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A Clinical Informatics Approach to Reengagement in HIV Care in the Emergency Department

Ridgway, Jessica P., MD, MS; Almirol, Ellen, MPH, MAMS; Schmitt, Jessica, LCSW; Wesley-Madgett, Lindsey; Pitrak, David, MD, FIDSA

Journal of Public Health Management and Practice: May/June 2019 - Volume 25 - Issue 3 - p 270–273
doi: 10.1097/PHH.0000000000000844
Research Reports: Practice Brief Report
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Emergency department visits provide an opportunity to reengage people living with HIV (PLWH) who are out of care. We developed an electronic medical record–based algorithm to identify PLWH in the emergency department and inpatient settings and utilized a trained HIV care navigator to reengage PLWH in these settings. The algorithm identified 420 PLWH during the 14-month observation period. Of these, 56 patients were out of care. Out-of-care individuals were significantly younger than those in care (mean age: 38.6 ± 15.5 vs 46.3 ±14.8 years, P < .001) and more likely to be uninsured (7.1% [4/56] vs 1.8% [6/337], P = .02). Among out-of-care patients, 66.1% (37/56) were reengaged in care. Only 21.4% (12/56) of out-of-care patients had previously received outpatient HIV care at our institution. This project demonstrates the feasibility of using an electronic medical record alert and HIV care navigator to reengage PLWH seeking emergency medical care.

Section of Infectious Diseases and Global Health, Department of Medicine, The University of Chicago, Chicago, Illinois (Drs Ridgway and Pitrak and Mss Almirol, Schmitt, and Wesley-Madgett); and University of Chicago Center for HIV Elimination, Chicago, Illinois (Drs Ridgway and Pitrak).

Correspondence: Jessica P. Ridgway, MD, MS, Section of Infectious Diseases and Global Health, Department of Medicine, The University of Chicago, 5841 South Maryland Ave, MC 5095, Chicago, IL 60637 (jessica.ridgway@uchospitals.edu).

This work was supported by a grant from the Chicago Department of Public Health.

The authors declare no conflicts of interest.

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