J Am Med Inform Assoc - Health information technology interventions enhance care completion, engagement in HIV care and treatment, and viral suppression among HIV-infected patients in publicly funded settings.

Tópicos

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{ state(1844) use(1261) util(961) }
{ ehr(2073) health(1662) electron(1139) }
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{ can(981) present(881) function(850) }
{ use(976) code(926) identifi(902) }
{ framework(1458) process(801) describ(734) }
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{ decis(3086) make(1611) patient(1517) }
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{ detect(2391) sensit(1101) algorithm(908) }

Resumo

CKGROUND: The National HIV/AIDS Strategy (NHAS) emphasizes the use of technology to facilitate coordination of comprehensive care for people with HIV. We examined the effect of six health information technology (HIT) interventions in a Ryan White-funded Special Projects of National Significance (SPNS) on care completion services, engagement in HIV care, and viral suppression.METHODS: Interventions included use of surveillance data to identify out-of-care individuals, extending access to electronic health records to support service providers, use of electronic laboratory ordering and prescribing, and development of a patient portal. Data from a sample of electronic patient records from each site were analyzed to assess changes in utilization of comprehensive care (prevention screening, support service utilization), engagement in primary HIV medical care (receipt of services and use of antiretroviral therapy), and viral suppression. We used weighted generalized estimating equations to estimate outcomes while accounting for the unequal contribution of data and differences in the distribution of patient characteristics across sites and over time.RESULTS: We observed statistically significant changes in the desired direction in comprehensive care utilization and engagement in primary care outcomes targeted by each site. Five of six sites experienced statistically significant increases in viral suppression.DISCUSSION: These results provide additional support for the use of HIT as a valuable tool for achieving the NHAS goal of providing comprehensive care for all people living with HIV. HIT has the potential to increase utilization of services, improve health outcomes for people with HIV, and reduce community viral load and subsequent transmission of HIV.

Resumo Limpo

ckground nation hivaid strategi nhas emphas use technolog facilit coordin comprehens care peopl hiv examin effect six health inform technolog hit intervent ryan whitefund special project nation signific spns care complet servic engag hiv care viral suppressionmethod intervent includ use surveil data identifi outofcar individu extend access electron health record support servic provid use electron laboratori order prescrib develop patient portal data sampl electron patient record site analyz assess chang util comprehens care prevent screen support servic util engag primari hiv medic care receipt servic use antiretrovir therapi viral suppress use weight general estim equat estim outcom account unequ contribut data differ distribut patient characterist across site timeresult observ statist signific chang desir direct comprehens care util engag primari care outcom target site five six site experienc statist signific increas viral suppressiondiscuss result provid addit support use hit valuabl tool achiev nhas goal provid comprehens care peopl live hiv hit potenti increas util servic improv health outcom peopl hiv reduc communiti viral load subsequ transmiss hiv

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