with no increased resources. Conclusion: A provider-driven rapid ED HIV testing model resulted in all patients age 13 and older being screened and offered an HIV test which has significantly increased the number of individuals who leave the ED aware of their HIV status and are linked to follow-up care requiring no additional resources.