title: Health information technology interventions enhance care completion, engagement in HIV care and treatment, and viral suppression among HIV-infected patients in publicly funded settings.
abstract: BACKGROUND
  The National HIV/AIDS Strategy (NHAS) emphasizes the use of technology to facilitate coordination of comprehensive care for people with HIV. We examined the effect of six health information technology (HIT) interventions in a Ryan White-funded Special Projects of National Significance (SPNS) on care completion services, engagement in HIV care, and viral suppression.
  
  
  METHODS
  Interventions included use of surveillance data to identify out-of-care individuals, extending access to electronic health records to support service providers, use of electronic laboratory ordering and prescribing, and development of a patient portal. Data from a sample of electronic patient records from each site were analyzed to assess changes in utilization of comprehensive care (prevention screening, support service utilization), engagement in primary HIV medical care (receipt of services and use of antiretroviral therapy), and viral suppression. We used weighted generalized estimating equations to estimate outcomes while accounting for the unequal contribution of data and differences in the distribution of patient characteristics across sites and over time.
  
  
  RESULTS
  We observed statistically significant changes in the desired direction in comprehensive care utilization and engagement in primary care outcomes targeted by each site. Five of six sites experienced statistically significant increases in viral suppression.
  
  
  CONCLUSIONS
  These results provide additional support for the use of HIT as a valuable tool for achieving the NHAS goal of providing comprehensive care for all people living with HIV. HIT has the potential to increase utilization of services, improve health outcomes for people with HIV, and reduce community viral load and subsequent transmission of HIV.
authors.affiliation: Center for AIDS Prevention Studies, University of California at San Francisco, San Francisco, California, USA.
authors.forename: Starley B
authors.initials: SB
authors.lastname: Shade
authors.affiliation: Center for AIDS Prevention Studies, University of California at San Francisco, San Francisco, California, USA.
authors.forename: Wayne T
authors.initials: WT
authors.lastname: Steward
authors.affiliation: Center for AIDS Prevention Studies, University of California at San Francisco, San Francisco, California, USA.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Koester
authors.affiliation: Center for AIDS Prevention Studies, University of California at San Francisco, San Francisco, California, USA.
authors.forename: Deepalika
authors.initials: D
authors.lastname: Chakravarty
authors.affiliation: Center for AIDS Prevention Studies, University of California at San Francisco, San Francisco, California, USA.
authors.forename: Janet J
authors.initials: JJ
authors.lastname: Myers
mesh_terms: D022126:Access to Information; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D057286:Electronic Health Records; D015658:HIV Infections / Q000628:therapy* / Q000821:virology; D006801:Humans; D008490:Medical Informatics; D010346:Patient Care Management; D011159:Population Surveillance; D011314:Preventive Health Services / Q000331:legislation & jurisprudence; D011632:Public Assistance; D012044:Regression Analysis; D014481:United States; D019562:Viral Load
chemical_list: D044966:Anti-Retroviral Agents
keywords: HIV care; Ryan White Care Program; coordination; engagement; health information technology; viral load