Online Program

Utilization of EMR Innovations to Improve Routine Opt-out HIV Screening in an Urban Academic Emergency Department

Tuesday, November 3, 2015 : 11:10 a.m. - 11:30 a.m.

Cammeo Mauntel-Medici, MPH, Department of Emergency Medicine, University of Illinois at Chicago, Chicago, IL
Sara Baghikar, MD, MPH, Department of Emergency Medicine, University of Illinois at Chicago, Chicago, IL
Janet Lin, MD, MPH, University of Illinois at Chicago, College of Medicine, Chicago, IL
Sweta Basnet, Department of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL
Issues: Routine HIV screening in emergency departments (EDs) has been recommended by the Centers for Disease Control and Prevention (CDC) for over 8 years, but is still not widely implemented in EDs throughout the United States. Innovations are needed to facilitate efficient routine opt-out HIV screening in time- and resource-constrained EDs.

Description: Our screening model utilizes an EMR algorithm to electronically screen patients for eligibility, and an order to “Consent patient for routine HIV screening” is automatically generated for all patients who meet the HIV screening eligibility criteria. Nurses inform patients they’ll be tested unless they decline, and use our “HIV Consent PowerForm” to document patients’ consent or refusal. If consent is documented, the PowerForm automatically places the order for the HIV test.These EMR innovations streamlined the process of determining patient eligibility, documenting consent, and ordering the HIV test. As a result, HIV testing in our ED increased 8757.14% within 2 months of program implementation, with a previous average of 7 tests per month and a current average of 620 tests per month.

Lessons Learned: Routine HIV screening in an urban ED is feasible and EMR innovations facilitate rapid improvement in screening practices. Utilization of EMR prompts and automated orders facilitates efficient integration of routine screening into ED workflow and minimizes burden for ED staff.

Recommendations: EMR technologies and innovations should be utilized to improve the efficiency, acceptability, and sustainability of routine screening programs in EDs. Innovations should be tailored to the existing workflow in each health care setting.

Learning Areas:

Administer health education strategies, interventions and programs
Administration, management, leadership
Implementation of health education strategies, interventions and programs
Protection of the public in relation to communicable diseases including prevention or control
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Describe different types of EMR innovations that can streamline routine HIV screening in various medical settings. Identify opportunities for automating the process of determining patient eligibility for screenings. Discuss EMR innovations that can facilitate more efficient documentation of patient consent and ordering of HIV tests.

Keyword(s): HIV/AIDS, Emergency Medical Services

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: With a background and training in public health I have extensive knowledge and experience with preventive health services and programming. In my current position as Project Manager of Project HEAL (HIV testing, Education, Awareness, and Linkage to care) it is my responsibility to serve as an expert on HIV/AIDS preventive services and best practices, and I personally helped design the EMR innovations described in this abstract.
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.

Back to: 4137.0: HIV Testing Strategies