Grantee

What is
the name of
the study?

What is the
study design?

What are
the sources
of data?

Health Care Delivery

Quality of Health Care

Cost Effectiveness of Intervention

Cornell University

Weill Medical College

Evaluation of A Patient-Centered Electronic Medical Record in a Medicaid Special Needs Program

Nonrandomized study with comparisons to historical results for same patients, patients not receiving intervention at same sites, and patients enrolled in Medicaid at other sites

Patient and provider interviews

Consultation with outside panel of experts

Chart abstraction

Data collection from EMRs

ACASI EMR implementation feasibility within Medicaid Managed Care plan:

Provider acceptance: provider interviews and observation at case conferences

Payer evaluation: consultation with Medicaid managed care plan and outside experts

Referrals: medical, psychiatric and substance abuse specialists and services

Medical and psychiatric hospital admissions

Patient health status:

Clinical markers: CD4 counts and viral loads

Quality of life: MOS-HIV, rating scale

Provider response to intervention:

HAART regimen: frequency, appropriateness of regimen changes, opportunistic infection (OI) prophylaxis

Frequency of screening:  substance abuse

Patient adherence to medications:  self-report, number of prescriptions filled

Patient acceptance of ACASI, measured by survey using Likert scale

Staff time for clinical care and evaluation

Patient time

Software development cost

External evaluation costs

IT technical support costs

Overhead costs

Johns Hopkins University

AIDS Service

HIV Outcomes Program

Computer Adherence Technology Study (CATS)

Randomized clinical trial with control group not receiving direct feedback from administration of ACASI

Data collection from EMRs

Chart abstractions

Patient and provider surveys

Feasibility within clinic setting:

Provider acceptance:

Surveys, observation at weekly care conference

Referrals:  medical, psychiatric, pharmacy, and substance abuse specialists and services

Patient health status:

Clinical markers:

Level and duration of viral suppression (whether 50 copies/ml or less at 6 and 12 months)

Change in CD4 count (at 6 and 12 months)

Genotype resistance at viral rebound

Duration of treatment with HAART

Patient adherence to treatment:

ACASI self-report with Medication Event Monitoring System validation

Patient acceptance of ACASI: measured by survey using 5-point Likert scale

Provider assessment of ACASI: measured by survey using 5-point Likert scale

Analysis of health care utilization data and cost of intervention based on variables such as length of time to complete interview, software cost, IT technical support cost, computer station cost, and overhead costs..

Johns Hopkins University

AIDS Service

HIV Outcomes Program

Computer Adherence Technology Study (CATS)

Randomized clinical trial with control group not receiving direct feedback from administration of ACASI

Data collection from EMRs

Patient and provider surveys

Feasibility within clinic setting:

Provider acceptance:

Surveys, observation at weekly care conference

Referrals:  medical, psychiatric, pharmacy, and substance abuse specialists and services

Patient health status:

Clinical markers:

Level and duration of viral suppression (whether 50 copies/ml or less at 6 and 12 months)

Change in CD4 count (at 6 and 12 months)

Genotype resistance at viral rebound

Duration of treatment with HAART

Patient adherence to treatment:

ACASI self-report with Medication Event Monitoring System validation

Patient acceptance of ACASI: measured by survey using 5-point Likert scale

Provider assessment of ACASI: measured by survey using 5-point Likert scale

Analysis of health care utilization data and cost of intervention based on variables such as length of time to complete interview, software cost, IT technical support cost, computer station cost, and overhead costs..

Grantee

What is
the name of
the study?

What is the
study design?

What are
the sources
of data?

Health Care Delivery

Quality of Health Care

Cost Effectiveness of Intervention

Evaluation of Provider-Focused Interventions

Columbia University

An Internet-Based IT to Reduce Prescription Errors with HIV/AIDS Anti-Retroviral Medications

Group randomized clinical trial with 3 arms: enhanced intervention, intervention without motivational component, and nonintervention control

Provider interviews

Chart abstraction

Collection of utilization data from website

Provider satisfaction measured by interview using Likert-type scale:

Attitudes about using the system;

Attitudes about IT clinical support

Clinician behavior in response to components of HIVTIPS guidelines:

Checklist:  diagnostic procedures and tests ordered or evaluated at initial visit

HAART treatment guidelines: dates and results of CD4 count and viral load; date of treatment start

Drug dose and combination guides: Medication prescribing and dosage information

Delayed initiation for psychosocial reasons: CD4 count, viral load, reason for delay noted in chart 

System alerts: Clinician response to specific alert

Patient health status:

Clinical markers: viral load, CD4 count

Incremental costs of IT (time for programming support, maintaining the system, and updating system information)

Clinical staff time on diagnosis, education, and treatment

Treatment costs

Future costs and effects analysis

Duke University

Health Inequalities Program

HIV Integration Health Outcomes Project Evaluation (HIHOPE)

Non-random case/control study

Longitudinal pre- and post-intervention analysis

Patient and provider surveys

Chart abstraction

Data collection from EMRs

Primary care: Whether patient has regular source of care

Continuity of care: measured by type and amount of information shared between providers and case managers, and the mode of sharing  measured by patient 

Health care utilization

Hospitalizations and ER visits

Primary care appts kept

Patient health status:

Clinical markers: CD4 count, viral load, OIs

Quality of life and functional status: MOS SF-36

Patient adherence to medications measured by quarterly adherence assessment administered by case manager

Provider and patient  satisfaction: Measured by satisfaction with health care received, perceived coordination of care and functionality of Provide.

More frequent communication among providers

Total costs of care

Treatment costs of clinical & non-clinical services

Overall cost of integrative care 

Effect of integrative care on health system indirect and direct costs

Employment status of patients

Los Angeles Department of Health Services (DHS)

Public Health

 Office of AIDS Programs and Policy (OAPP)

HIV/AIDS Interface Technology System (HITS)

Nonrandomized intervention study with control

Pre- and post-HITS implementation analysis

Data collection from electronic databases

Data from ADAP database

Client surveys

Provider pre- and post-HITS implementation surveys

Health care utilization:

Proportion of confidentially testing clients who return for HIV test results

Time between confidentially testing clients learning seropositive status and entering medical care

Client health status:

Clinical markers: CD4 count, viral load

Client satisfaction: measured using  4-point Likert scale survey:

client experiences moving from HCT into medical care

Utilization of third party and other payment sources

Time utilization by HCT and medical outpatient staff

Louisiana State University

Health Care Services Division (HCSD)

Evaluating Information Technology’s Impact on a Statewide System of HIV Care

Concurrent cohort studies

Pre/post implementation studies

Quasiexperimental and experimental studies

Validation study

Chart abstraction

Data collection from the electronic database

Provider and patient satisfaction surveys, interviews, and focus groups

Health care utilization:

Hospitalizations, emergency room visits, frequency of primary care visits, completed referrals to ancillary services

Provider satisfaction measured by interview (scale): quality of the IT, associated time savings; reduction in problems in finding patient medical record

Clinician adherence to standards of care

Administration of HAART and OI prophylaxis, presence of opportunistic infections, frequency of pelvic exams, Pap smears, and PPD screening, receipt of CD4 and viral load testing within last 6 months, hepatitis testing, immunizations, and perinatal transmission prophylaxis

Patient health status:

Clinical markers: CD4 counts and viral loads, occurrence of OI’s

Patient adherence to HAART: reduction in viral load

Health care utilization:

Length of time between learning HIV positive test result and entry into care, number of visits, type of visit

Patient satisfaction measured by survey: Acceptability of the intervention, improvement in clinic efficiency

Reduction in care costs

Increased provider efficiency

Infrastructure and software development costs