193749 Louisiana Public Health Information Exchange (LaPHIE): A health information technology partnership to improve access to HIV care

Monday, November 9, 2009: 8:30 AM

Jane Herwehe, MPH , Louisiana State University, Health Care Services Division, Baton Rouge, LA
Michelle Murtaza-Rossini, MPH , Louisiana State University, Health Care Services Division, Baton Rouge, LA
Ke Xiao, PhD , Louisiana State University Health Sciences Center, School of Public Health, New Orleans, LA
Amy Zapata, MPH , Louisiana Office of Public Health, HIV/AIDS Program, New Orleans, LA
Joe Foxhood , Louisiana Office of Public Health, HIV/AIDS Program, New Orleans, LA
M. Beth Scalco, MPA, LCSW , Louisiana Office of Public Health, HIV/AIDS Program, HIV/AIDS Director, New Orleans, LA
Susan Bergson, MPH , Health Systems Development- HIV/AIDS Programs, Louisiana Public Health Institute, New Orleans, LA
Lisa Longfellow, MPH , Office of Public Health, Louisiana Department of Health and Hospitals, New Orleans, LA
Manya Magnus, PhD, MPH , The George Washington University, School of Public Health and Health Sciences, Department of Epidemiology and Biostatistics, Washington, DC
Michael Kaiser, MD , Louisiana State University, Health Care Services Division, Baton Rouge, LA
  
Background: The Louisiana Office of Public Health HIV/AIDS Program (OPH HAP) reported that 16,430 people were living with HIV/AIDS (PLWH/A) by December 2008 and 45% of PLWH/A were not in care as indicated by laboratory testing to monitor immune function. Lack of awareness of serostatus, delays in treatment initiation, and disruptions in care contribute to morbidity and mortality, increasing the potential for HIV transmission in the population. Objective/Purpose: Public health information exchanges such as the Louisiana Public Health Information Exchange (LaPHIE) can improve surveillance and linkage into care for PLWH/A. The purpose of this study was to examine whether electronic disease reporting and clinical messaging facilitates rapid identification and linkage into care of newly diagnosed persons, possibly unaware of serostatus, and out-of-care persons. Methods: LaPHIE is a secure bi-directional data exchange linking Louisiana State University Health Care Services Division (LSU HCSD) hospitals and OPH HAP. Evaluation of LaPHIE includes mixed methods (quantitative and qualitative) to measure its impact on access to care as well as public health practice. Cohort data will be used to assess changes in individual and population level HIV/AIDS-related endpoints and utilization effects. Results: Nearly 1100 unduplicated out of care persons could be reached through LaPHIE. Of these ~70% have not accessed care or dropped out of care and ~30% are in need of updated contact information for additional public health follow-up. An estimated 27% are individuals possibly unaware of status and 20% are perinatally exposed children needing follow-up. Qualitative data indicate acceptability in the system's initial rollout phase, with providers and consumers stating a high degree of expectation that the system will improve HIV related healthcare outcomes. Discussion/Conclusions: This study is the first of its kind to examine endpoints using a mixed model approach, preliminarily demonstrating acceptability by providers and consumers as well as positive outcomes.

Learning Objectives:
1. Describe the role of work flow analysis in development of a business case for public health information exchanges. 2. Discuss methodology for evaluation of health information exchanges. 3. Identify opportunities for transforming public health practice through health information exchanges.

Keywords: Information Systems, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Survellance Manager of the Louisiana Office of Public Health and the Office HIV Aids Program Coordinator for the LA Public Health Information Research Exchange.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Legal and Ethical Questions: Building a Case for Public Health Information Exchanges
See more of: Health Informatics Information Technology