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Background Advances in medical treatments in recent years have contributed to an overall decline in HIV-related opportunistic infections and deaths in youth; however, mortality and morbidity rates in perinatally and nonperinatally infected adolescents and young adults (AYA) living with HIV remain relatively high today. Objective The goal of this project was to assess the use, utility, and cost-effectiveness of PlusCare, a digital app for HIV case management in AYA living with HIV. The app supports routine case management tasks, such as scheduling follow-up visits, sharing documents for review and signature, laboratory test results, and between-visit communications (eg, encouraging messages). Methods We conducted a single-group mixed methods pre-post study with HIV case management programs in 2 large urban hospitals in the Boston metro area. Case management staff (case managers [CMs], N=20) and AYA living with HIV participants (N=45) took part in the study with access to PlusCare for up to 15 and 12 months, respectively. Results The CMs and AYA living with HIV reported mean System Usability Scale scores of 51 (SD 7.9) and 63 (SD 10.6), respectively. Although marginally significant, total charges billed at 1 of the 2 sites compared with the 12 months before app use (including emergency, inpatient, and outpatient charges) decreased by 41% (P=.046). We also observed slight increases in AYA living with HIV self-reported self-efficacy in chronic disease management and quality of life (Health-Related Quality of Life-4) from baseline to the 12-month follow-up (P=.02 and P=.03, respectively) and increased self-efficacy from the 6- to 12-month follow-up (P=.02). There was no significant change in HIV viral suppression, appointment adherence, or medication adherence in this small-sample pilot study. Conclusions Although perceived usability was low, qualitative feedback from CMs and use patterns suggested that direct messaging and timely, remote, and secure sharing of laboratory results and documents (including electronic signatures) between CMs and AYA living with HIV can be particularly useful and have potential value in supporting care coordination and promoting patient self-efficacy and quality of life. Trial Registration ClinicalTrials.gov NCT03758066; https://clinicaltrials.gov/ct2/show/NCT03758066

BACKGROUND Advances in medical treatments in recent years have contributed to an overall decline in HIV-related opportunistic infections and deaths in youth; however, mortality and morbidity rates in perinatally and non-perinatally infected youth living with HIV (YLWH) remain relatively high today. OBJECTIVE The goal of this project is to assess the usage, utility, and cost-effectiveness of PlusCare, a mobile/web application (app) for HIV case management for YLWH. The app supports routine case management tasks such as scheduling follow-up visits, sharing documents for review and signature, lab test results, and between-visit communications (e.g., encouraging messages). METHODS We conducted a single-group mixed-methods, pre-post study conducted with HIV case management programs in 2 large, urban hospitals in the Boston metro area. Case management staff (CMs, N=20) and YLWH patients (N=45) participated in the study with access to PlusCare for up to 15 months and 12 months, respectively. RESULTS CMs and YLWH reported System Usability Scale scores of 51 (SD=7.9) and 63 (SD=10.6), respectively. Although marginally significant, total charges billed at one of the two sites compared to the 12 months prior to app use (including emergency, inpatient, and outpatient charges) decreased by 41% (P=.046). We also observed slight increases in YLWH self-reported self-efficacy (SEMCD6) and quality of life (CDC HRQOL-4) from baseline to 12-month follow-up (P=.02 and P=.03, respectively) and increases in self-efficacy from 6-month to 12-month follow-up (P=.02). There was no significant change in HIV viral suppression or appointment or medication adherence in this small sample pilot study. CONCLUSIONS While perceived usability was low, qualitative feedback from CMs and usage patterns suggest direct messaging and timely, remote, and secure sharing of lab results and documents (including electronic signatures) between CMs and YLWH can be particularly useful and have potential value in supporting care coordination and promotion of patient self-efficacy and quality of life. CLINICALTRIAL ClinicalTrials.gov NCT03758066