On
October 1st, 2002, HRSA awarded
six (6) grants to better assess
the impact of various information
technologies utilized in the care
of HIV infected patients. The
initiative will assess the extent
to which IT, applied in various
HIV care settings, can contribute
to measurable and sustainable
improvements in the delivery,
quality and cost-effectiveness
of care for people living with
HIV (PLWH), especially among communities
of color and underserved populations.
Columbia
University Mailman School of Public
Health
722 West 168 St. Room 1121.4
New York, NY 10032
Funding
Period: 2003-2006
A
web-based, interactive decision-support
system will be used as a point
of care for physicians when they
are formulating a patient's medication
regimen. The system will suggest
optimal anti-retroviral treatment,
review proposed medication plans
and warn physicians of potentially
dangerous drug interactions and
serious side effects. An agency
and provider information technology
(IT) needs assessment will identify
institutional barriers and physicians'
readiness for such IT applications.
The intervention will be implemented
in 42 agencies in at least three
states.
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OF GRANT SITES
Cornell
University, Dept of Public Health
Weill Medical College of Cornell
411 East 69th Street
New York, NY 10021
Funding
Period: 2003-2006
Computer
workstations will be established
in HIV clinics for patients to
review information from their
own medical record and complete
confidential screening questionnaires
related to treatment adherence,
side effects, substance use and
depression. The goal is to enhance
shared decision-making and improve
patient outcomes through the identification
of adherence problems and co-morbidities.
The feasibility and cost-effectiveness
of the intervention within a Medicaid
managed care environment will
also be tested.
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Department
of Health Services, County of
Los Angeles
6th Floor
600 South Commonwealth Avenue
Los Angeles, Ca 90005-4001
Funding
Period: 2003-2006
The
HIV/AIDS Interface Technology
Systems (HITS) is designed to
establish new computer interfaces
with existing information systems
that will improve client access
to services. HITS will: 1) identify
individuals who test HIV-positive
but do not return for their results;
2) minimize delays between testing
HIV-positive and entering an HIV
system of care; and 3) improve
local ability to appropriately
screen patients for service eligibility.
Service delivery, quality of care
and cost-effectiveness will be
assessed as part of the project.
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Duke
University Center for Health Policy,
Law & Management
125 Old Chemistry Building
PO Box 90253
Durham, NC 27708-0253
Funding
Period: 2003-2006
A
statewide computer network will
be used to gather data and evaluate
the effectiveness of IT technology
on integration of HIV care at
both the provider practice and
patient outcome level. The effects
of the IT network on health status,
quality of health and social services,
and cost of health care will be
assessed. The project goals include:
1) improving the quality of care
through IT-facilitated case coordination,
ongoing discussions among providers
and implementation of standard
care protocols (Care Maps); and
2) reducing health care costs
as improved medication adherence
impacts the client's need for
costly health interventions.
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Johns
Hopkins University
1830 E. Monument Street, Suite
8059
Baltimore, MD 21287
Funding
Period: 2003-2006
An
audio, computer-assisted self-interview
(ACASI) will be used to evaluate
patient adherence to treatment
regimens and solicit information
about behaviors that might interfere
with adherence, e.g. illicit drug
use. The study will conduct a
randomized clinical trial in the
John Hopkins HIV clinical program
to assess if ACASI enhances the
delivery of HIV care and improves
clinical outcomes. A group of
patients, who are starting HAART
regimen, will be randomized to
ACASI with no provider feedback,
while another group will have
an ACASI report generated for
the provider to review at the
time of each clinical visit. Primary
and secondary outcomes to be evaluation
include HIV-1 RNA suppression,
CD4 lymphocyte change, durable
HIV-1 RNA suppression, and duration
of HAART use. Acceptance of the
information technology by providers
and patients will also be assessed
during the project.
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Louisiana
State University
LSUHSC Health Care Service Division
8550 United Plaza Blvd.
Baton Rouge, LA 70809
Funding
Period: 2003-2006
The
impact of an electronic patient
database, LabTracker, to optimize
delivery of HIV care, improve
morbidity and mortality outcomes
among patients, and improve the
quality of HIV outpatient care
being delivered will be evaluated.
The cost effectiveness of this
IT strategy, which is utilized
at nine hospitals, will also be
assessed.
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OF GRANT SITES