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HRSA
awarded grants under its Special Projects of National
Significance program to the applicants listed
below. Each abstract provides both contact information
and a brief description of their project.
Bronx
Lebanon
Bronx-Lebanon Hospital Center is a designated
New York AIDS Center, serving the health-related
needs of PLWHA through its Comprehensive Care
Center, dedicated inpatient unit, and long-term
care facility. In conjunction with nine service
network sites, Bronx-Lebanon will establish an
innovative model to promote the enhancement and
evaluation of an existing health information electronic
network system linking New York City providers
serving people living with HIV/AIDS (PLWHA). The
Hospital and its partners currently operate an
electronic network of care system using more than
one software application to manage data and will
enhance the existing database to receive data
transmitted in a standardized format. Bronx-Lebanon's
outpatient HIV/AIDS program, the Comprehensive
Care Center (CCC) serves as the information hub
for the network, with a centralized database containing
the desired clinical patient-associated data to
provide comprehensive primary medical care and
support services for PLWHA in New York City. The
project will use management information services
from its existing clinical database to coordinate
care, improve communication, and develop novel,
proactive workflows to deliver a comprehensive
range of patient services.
Linkages
for exchanging electronic health information will
be enhanced among the project partners providing
a comprehensive set of services to PLWHA including
health, housing, educational, employment, legal
and other social services. The Service Network
Sites will focus on serving the residents living
in the medically underserved neighborhoods of
the South and Central Bronx borough in New York
City. The residents are predominantly ethnic minority,
African-American (30%) and Hispanic/Latino (60%),
including recent waves of new immigrants from
West Africa, the Caribbean and Central America.
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New
York Presbyterian Hospital
New York Presbyterian Hospital will enhance
the existing electronic health information (EHI)
network for its HIV Special Needs Plan (SNP),
SelectHealth. The hospital will implement the
Continuity of Care Records (CCR) as their standard
in EHI exchange. The SelectHealth CCR Project
will aggregate members' critical patient information
to provide "a snapshot in time," making
it easily available via a secure Internet connection
to the member who is living with HIV/AIDS and
his/her care providers.
The
CCR project will fundamentally shift care to ensure
that provider, case manager, and any other designee
can electronically reference a member's clinical,
pharmacy and referral information at the time
of service. This innovation has the ability to
significantly improve treatment protocols, patient
retention, health outcomes and quality of life
for people who are living with HIV/AIDS (PLWHA)
and who are struggling with the now chronic nature
of their disease.
The
need for consolidating health information in a
Continuity of Care Record (CCR) that is accessible
to any physician, case manager, or member in a
large network is absolutely crucial for improving
quality of care and overall health outcomes. As
an HIV SNP, SelectHealth provides an overarching
structure and coordination framework for the provision
of services to PLWHA in the Bronx, Brooklyn, Queens,
and Manhattan. Enhancement of SelectHealth's EHI
network and implementation of Continuity of Care
Records will provide a replicable and sustainable
model of HIV/AIDS care that ensures that all patients
and their providers will have access to critical
member-level health information when they need
it.
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Duke
University
The Regional Health Information Integration
Project (RHIIP) will work intensively with an
existing regional network of HIV care, comprised
of one Ryan White (RW) Part C funded HIV primary
medical provider, three RW Part B contracted HIV
ancillary care providers, and one regional RW
Part B funded HIV Care Consortium on a network
administered by the North Carolina HIV/STD Prevention
and Care Branch.
The
North Carolina HIV/STD Prevention and Care Branch
administers a wide area network using CAREWare
to collect data for administrative and reporting
functions. Using this network, RHIP will develop
a regional health information consortium (RHIC)
to support administrative and clinical functioning
through the sharing of electronic health information
among partner agencies. RHIP will work with the
RHIC to develop policies, protocols, and interventions
to plan and implement a shared network with the
ultimate goal of improving patient health outcomes
and satisfaction.
