Online Program

320036
Use of a real-time text message alert to improve re-engagement for lost-to-care people living with HIV/AIDS


Monday, November 2, 2015 : 11:10 a.m. - 11:30 a.m.

Melanie Fritz, BA, Social Services Department, Ruth M. Rothstein CORE Center, Chicago, IL
Katelynn Finnegan, MPH, Research Department, Ruth M. Rothstein CORE Center, Chicago, IL
Blanca Lopez, MPH, Social Services Department, Ruth M. Rothstein CORE Center, Chicago, IL
George Markovski, BS, Collaborative Research Unit, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL
William Trick, MD, Collaborative Research Unit, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL
Ronald Lubelchek, MD, Medical Services, Ruth M. Rothstein CORE Center, Chicago, IL
Background:  Retention-in-care represents a key component of the HIV care continuum and rates of retention for people living with HIV/AIDS (PLWHA) remain sub-optimal.  Our work helps elucidate how health information technology can improve re-engagement for PLWHA. 

Methods:  We used real-time text message alerts linked to electronic medical record (EMR) registration events to help re-engage lost-to-care PLWHA.  Our query interfaced with the Cook County Health and Hospitals System (CCHHS) EMR to identify PLWHA receiving primary care at the CORE Center, CCHHS’s ambulatory HIV clinic.  When a CORE patient with no primary care visits in ≥ 7 months registered at any non-CORE CCHHS site, our system sent a real-time text to our project coordinator who contacted the patient, in person during the alert-triggering visit when possible, to schedule follow-up.  We report alert volume, and 3-month post-alert primary care follow-up rates. 

Results:  During 6 months of observation 188 patients triggered 362 alerts; 67% of patients were male; 78% African-American vs. 22% White/other; 12% identified as Hispanic; mean age was 44.  Sixty percent of patients triggering alerts returned for primary care visits within 3 months.  Alerts resulting in face-to-face vs. phone contact led to 3-month follow-up for 75% vs. 28% of the patients (p = 0.0015).   

Conclusions: Real-time text alerts can facilitate re-engagement for lost-to-care PLWHA.  We noted better post-alert follow-up when alerts led to in person vs. phone contact.  This use of health information technology to facilitate re-engagement of lost-to-care PLWH may represent a relatively low-cost and reproducible intervention warranting further evaluation.

Learning Areas:

Chronic disease management and prevention
Communication and informatics

Learning Objectives:
Demonstrate how real-time text alerts linked to non-patient centered medical home visit registration events within a large, urban, safety-net health system can be used to improve re-engagement for lost-to-care people living with HIV/AIDS (PLWHA). Explain how health information technology can leverage patient navigation to improve re-engagement of lost-to-care PLWHA.

Keyword(s): HIV/AIDS, Technology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have years of experiences conducting research in the realm of HIV. As project coordinator for the work presented, I performed the day-to-day work presented in abstract, collected the data, summarized the data and assisted in writing the abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3157.0: Access to HIV/AIDS Care