title: Using HIV Surveillance Laboratory Data to Identify Out-of-Care Patients.
abstract: HIV-associated laboratory tests reported to public health surveillance have been used as a proxy measure of care engagement of HIV+ individuals. As part of a Health Resources and Services Administration (HRSA) Special Projects of National Significance (SPNS) Initiative, the Massachusetts Department of Public Health (MDPH) worked with three pilot clinical facilities to identify HIV+ patients whose last HIV laboratory test occurred at the participating facility but who then appeared to be out of care, defined as an absence of HIV laboratory test results reported to MDPH for at least 6 months. The clinical facilities then reviewed medical records to determine whether these patients were actually not in care, or if there was another reason that they did not have a laboratory test performed, and provided feedback to MDPH on each of the presumed out-of-care patients. In the first year of the pilot project, 37% of patients who appeared to be out of care based on laboratory data were confirmed to be out of care after review of clinical health records. Of those patients who were confirmed to be out of care, 55% had a subsequent laboratory test within 3 months, and 72% had a laboratory test within 6 months, indicating that they had re-engaged with a care provider. MDPH found that it was essential to have clinical staff confirm the care status of patients who were presumed to be out of care based on surveillance data.
authors.affiliation: Massachusetts Department of Public Health, Boston, MA, USA. j.christian.hague@state.ma.us.
authors.forename: John Christian
authors.initials: JC
authors.lastname: Hague
authors.affiliation: Massachusetts Department of Public Health, Boston, MA, USA.
authors.forename: Betsey
authors.initials: B
authors.lastname: John
authors.affiliation: Massachusetts Department of Public Health, Boston, MA, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Goldman
authors.affiliation: Massachusetts Department of Public Health, Boston, MA, USA.
authors.forename: Kshema
authors.initials: K
authors.lastname: Nagavedu
authors.affiliation: Massachusetts Department of Public Health, Boston, MA, USA.
authors.forename: Sophie
authors.initials: S
authors.lastname: Lewis
authors.affiliation: Massachusetts Department of Public Health, Boston, MA, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hawrusik
authors.affiliation: Boston University School of Public Health, Boston, MA, USA.
authors.forename: Serena
authors.initials: S
authors.lastname: Rajabiun
authors.affiliation: Massachusetts Department of Public Health, Boston, MA, USA.
authors.forename: Noelle
authors.initials: N
authors.lastname: Cocoros
authors.affiliation: Massachusetts Department of Public Health, Boston, MA, USA.
authors.forename: H Dawn
authors.initials: HD
authors.lastname: Fukuda
authors.affiliation: Massachusetts Department of Public Health, Boston, MA, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Cranston
mesh_terms: D000328:Adult; D003266:Continuity of Patient Care / Q000458:organization & administration*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D016247:Information Storage and Retrieval; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D010865:Pilot Projects; D062486:Public Health Surveillance
keywords: Care engagement; HIV laboratory surveillance; Linkage; Out-of-care