Implementing client-level data reporting at HIV medical and supportive service agencies

Background: In 2009 Health Resources Services Administration (HRSA) began collecting client level data from all programs funded under the Ryan White Care Act. Client-level data includes information that is unique to each individual client such as, date of service, type of service provided, outcomes of those services and health status. Collecting and reporting client-level data requires specific data management systems and Ryan White grantees throughout the country are challenged by trying to obtain these data from agencies whose systems are not integrated or equipped to collect or provide the required client-level variables. Methods: Agencies completed a readiness survey that assessed the capacity of their current data management systems to produce client-level data reports and to identify types of patient data being collected and the process for collecting and storing data. All agencies received onsite technical assistance from a HRSA sponsored CAREWare expert to further define their needs for a client-level data reporting system and participated in a group learning session on client-level data entry and reporting. Results: 13 agencies adopted CAREWare, a secured client-level data management system that collects and exports client-level data reports, and were linked to a secured, centralized server, that was stored at the offices of the grant administrator. The grant administrators provided technical assistance and support services for historic data entry and ongoing education regarding use of CAREWare. The centralized server further enhanced the grantee's capacity to monitor service utilization, quality performance measures and retention in care. Conclusions/Implications: With the implementation of CAREWare, Ryan White grantees were able to comply with the federal client-level data reporting requirements, ensure accountability of CARE Act funds and improve their capacity to monitor coordination of care within their system of care. Implementing a large-scale transition to new data management systems requires strategic planning complete with specific timelines for deployment and policies and procedures to address timeliness and accuracy of data entry and reporting.