DataToCare_CDCPresentation_final

© 2014 Denver Public Health

Localizing HIV: the Data to Care Tool2014 National HIV Surveillance Grantees’ Meeting

Dec. 5, 2014

Lauren Snyder, MPH

Applied Public Health Informatics Fellowship Program

Denver Public Health

Mark Thrun, MD

Associate Professor, University of Colorado

Division of Infectious Diseases

Director, HIV/STD Prevention and Control

Denver Public Health

Director, Denver Prevention Training Center

© 2014 Denver Public Health

Opportunity and Need

• Mandatory reporting of HIV labs – CD4/VL – and increasing adoption of EHRs means more robust data available to help monitor epidemic

• Democratized data puts tools in hands of those most in need of it, but a user interface needed

• Real-time, local data more useful for both program planning and intervening at patient level

© 2014 Denver Public Health

Development Process - Phased Planning

HIV 1• Requirements document

• What do we want and how does it back translate with data being collected

HIV 2• Merging of primary data into one warehouse

• Common variable names, etc

HIV 3 • Visualization process

• Translating the data for web consumption

HIV4 • Redefining requirements and modifying visualized output

© 2014 Denver Public Health

eHARS

CD4/VL

DH Labs

Eval WebStaging

Data Warehouse

Invision

Web page access points

Diagnoses

Linkage

Retention/Re-engagement

Other: CVLCare, etc

© 2014 Denver Public Health

eHARS

CD4/VL

DH Labs

Eval WebStaging

Data Warehouse

Invision

Web page access points

Diagnoses

Linkage

Retention/Re-engagement

Other: CVLCare, etcHIV 2

© 2014 Denver Public Health

eHARS

CD4/VL

DH Labs

Eval WebStaging

Data Warehouse

Invision

Web page access points

Diagnoses

Linkage

Retention/Re-engagement

Other: CVLCare, etcHIV 3

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© 2014 Denver Public Health

© 2014 Denver Public Health

Program Planning

Outreach

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HIV Surveillance Summary

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© 2014 Denver Public Health

Diagnosis HIV Summary – Denver County

Residence at Diagnosis, Denver,1/1/2012-12/31/2012

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Linkage to Care Summary – Denver County

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Retention in Care Summary

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HIV Care Summary – Denver Health

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Community Viral Load

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© 2014 Denver Public Health

Data to Care: Uses of the Tool

Program planning

• Improved understanding of the nuances of the local epidemic

• Improve communication regarding prevention needs

• Better allocation of staffing resources/needs– Within the HD

– In the community

• Greater efficiency in evaluation of program

Patient management

• Improved linkage assessment

• Real-time assessment of retention and reengagement efforts by subpopulations– Develop NIC lists

– Allow for outreach interventions

• Assess clinical outcomes : OI’s, STD screening, etc

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• Additional slides, as needed/not for distribution

© 2014 Denver Public Health

Team approach

• Prep team

– What are we talking about as an end result

– How does that back translate to current data

• Very specific – Date of certain test; Need to merge or limit variables, etc

• Build team

– IT experts creating code and software

• Test team/Data reconciliation

– Validate Build team’s output with known data

© 2014 Denver Public Health

© 2014 Denver Public Health

© 2014 Denver Public Health

Next steps: 2a1- Incidence

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Next steps: 2b1- Linkage to Care

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Next steps: 2c1- Retention in Care

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Next steps: 2e1- Community Viral Load

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Next steps: 1a1: Surveillance Summary