How to improve the quality of a disease management program for HIV-infected patients using a computerized data system. The Saint-Antoine Orchestra program

Fonquernie, L.; Lacombe, Karine; Vincensini, Jean-François; Boccara, Franck; Clozel, S.; Boda, A; Bollens, Diane; Campa, Pauline; Pacanowski, Jérôme; Meynard, J.-L.; Meyohas, Marie-Caroline; Girard, Pierre‐Marie

doi:10.1080/09540120903280893

Cited by 7 publications

(11 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Ten studies were conducted in the USA,2,26,29–36 three in the UK/Europe,37–39 and three in sub-Saharan Africa 27,28,40. All studies examined care in the ambulatory setting.…”

Section: Resultsmentioning

confidence: 99%

“…The risk of bias for cohort, time-motion, and prospective time-series studies was assessed using the Newcastle-Ottawa scale, and results are presented in Appendix 3, available online, Table 2. Six of these studies did not provide adequate information regarding follow-up of patients,26,27,31,38–40 and another seven did not provide any details regarding the control of important confounding variables between the intervention and control groups 26,27,31,34,36,38,39…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Chronic Care Model Decision Support and Clinical Information Systems Interventions for People Living with HIV: A Systematic Review

et al. 2012

View full text Add to dashboard Cite

BACKGROUNDThe Chronic Care Model is an effective framework for improving chronic disease management. There is scarce literature describing this model for people living with HIV. Decision Support (DS) and Clinical Information Systems (CIS) are two components of this model that aim to improve care by changing health care provider behavior.OBJECTIVEOur aim was to assess the effectiveness of DS and CIS interventions for individuals with HIV, through a systematic literature review.DESIGNWe performed systematic electronic searches from 1996 to February 2011 of the medical (E.g. Medline, EMBASE, CINAHL) and grey literature. Effectiveness was measured by the frequency of statistically significant outcome improvement. Data and key equity indicator extraction and synthesis was completed.PARTICIPANTS AND INTERVENTIONSWe included comparative studies of people living with HIV that examined the impact of DS or CIS interventions on outcomes.MAIN MEASURESThe following measures were assessed: outcome (immunological/virological, medical, psychosocial, economic measures) and health care process/performance measures.KEY RESULTSRecords were screened for relevance (n = 10,169), full-text copies of relevant studies were obtained (n = 123), and 16 studies were included in the review. Overall, 5/9 (55.6%) and 17/41 (41.5%) process measures and 5/12 (41.7%) and 3/9 (33.3%) outcome measures for DS and CIS interventions, respectively, were statistically significantly improved. DS–explicit mention of implementation of guidelines and CIS-reminders showed the most frequent improvement in outcomes. DS-only interventions were more effective than CIS-only interventions in improving both process and outcome measures. Clinical, statistical and methodological heterogeneity among studies precluded meta-analysis. Primary studies were methodologically weak and often included multifaceted interventions that made assessment of effectiveness challenging.CONCLUSIONSOverall, DS and CIS interventions may modestly improve care for people living with HIV, having a greater impact on process measures compared to outcome measures. These interventions should be considered as part of strategies to improve HIV care through changing provider performance.Electronic supplementary materialThe online version of this article (doi:10.1007/s11606-012-2145-y) contains supplementary material, which is available to authorized users.

show abstract

“…Ten studies were conducted in the USA,2,26,29–36 three in the UK/Europe,37–39 and three in sub-Saharan Africa 27,28,40. All studies examined care in the ambulatory setting.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Chronic Care Model Decision Support and Clinical Information Systems Interventions for People Living with HIV: A Systematic Review

et al. 2012

View full text Add to dashboard Cite

show abstract

“…In addition, it overcame some of the drawbacks of the previously proposed solutions. First, as reported in the Results section, a wide range of parameters are considered in order to extend the area of actions analysed within the Orchestra program [11] and the adoption of an approach as comprehensive as possible during primary care with the possibility of easily adding new clinical aspects was applied. Furthermore, instead of NADIS [12,13] the proposed solution is a Web-platform to ensure low maintenance costs and wide access.…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, in the HIV domain, the efficacy of comprehensive systems to optimally treat the disease has already been proven [11]. In particular, the Orchestra program [11] is a computer-assisted HIV care and support tool implemented in the outpatient clinic of a University Hospital (Paris, France).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Ligurian Human Immunodeficiency Virus Clinical Network: A Web Tool to Manage Patients With Human Immunodeficiency Virus in Primary Care and Multicenter Clinical Trials

