Implementation of an innovative, integrated electronic medical record (EMR) and public health information exchange for HIV/AIDS

Herwehe, Jane; Wilbright, Wayne; Abrams, Amir; Bergson, Susan; Foxhood, Joseph; Kaiser, Michael; Smith, Luis; Xiao, Ke; Zapata, Amy; Magnus, Manya

doi:10.1136/amiajnl-2011-000412

Cited by 84 publications

(68 citation statements)

References 22 publications

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“…18,19 One facet of the evaluation was intended to characterize trends regarding acceptance of health information technology among patients affected by LaPHIE, as a part of a multi-site evaluation coordinated by a centralized evaluation and support center located at the University of California, San Francisco (UCSF)/Center for AIDS Prevention Studies (CAPS). Within the Louisiana State University Health System, seven hospitals and their related primary care and specialty clinics, and emergency departments participated in LaPHIE; patients attending six of the HIV clinics were eligible to participate in an interview that collected detailed demographic, clinical, and perception data.…”

Section: Data Collectionmentioning

confidence: 99%

Linking and Retaining HIV Patients in Care: The Importance of Provider Attitudes and Behaviors

Magnus

Herwehe

Murtaza-Rossini

et al. 2013

AIDS Patient Care and STDs

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Retention in HIV treatment may reduce morbidity and mortality, as well as slow the epidemic. Myriad barriers to retention include stigma, homophobia, structural barriers, transportation, and insurance. The purpose of this study was to evaluate patient perceptions of provider attitudes among HIV-infected persons within a state-wide public hospital system in Louisiana. A convenience sample of patients attending HIV clinics throughout the state participated in an anonymous interview. Factors associated with negative perceptions of care were evaluated in conjunction with a validated stigma measure. Factors associated with having a delayed entry into or break in care were evaluated in conjunction with perceived stigma. Between 2/1/09 and 7/31/11, 479 participants were interviewed and had sufficient data available, of whom 53.4% were male, 79.3% were African American, and 29.4% reported a break or delayed entry into HIV care of > 1 year. A break in care was associated with perceiving that the doctor or health professionals do not listen carefully most or all of the time ( p < 0.01), having an elevated stigma score ( p < 0.05), and indicating that providers dislike caring for HIV-infected people ( p < 0.01). Women were more likely to have an elevated stigma score than men ( p < 0.01), as were participants over 30 ( p < 0.01); those with a gay/bisexual orientation ( p < 0.05) were less likely to have an elevated stigma score. Those with a break in care were less likely to have Medicaid ( p < 0.05). Providers play a key role in the retention of HIV-infected persons in care and are critical to improving outcomes and slowing the epidemic. Development of novel approaches to reduce stigma are imperative in improving retention.

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Section: Data Collectionmentioning

confidence: 99%

Linking and Retaining HIV Patients in Care: The Importance of Provider Attitudes and Behaviors

Magnus

Herwehe

Murtaza-Rossini

et al. 2013

AIDS Patient Care and STDs

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“…An innovative project, the Louisiana Public Health Information Exchange, demonstrates how surveillance data can be used to leverage non-HIV-related care visits in settings with electronic health records. 48 Yet, the majority of those we interviewed did not have any medical care visits, which suggests that waiting for such a visit to occur to start HIV care may lead to later-thanoptimal HIV care entry, and that approaches such as surveillance-based follow-up may also be needed.…”

Section: Discussionmentioning

confidence: 99%

Missed Connections: HIV-Infected People Never in Care

et al. 2013

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Objective. Clinical interventions that lengthen life after HIV infection and significantly reduce transmission could have greater impact if more HIV-diagnosed people received HIV care. We tested a surveillance-based approach to investigating reasons for delayed entry to care. Methods. Health department staff in three states and two cities contacted eligible adults diagnosed with HIV four to 24 months previously who had no reported CD4+ lymphocyte (CD4) or viral load (VL) tests. The staff conducted interviews, performed CD4 and VL testing, and provided referrals to HIV medical care. Reported CD4 and VL tests were prospectively monitored to determine if respondents had entered care after the interview. Results. Surveillance-based follow-up uncovered problems with reporting CD4 and VL tests, resulting in surveillance improvements. However, reporting problems led to misspent effort locating people who were already in care Follow-up proved difficult because contact information in surveillance case records was often outdated or incorrect. Of those reached, 37% were in care and 29% refused participation. Information from 132 people interviewed generated ideas for service improvements, such as emphasizing the benefits of early initiation of HIV care, providing coverage eligibility information soon after diagnosis, and leveraging other medical appointments to provide assistance with linkage to HIV care. Conclusions. Surveillance-based follow-up of HIV-diagnosed individuals not linked to care provided information to improve both surveillance and linkage services, but was inefficient because of difficulties identifying, locating, and recruiting eligible people. Inefficiencies attributable to missing, incomplete, or inaccurate surveillance records are likely to diminish as data quality is improved through ongoing use.

