The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #64541

Frank McCorkle Lombard, LCSW, Kathryn Whetten, PhD, and Charles Micha Belden, BA. Health Inequalities Program, Duke University, 110 Swift Avenue Suite 2, Durham, NC 27705, (919) 416-4598, Frank_Lombard@ncsip.duke.edu

Information technology has the potential to improve care integration at the provider and patient level. We will develop a care management software program using a set of relational databases that provide an electronic interface between infectious disease clinics and referring community-based clinicians. Using this network, with patient consent, medical providers will share clinical data electronically (medications and laboratory results) with community-based case managers while case managers will share adherence assessment results and other service data with clinic staff. Evaluation activities will include measuring the impact of this network on cost-effectiveness, health and social service delivery and quality of care. We will conduct medical chart reviews before and after the implementation of the intervention to assess if timeliness, continuity, and appropriateness of care have been achieved (e.g. change in CD4, viral load), and will use patient interviews (MOS SF-36) to assess change in health status. We will assess cost-effectiveness by measuring the total cost of care (clinical and non-clinical services), and determining the effect of integrative care on costly interventions such as hospitalizations and ER visits. Other measures will include case manager’s adherence assessments, adherence to regularly scheduled medical appointments, presence of opportunistic infections, hospitalizations, and ER visits to assess each of these dimensions. Through development of a software package that provides integration at the provider and patient level, this project seeks to enhance coordination and communication between providers and improve the timeliness, appropriateness and quality of care.

Learning Objectives:

These learning objectives are for the panel as a whole and not the individual abstract. Following this panel discussion, attendees will be able to: (
• identify four mechanisms by which IT interventions are expected to improve HIV-care delivery; (
• identify four methodological approaches in evaluation of IT interventions; (
• discuss challenges to implementation of IT interventions in community-based settings.

Keywords: HIV Interventions, Information Technology

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.