Fraccaro

Pupella

Gazzarata

et al. 2013

Med 2.0

View full text Add to dashboard Cite

BackgroundIn recent years, Highly-Active Anti-Retroviral Therapies (HAARTs) have modified the Human Immunodeficiency Virus (HIV) life-cycle and the disease is now considered chronic. Consequently, a longitudinal and complex follow-up is now required for HIV positive patients during their lifetime. Moreover, patients often encounter various complications due to comorbidities, related to the immunodeficiency state and HAARTs’ side effects. Thus, HIV positive patients are involved in multicenter clinical trials (MCTs) to improve treatments and discover a preventive vaccine. Therefore, physicians require proper instruments to access comprehensive patient data for managing patients during follow-ups, and tools for data collection and analysis in MCTs.ObjectiveThe Ligurian HIV Clinical Network aims to provide physicians with a Web-tool to administrate HIV positive patients’ data within primary-care and to reuse the collected clinical information to perform MCTs in Northern Italy.MethodsThe key aspect of the system is a relational database which allows the storage of various types of clinical information (eg, related to HIV, cardiovascular, or hepatic diseases) in multiple formats. The modular design of the database permits a rapid insertion of new parameters without requiring any changes in the database structure. Furthermore, codes from biomedical ontologies controlled vocabularies (“Logical Observation Identifier Names and Codes”, and “International Classification of Diseases 9”) and ontologies (“Systematized Nomenclature of Medicine Clinical Terms”), units and normality ranges used by all partners participating in the project were collected to achieve a complete semantic interoperability. Accordingly, data can be automatically normalized through the z score formula and physicians can extract and correctly compare information with external statistical tools. Moreover, to respect patients’ privacy and legal issues, a local identifier, determined through an HASH cryptography algorithm, is assigned to each patient during the registration process. The database is managed by a user-friendly Web-platform which allows quick access to information during medical examinations and the reusing of the collected data for present and future MCTs. Furthermore, a bidirectional middleware was created in order to import/export information through HL7 messaging. Hence, data can be manually entered by physicians or automatically collected within HL7-compliant Hospital Information systems.ResultsPresently, the direct storage of patients’ information from the San Paolo Hospital (Savona, Italy), and San Martino and Galliera hospitals in Genoa is in a test phase. Currently, 8 centers of Infectious Diseases (located in Liguria and Piedmont) are participating in the project and almost 400 HIV positive patients have been recorded in the system. Patient data has been used for primary care and research purposes. Currently, there are 4 on-going MCTs and preliminary results have already been presented at International HIV congresses.ConclusionsThe ...

show abstract

Le NOOQUIZZ, nouvel outil d’évaluation des patients infectés par le VIH : bilan à deux ans

Lemaire

Fournier

Grunderbeeck

et al. 2015

Le Pharmacien Hospitalier et Clinicien

View full text Add to dashboard Cite

How to improve the quality of a disease management program for HIV-infected patients using a computerized data system. The Saint-Antoine Orchestra program

Abstract: The Orchestra program has provided a unique opportunity to assess and improve prevention and management of co-morbidities in HIV patients.

Cited by 7 publications

References 26 publications

Chronic Care Model Decision Support and Clinical Information Systems Interventions for People Living with HIV: A Systematic Review

Chronic Care Model Decision Support and Clinical Information Systems Interventions for People Living with HIV: A Systematic Review

The Ligurian Human Immunodeficiency Virus Clinical Network: A Web Tool to Manage Patients With Human Immunodeficiency Virus in Primary Care and Multicenter Clinical Trials

Le NOOQUIZZ, nouvel outil d’évaluation des patients infectés par le VIH : bilan à deux ans

Contact Info

Product

Resources

About