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H H S Department of Health and Human Services
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Evaluating the Impact of IT on Improving Delivery & Quality for Care for HIV Seropositive Individuals

About this initiative...
Background  
Grantees
Journal Articles
Initiative's Website

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SPNS-related publications...
Listing of SPNS Products  
Download SPNS technical assistance publications (government- and grantee-produced) from the TARGET Center Library Exit Disclaimer keyword: SPNS

Background 

The Special Projects of National Significance (SPNS) Information Technology Initiative evaluates the impact of interventions using information technology (IT) on the delivery and quality of primary care for underserved people living with HIV. Six grantees have been funded in the four-year initiative, which began in October 2002 and will continue through September 2006. Both the Special Projects of National Significance (SPNS) and the AIDS Education and Training Centers (AETC) in the Health Resources Services Administration (HRSA) HIV/AIDS Bureau (HAB) are involved in the initiative.

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Grantees 

On October 1st, 2002, HRSA awarded six (6) grants to better assess the impact of various information technologies utilized in the care of HIV infected patients. The initiative will assess the extent to which IT, applied in various HIV care settings, can contribute to measurable and sustainable improvements in the delivery, quality and cost-effectiveness of care for people living with HIV (PLWH), especially among communities of color and underserved populations.


Columbia University Mailman School of Public Health  
722 West 168 St. Room 1121.4
New York, NY 10032

Funding Period: 2003-2006

A web-based, interactive decision-support system will be used as a point of care for physicians when they are formulating a patient's medication regimen. The system will suggest optimal anti-retroviral treatment, review proposed medication plans and warn physicians of potentially dangerous drug interactions and serious side effects. An agency and provider information technology (IT) needs assessment will identify institutional barriers and physicians' readiness for such IT applications. The intervention will be implemented in 42 agencies in at least three states.

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Cornell University, Dept of Public Health 
Weill Medical College of Cornell
411 East 69th Street
New York, NY 10021

Funding Period: 2003-2006

Computer workstations will be established in HIV clinics for patients to review information from their own medical record and complete confidential screening questionnaires related to treatment adherence, side effects, substance use and depression. The goal is to enhance shared decision-making and improve patient outcomes through the identification of adherence problems and co-morbidities. The feasibility and cost-effectiveness of the intervention within a Medicaid managed care environment will also be tested.

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Department of Health Services, County of Los Angeles  
6th Floor
600 South Commonwealth Avenue
Los Angeles, Ca 90005-4001

Funding Period: 2003-2006

The HIV/AIDS Interface Technology Systems (HITS) is designed to establish new computer interfaces with existing information systems that will improve client access to services. HITS will: 1) identify individuals who test HIV-positive but do not return for their results; 2) minimize delays between testing HIV-positive and entering an HIV system of care; and 3) improve local ability to appropriately screen patients for service eligibility. Service delivery, quality of care and cost-effectiveness will be assessed as part of the project.

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Duke University Center for Health Policy, Law & Management
125 Old Chemistry Building
PO Box 90253
Durham, NC 27708-0253

Funding Period: 2003-2006 

A statewide computer network will be used to gather data and evaluate the effectiveness of IT technology on integration of HIV care at both the provider practice and patient outcome level. The effects of the IT network on health status, quality of health and social services, and cost of health care will be assessed. The project goals include: 1) improving the quality of care through IT-facilitated case coordination, ongoing discussions among providers and implementation of standard care protocols (Care Maps); and 2) reducing health care costs as improved medication adherence impacts the client's need for costly health interventions.

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Johns Hopkins University  
1830 E. Monument Street, Suite 8059
Baltimore, MD 21287

Funding Period: 2003-2006

An audio, computer-assisted self-interview (ACASI) will be used to evaluate patient adherence to treatment regimens and solicit information about behaviors that might interfere with adherence, e.g. illicit drug use. The study will conduct a randomized clinical trial in the John Hopkins HIV clinical program to assess if ACASI enhances the delivery of HIV care and improves clinical outcomes. A group of patients, who are starting HAART regimen, will be randomized to ACASI with no provider feedback, while another group will have an ACASI report generated for the provider to review at the time of each clinical visit. Primary and secondary outcomes to be evaluation include HIV-1 RNA suppression, CD4 lymphocyte change, durable HIV-1 RNA suppression, and duration of HAART use. Acceptance of the information technology by providers and patients will also be assessed during the project.

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Louisiana State University 
LSUHSC Health Care Service Division
8550 United Plaza Blvd.
Baton Rouge, LA 70809

Funding Period: 2003-2006

The impact of an electronic patient database, LabTracker, to optimize delivery of HIV care, improve morbidity and mortality outcomes among patients, and improve the quality of HIV outpatient care being delivered will be evaluated. The cost effectiveness of this IT strategy, which is utilized at nine hospitals, will also be assessed. 

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Journal Articles 

Magnus M., Herwehe J., Proescholdbell R.J, Lombard F., Cajina A., Dastur Z., Millery M., Sabundayo B.P. Guidelines for effective integration of information technology in the care of HIV-infected populations. Journal of Public Management Practice, 2007, 13(1), 39-48. 

Nguyen T.Q., Whetten K. Is anybody out there? Integrating HIV services in rural regions. Public Health Reports. 2003 Jan-Feb; 118(1): 3-9.

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Part F - SPNS Resources

A Living History: Get the Back Story Image.

The SPNS program began with some of the first Federal grants to target adolescents and women living with HIV, and over the years, initiatives have been developed to reflect the evolution of the epidemic and the health care arena.



Part F - SPNS Products and Publications

iHiP Exit Disclaimer

Products from SPNS Initiatives

Technical Assistance TARGET Center Library Exit Disclaimer

SPNS Staff

Adan Cajina
Branch Chief
acajina at hrsa.gov
301-443-3180

Pamela Belton
Public Health Analyst
pbelton at hrsa.gov
301-443-4461

Renetta Boyd
Public Health Analyst
rboyd at hrsa.gov
301-443-4549

Chau Nguyen
Public Health Analyst
cnguyen1 at hrsa.gov
301-443-5785

Natalie Solomon
Public Health Analyst
nsolomon at hrsa.gov
301-443-7753

Melinda Tinsley
Public Health Analyst
mtinsley1 at hrsa.gov
301-443-3496

Jessica Xavier
Public Health Analyst
jxavier at hrsa.gov
301-443-0833