Implementing electronic health record alert and documentation programs significantly increased routine HIV screening rates at health facilities in New York City and New Orleans, according to an article published in the Journal of the American Medical Association, Becker’s Hospital Review‘s “Hospital CIO” reports (Jayanthi, “Hospital CIO,” Becker’s Hospital Review, 8/27).
CDC since 2006 has recommended health care professionals conduct routine HIV screenings of all patients ages 13 to 64 unless the rate of undiagnosed infections among their patient population is below 0.1%. However, many clinicians are not conducting routine screenings, according to the article (Bresnick, EHR Intelligence, 8/27).
Details of Alert Program
In March 2013, New Orleans-based Interim LSU Hospital began using an EHR alert to remind staff members to offer HIV screenings to all emergency department and urgent care center patients who had not been tested for HIV in the previous six months.
Following implementation of the alert program, rates of HIV testing at Interim LSU Hospital increased:
- In the ED, from 17% in 2012 to 26% in December 2013; and
- In the urgent care center, from 3% in 2012 to 17% in December 2013.
Further, 102 patients tested positive for HIV under the program, including 91 who had not previously been receiving medical care for the disease.
Details of Documentation Program
Separately, Urban Health Plan — a federally qualified health center with 16 care sites in New York City — in January 2011 began having clinicians document when they offered HIV tests to patients ages 13 to 64 who had not been tested in the past year. If a patient tested positive for HIV, a follow-up appointment was scheduled to discuss potential care options (JAMA, 8/27).
According to the article, HIV testing at UHP increased from 8% to 56% over three years, resulting in 120 additional patients being diagnosed with HIV (EHR Intelligence, 8/27).