title: Evaluating health information technology: provider satisfaction with an HIV-specific, electronic clinical management and reporting system.
abstract: Health information technology (HIT) offers the potential to improve care for persons living with HIV. Provider satisfaction with HIT is essential to realize benefits, yet its evaluation presents challenges. An HIV-specific, electronic clinical management and reporting system was implemented in Louisiana's eight HIV clinics, serving over 7500. A serial cross-sectional survey was administered at three points between April 2002 and July 2005; qualitative methods were used to augment quantitative. Multivariable methods were used to characterize provider satisfaction. The majority of the sample (n = 196; T1 = 105; T2 = 46; T3 = 45) was female (80.0%), between ages of 25 and 50 years (68.3%), frequent providers at that clinic (53.7% more than 4 days per week), and had been at the same clinic for a year or more (85.0%). Improvements in satisfaction were observed in patient tracking ( p < 0.05), distribution of educational materials ( p < 0.04), and belief that electronic systems improve care ( p < 0.05). Provider self-reports of time to complete critical functions decreased for all tasks, two significantly so. Time (in minutes) to find current CD4 count decreased at each time point (mean 3.9 [standard deviation {SD} 5.8], 2.9 [2.3], 2.1 [2.6], p>0.05), current viral load decreased at each time point (mean 4.0 [SD 5.6], 2.9 [2.5], 1.8 [2.6], p = 0.08], current antiretroviral status decreased at each time point (mean 3.9 [SD 4.7], 2.9 [3.7], 1.5 [1.1], p < 0.04), history of antiretroviral use decreased at each time point (mean 15.1 [SD 21.9], 6.0 [5.4], 5.4 [7.2], p < 0.04]. Time savings were realized, averaging 16.1 minutes per visit ( p < 0.04). Providers were satisfied with HIT in multiple domains, and significant time savings were realized.
authors.affiliation: Department of Epidemiology and Biostatistics, George Washington University, 2300 Eye Street, Ross Hall 120b, Washington, D.C. 20037, USA. sphmdm@gwumc.edu
authors.forename: Manya
authors.initials: M
authors.lastname: Magnus
authors.forename: Jane
authors.initials: J
authors.lastname: Herwehe
authors.forename: Laura
authors.initials: L
authors.lastname: Andrews
authors.forename: Laura
authors.initials: L
authors.lastname: Gibson
authors.forename: Nathan
authors.initials: N
authors.lastname: Daigrepont
authors.forename: Jordana M
authors.initials: JM
authors.lastname: De Leon
authors.forename: Newton E
authors.initials: NE
authors.lastname: Hyslop
authors.forename: Steven
authors.initials: S
authors.lastname: Styron
authors.forename: Ronald
authors.initials: R
authors.lastname: Wilcox
authors.forename: Michael
authors.initials: M
authors.lastname: Kaiser
authors.forename: Michael K
authors.initials: MK
authors.lastname: Butler
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000628:therapy*; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D007256:Information Systems / Q000706:statistics & numerical data*; D008145:Louisiana; D008297:Male; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D008875:Middle Aged; D015397:Program Evaluation; D013672:Technology / Q000295:instrumentation
chemical_list: D019380:Anti-HIV Agents