Knowing is best, take the test: An inner-city hospital's experience with routine HIV screening

Drexel University College of Medicine’s Hahnemann Hospital is an inner-city hospital servicing over 120,000 patients annually. The FOCUS program is nearing the end of its first year implementing routine HIV screening hospital-wide utilizing a lab-based approach with fourth-generation technology. The launch of the campaign in April 2013, was groundbreaking as Hahnemann is the first adult tertiary care hospital in Philadelphia to incorporate routine testing as a standard of care.

From April 2013 to January 2014, Hahnemann has tested over 1622 persons of which, 98 patients had a reactive result (seropositivity rate is 6%).  To date, 66 patients (67%) have been linked into care of which 20 patients are linked into Drexel’s HIV Partnership Practice.   Due to our locale, Hahnemann services a largely transient population making Linkage efforts arduous and consequently, 12 patients are pending linkage.

The success of our program largely hinges upon EMR integration.  This has been the biggest barrier we face and our data illustrate how critical EMR integration is to routinizing testing.  We have been advocating for such integration prior to launching and are currently in the development stage, working closely with parties involved.  Hahnemann is a unique FOCUS partner in that the hospital is run by two differing entities (Drexel University College of Medicine and Tenet) which has made program implementation efforts an ongoing challenge.

A Provider Advisory Board was created at the inception of this campaign to allow for an open forum discussing successes, challenges and barriers in implementation of routine testing.  Providers serving on the Board share their expertise forming a truly multi-disciplinary approach.  While the program is still growing in its first year, our team attributes early successes to the continual engagement of key stakeholders, including hospital executives. Because of this outreach, the hospital c-suite has proven to be very supportive of the philosophy of the program; the Chief Medical Officer drove hospital-wide institution policy change routinizing HIV testing.