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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