title: Health information exchange interventions can enhance quality and continuity of HIV care.
abstract: OBJECTIVE
  The purpose of this article is to describe how comprehensive HIV care is delivered within Ryan White Program (RWP)-funded clinics and to characterize proposed health information exchange (HIE) interventions, which employ technology to exchange information among providers, designed to improve the quality and coordination of clinical and support services.
  
  
  METHODS
  We use HIV patient care quality and coordination indicators from electronic data systems to describe care delivery in six RWP demonstration sites and describe HIE interventions designed to enhance that care.
  
  
  RESULTS
  Among patients currently in care, 91% were retained in care in the previous six months (range across sites: 63-99%), 79% were appropriately prescribed antiretroviral therapy (54-91%) and 52% had achieved undetectable HIV viral load (16-85%). To facilitate coordination of care across clinical and support services, sites designed HIE interventions to access a variety of data systems (e.g. surveillance, electronic health records, laboratory and billing) and focused on improving linkage and retention, quality and efficiency of care and increased access to patient information.
  
  
  CONCLUSIONS
  Care quality in RWP settings can be improved with HIE tools facilitating linkage, retention and coordination of care. When fully leveraged, HIE interventions have the potential to improve coordination of care and thereby enhance patient health outcomes.
authors.affiliation: Center for AIDS Prevention Studies, University of California at San Francisco, San Francisco, CA 94105, United States. starley.shade@ucsf.edu
authors.forename: Starley B
authors.initials: SB
authors.lastname: Shade
authors.forename: Deepalika
authors.initials: D
authors.lastname: Chakravarty
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Koester
authors.forename: Wayne T
authors.initials: WT
authors.lastname: Steward
authors.forename: Janet J
authors.initials: JJ
authors.lastname: Myers
mesh_terms: D000328:Adult; D003266:Continuity of Patient Care; D005260:Female; D015658:HIV Infections / Q000628:therapy*; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D011320:Primary Health Care; D011787:Quality of Health Care