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Harnessing the Power of the Electronic Medical Record to Facilitate an Opt-Out HIV Screening Program in an Urban Academic Emergency Department

Lin, Janet MD, MPH; Mauntel-Medici, Cammeo MPH; Heinert, Sara MPH; Baghikar, Sara MD, MPH

Journal of Public Health Management and Practice: May/June 2017 - Volume 23 - Issue 3 - p 264–268
doi: 10.1097/PHH.0000000000000448
Practice Brief Report

Emergency Departments (EDs) are important settings for routine HIV screening because they are safety nets for populations with limited access to primary care and high risk for HIV infection. However, EDs rarely perform routine HIV screening due to logistical barriers. An electronic medical record (EMR)-driven routine opt-out HIV screening program was implemented in an urban academic ED and led to rapid scale-up of screening volume and detection of unknown HIV infection. The streamlined tool, requiring 4 mouse clicks, automates screening for eligibility, facilitates documentation of consent and orders the HIV test. HIV screening increased to a monthly average of 550 tests compared to an average of 7 tests prior to program implementation. Similar EMR innovations can be leveraged in a variety of other clinical settings and for testing of other diseases to improve clinical flow and outcomes.

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Department of Emergency Medicine, University of Illinois Hospital and Health Science Systems, Chicago, Illinois.

Correspondence: Sara Baghikar, MD, MPH, Department of Emergency Medicine, University of Illinois Hospital and Health Science Systems, 808 S. Wood St, CMET 471H, Chicago, IL 60612 (

Project HEAL is supported by FOCUS, a program of Gilead Sciences, Inc. and by the Department of Public Health Chicago, Illinois (grant 57429). The authors received salary support from these grants and have no conflicts of interest to report.

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