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“…‘Health information’,2 , 5 , 45 , 49 , 54 – 98 ‘clinical information’,21 , 33 , 37 , 46 , 61 , 71 , 88 , 97 , 99 – 120 ‘clinical data’,23 , 30 , 33 , 87 , 110 , 111 , 121 – 131 ‘health data’,17 , 24 , 43 , 69 , 70 , 76 , 100 , 132-140 ‘patient data’,31 , 33 , 55 , 107 , 141 – 145 ‘healthcare information’,35 , 72 , 84 , 110 , 115 , 126 , 146 – 148 ‘clinical patient data’,1 , 149 ‘patient clinical data’,150 ‘patient health information’,151 – 158 ‘patient information’,16 , 26 , 29 , 40 , 41 , 47 , 66 , 97 , 116 , 159 – 165 ‘medical information’,21 , 28 , 34 , 97 , 107 , 129 , 166 – 171 ‘health-related information’,16 , 81 , 82 , 121 , 163 , 172 – 182 ‘patient-medical information’,183 , 184 ‘personal health information’,185 ‘clinical and demographic data’,186 , 187 ‘healthcare-related data’, 188 – 190 ‘health surveillance data’,191 ‘clinical and other patient data’...…”

Section: Key Themes Identifiedmentioning

confidence: 99%

“…‘Paper records’,161 ‘provider health records’ and ‘state registries’,79 ‘digital medical records’,192 ‘electronic medical record’ (EMR),113 , 165 , 191 , 193 – 198 ‘EHR’,5 , 57 , 67 , 81 , 107 , 136 , 162 , 169 , 179 , 199 – 209 ‘health information records’,130 ‘care records’,210 ‘personal health record’ (PHR),114 , 194 ‘patient health records’,211 ‘electronic patient records’212and ‘patient clinical records.’51…”

Section: Key Themes Identifiedmentioning

confidence: 99%

“…‘Exchange’,55 – 57 , 141 ‘access’,69 , 82 , 138 , 207 , 218 – 220 ‘movement’,154 , 163 , 172 , 173 , 175 – 177 , 221 ‘sharing’,2 , 59 , 99 , 200 , 222 ‘multi-directional transfer’,223 ‘moving’,127 , 224 , 225 ‘bi-directional’,47 , 191 , 194 ‘mobilizes’,226 ‘connectivity’,54 ‘data flow’,122 ‘transferring’,55 , 61 ‘transfer’,58 , 70 , 109 , 112 , 115 , 133 , 160 , 216 ‘feed data repositories’,109 ‘transmission’,76 , 80 , 186 , 188 , 189 , 217 , 227 , 228 ‘transport’,49 , 100 , 184 ‘moves’,162 ‘access to and retrieval’87 , 110 , 111 , 115 , 121 , 130 , 160 and ‘link’/‘linking.’191 , 229 – 231 …”

Section: Key Themes Identifiedmentioning

confidence: 99%

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Defining Health Information Exchange: Scoping Review of Published Definitions

Akhlaq

Sheikh

Pagliari

2017

jhi

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Objective The term health information exchange (HIE) is often used in health informatics, yet uncertainties remain about its precise meaning. This scoping review aimed to capture and analyse existing definitions in order to map variations in the use of this term and the concepts associated with it. Methods Systematic literature search to identify published definitions of HIE and related terms. Medline, Web of Science, Library Information Science and Technology Abstracts, EMBASE and CINAHL Plus were searched to identify relevant papers, and Google to identify grey literature. Searches were not limited by language or date of publication. Both explicit and equivalent conceptual definitions were included. Included definitions were summarised and thematically analysed in order to identify and map the underpinning constructs. Results Our searches revealed 603 scientific articles and 5981 website links. From these, a total of 268 unique definitions of HIE were identified and extracted: 103 from scientific databases and 165 from Google. Eleven constructs emerged from the thematic analysis. Contextual factors influenced the emphasis of the definitions and the overall framing of HIE as an organisational entity that facilitates and or as a process of sharing health information between diverse stakeholders. Conclusions HIE is a complex and evolving construct, for which multiple definitions exist. In order to encourage consensus, the authors propose this broad definition, which encompasses the key attributes of HIE described in the literature: "HIE is the electronic mobilisation of clinical and administrative information within or across organisations in a region or community and, potentially, internationally between various systems according to locally and/or nationally recognised standards while maintaining the authenticity and accuracy of the information being exchanged, enabling stakeholders to make informed decisions to enhance healthcare quality of a patient and population. HIEs are multi-stakeholder organisations that oversee the business, operational and legal issues involved in the exchange of information."

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Implementation of an innovative, integrated electronic medical record (EMR) and public health information exchange for HIV/AIDS

Cited by 84 publications

References 22 publications

Linking and Retaining HIV Patients in Care: The Importance of Provider Attitudes and Behaviors

Linking and Retaining HIV Patients in Care: The Importance of Provider Attitudes and Behaviors

Missed Connections: HIV-Infected People Never in Care

Defining Health Information Exchange: Scoping Review of Published Definitions

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