Creating A HIV Registry Steven Levine, MD June 2, 2010.

Creating A HIV Registry

Steven Levine, MDJune 2, 2010

Organizational Background

www.institute2000.org

The Institute for Family Health

15 Community Health Centers – 5 Bronx, 4 Manhattan, 6 Mid-Hudson Valley

8 homeless healthcare sites 1 School based health programs3 Dental centers2 Community Mental Health Centers2 Free Clinics

230,000 primary care visits 72,000 patients

The Institute has been fully paperless since September 2002 on Epic Systems (Verona, Wisconsin) Electronic Health Record and Practice Management System

In 2007 the Institute doubled in size with the acquisition of the Mid Hudson Family Health Institute. In the first month all 6 sites were live on the PMS. Six months later all sites were fully live on the EHR.

Background

Why develop an HIV registry?

• Aggregate view of HIV related outcomes;

• Timely accessibility of data; and

• Discover what interventions are needed and for whom.

Institute’s Strategy

• The Institute seeks to ensure that all patients with HIV/AIDS receive high quality care consistent with expert recommendations.

• We intend to develop an HIV/AIDS patient registry populated by electronic health record data.

Goals and Objectives

• To create and implement a guideline-based registry of patients with HIV/AIDS that can be used as a tool to improve quality of care across multiple care sites; and

• Develop a registry of HIV/AIDS patients that can be used to identify and address racial and ethnic disparities in care and outcomes by providing outreach to patients at highest risk of poor outcomes.

Development

Where to start?

• Plan

• Meet

• Design

Who is on the development team?

• The team should be multidisciplinary.

• Including members from all departments who interact and treat patients with HIV and EHR support staff and a report writer.

Team at the Institute

• John Weiser, MD• Steven Levine, MD• Kwame Kitson, MD

Medical Team

What standards should be considered?

• Identify the specific parameters.

• Share with project team

• Review a test run of the report

Documenting the specifications

Show screen shot of smart set

Preliminary Findings

HIV/AIDS Patients by Sex and Age

Males Females 13-19 20-25 26-45 46-64 65+0%

10%

20%

30%

40%

50%

60%

70%

80%

70%

30%

1%6%

45% 45%

4%

HIV/AIDS Patients by Race and Ethnicity

Hispanic 25.3%Non-Hispanic 74.7%

White 19.1%Black 45.2%Not collected 32.5%More than one race 2.2%American Indian/Alaska Native 0.4%Asian/Pacific Islander 0.4%Asian 0.1%Native Hawaiian 0.1%

Percentage of HIV/AIDS Patients Who Received Selected Screening over the Past 12 Months

0%

20%

40%

60%

80%

100%

41%

13% 12%

58% 55% 52%

20%25%

(n=807)

0.0%

5.0%

10.0%

15.0%

20.0%

0.6% 0.2% 0.0% 0.0%0.6%

4.8%

0.6% 0.5% 0.2%1.0%

3.2%

11.9%

15.0%

0.7% 0.5%

Percentage of HIV/AIDS Patients Screened for Syphilis in the Past 12 Months by Location

Number of Patients with Resulted Viral Load 400+ 50-399 Undetectable0

20

40

60

80

100

120

140

160

180

200188

164

23

1

Number of Patients Screened for Viral Load and Those Resulted

Final Thoughts

• User friendly• Time efficient• Ongoing and always current• Easily display trends• Identify needs quickly and • Effectively plan interventions

Thank You!

Steven Levine, MD

[email protected]

212-633-0800 ext. 1275