Study focus area

OUR STUDIES

UTILIZING CLINICAL DECISION SUPPORT SYSTEM ALERTS TO RETAIN PLHIV IN CARE IN CHARLOTTE, NC

Background

Clinical decision support system (CDSS) alerts may help retain people living with HIV (PLHIV) in care. A system of CDSS alerts utilizing the CHORUS™ portal in the OPERA Cohort was developed to identify PLHIV at risk of being lost to care. To evaluate feasibility for a larger scale study, a before and after implementation research pilot study was implemented in the OPERA Cohort at three clinic sites in Charlotte, NC.

 

(N or % of PLWH)

Site A

Site B

Site C 

Before

After

Before

After

Before

After

Participants1
10,220 9,926 538 723 1,202 1,113
Alerts / Responses --- 2,245 / 189 --- 756 / 334 --- 1,202 / 896
Ratio of Alerts to Responses --- 11.9 --- 2.2 --- 1.5
>1 Visit with Healthcare Provider 46% 46% 91% 80% 72% 81%
>2 Visits with Healthcare Provider 41% 41% 85% 74% 64% 72%

Design

This project follows a design to assess the pre- and post-baseline “kept appointment rate”. A sample of patients with ≥1 visit (identified as 1 viral load and/or 1 CD4 count) in 12 months pre- and post-baseline/alert initiation, and patients with ≥2 visits (identified as 2 viral loads and/or 2 CD4 counts) in 12 months pre- and post-baseline/alert initiation. Participants were from three diverse clinics in Charlotte, North Carolina. For all patients, interactive alerts were displayed on staff’s private CHORUS portal page. Patients identified as high risk to loss of follow-up were summarized in bi-weekly emails with the CHORUS portal link.

Primary objective

  • Assess if the clinical prompts can decrease missed visits within a clinic and increase retention in care.

Results

  • Clinical decision support system alerts successfully implemented in CHORUS™ clinical reporting portal, despite suboptimal engagement at some sites
  • Clinic with dedicated site staff and consistent utilization of alerts experienced improvement in retention of PLWH at-risk of falling out of care

Collaborators

Rodney Mood

Dr. Michael Leonard

Setting

Three diverse infectious disease clinics

Location

U.S.A.

Duration

Jul 2018 - Oct 2019

Category

Retention in Care and Adherence

Key study materials

ViiV study lead and contact

Tammeka Evans,

Director of Global Public Health and Innovation

Contact

RELATED STUDIES

USA

As part of an effort to re-engage patients into care, this study determined the effectiveness of using an outreach nurse as a direct clinical liaison through the State Bridge Counsellor (SBC) Program.

USA

As part of this project, financial incentives were used to engage and retain people living with HIV with the goal of contributing to viral suppression in the Baton Rouge, LA area.

ITALY

The RELAPP study is focused upon developing an algorithm for general practitioners in Italy to identify earlier those at risk of HIV.

Our partnerships

Our partnerships

We are proud to partner with multiple organizations that work to prevent HIV and improve the lives of people who live with HIV.

Find out more

NP-GBL-HVU-WCNT- 210058 | March 2022

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