HIV
service delivery in North Carolina is organized
around the provision of HIV medical care in centrally
located clinics, most often Academic Medical Centers
or local Ryan White funded Part C Early Intervention
Clinics, while ancillary care services (mental
health, case management, and emergency assistance)
are provided within local communities. This fractured
service provision makes coordination and communication
difficult, and places greater importance on systems
which directly support patients' ability to enter
and continue with medical care. The intervention
will be anchored by Winston-Salem and will include
the 13 surrounding rural counties served by network
partners. The target patient population is predominantly
poor, non white, and disenfranchised.
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St.
Mary Medical Center Foundation - Long Beach, CA
The Comprehensive AIDS Resource Education
(CARE) Program will expand its information technology
network to include four points of service across
a heterogeneous group of providers, each utilizing
a different clinical management software application.
Patient data will be managed in CARE's central
database. CARE will evaluate the interventions
effect on the quality of patient care and on patient
health outcomes.
The
CARE program will enhance the EMR system to improve
utilization of its technological capabilities
by establishing a bi-directional lab interface
allowing physicians and lab to electronically
exchange information, including electronically
requisitioned blood tests. The program will also
establish an electronic prescription ordering
interface that will allow providers to electronically
order and refill patient prescriptions at multiple
local pharmacies.
The
project will improve the efficiency and effectiveness
of the referral process resulting in a decrease
in the time it takes newly diagnosed patients
to get into the appropriate level of care, which
is replicable among regional providers. The project
will also study the effects of enhancements to
CARE's EMR, including its usefulness in increasing
patient adherence to treatment and increasing
the timeliness of provider's access to critical
lab results.
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Louisiana
Public Health Information Exchange (LaPHIE)
Louisiana State University Health Care Services
Division (HCSD) will use health information technology
(HIT) to share information across providers to
afford opportunities for prevention and linkage
to HIV specialty care and supportive services
for several vulnerable and hard to reach populations:
The
goals of the project are: 1) to improve the health
of the under/uninsured PLWHA through the use of
public health informatics to ensure the timely
transfer of data for surveillance and improved
linkage to HIV care and supportive services, 2)
to conduct analyses to determine the extent to
which the network data exchange provides benefit
and value; and 3) to build capacity and knowledge
resources for the ongoing development and implementation
of public health information exchange systems.
Sharing
information across an integrated, interoperable
electronic network is needed to provide patients
early access and continuity in clinical care and
ancillary services, thereby improving a person's
health, to reduce costs associated with morbidity
and mortality from patients with advanced disease
due to delayed entry into care, and to prevent
HIV transmission leading to new pediatric and
adult infections. LSU hopes the network will have
a positive impact the individual, systems, and
population levels.
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City
of Paterson
The City of Paterson's Information Technology
Networks of Care Initiative will promote the development
and application of electronic health information
systems to improve clinical applications for persons
living with HIV/AIDS. The project facilitates
the expansion of clinical information available
to care providers in the counties of Bergen and
Passaic, New Jersey through the use of a web-based
health information system, e2. Partners in the
project will share pertinent clinical information
to enhance performance improvement, health care
delivery efficiencies and optimal client outcomes.
The
activities will take place in an STD/HIV Counseling
and Testing site in Paterson and an HIV Counseling
and Testing site in Bergen County. These sites
assist in the development and expansion of the
currently deployed system and will focus on improving
information exchange related to HIV diagnosis
and referral to medical care, patient management
(referrals, appointments, and care retention)
and health outcomes/quality of life measurement.
The
health information system, e2, is a web-based
single electronic platform for the collection
and processing of clinical, service and utilization
data. System characteristics make it an effective
tool for these applications and include: customized
and user-friendly data entry and reporting mechanisms;
an array of utilization, quality and care management
modules; cost management especially for clinical
users; accuracy and privacy; and opportunity for
client/patient involvement. It has been in use
by all Part A providers since 2004, and it has
received the recognition of state and national
HIV/AIDS organizations including the National
Quality Center and the New Jersey Department of
Health and Senior Services.
The
overall goal of the demonstration project is to
advance the exchange of clinical information through
electronic health information systems. Three additional
goals support the project: (1) to enhance linkages
between counseling/testing and engagement into
care through timely sharing of test results, (2)
to improve management of health information through
integration and coordination and online access
to lab and other test results, (3) to enhance
quality management through timely and accurate
process improvement and outcomes data.
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