Promise of Health IT: Improving HIV Care Services

Background: Six unique electronic network systems (ENS) have been implemented to interconnect providers from different care locations in a new HRSA-SPNS Information Technology Networks of Care Initiative. These systems aim to promote health information exchange to improve the delivery, continuity, and quality of care to people living with HIV/AIDS receiving services in publicly-funded settings. ENS offer a mechanism for improving providers' understanding of the kinds of care that patients receive, and for facilitating referrals across medical clinics and service agencies. Enhanced coordination may promote better health outcomes and improved satisfaction.

Methods: We conducted 49 in-depth interviews with key stakeholders including system collaborators and users to assess system development, collaboration, confidentiality, usability, technological, attitudinal, financial, logistical and structural challenges. Interviews were coded to identify converging and diverging themes.

Results: Acceptability of ENS was highest when a common vision was present across collaborating agencies. Successful systems were built under conditions of openness and inclusiveness to partnering agencies to provide input on the design and implementation of the system. Organizational readiness and technological preparedness, such as having needed computer hardware, facilitated acceptability. Perceived benefits of ENS included improved workflow efficiency and patient care. Barriers to implementation included incompatible systems at partnering sites, costly system upgrades and concerns about the relevance of ENS to improving care.

Conclusions: Electronic network systems are perceived as beneficial in reducing inefficiencies and duplication of errors. In publicly-funded HIV care sites, ENS hold promise for improving continuity and quality of care particularly when collaborators agree on a shared vision.