Journal of
AIDS and HIV Research

  • Abbreviation: J. AIDS HIV Res.
  • Language: English
  • ISSN: 2141-2359
  • DOI: 10.5897/JAHR
  • Start Year: 2009
  • Published Articles: 298

Full Length Research Paper

Integrating a web-based, patient-administered assessment into primary care for HIV-infected adults

R. Fredericksen
  • R. Fredericksen
  • Center for AIDS Research, University of Washington, Box 359931, 325 9th Avenue, Seattle, WA, 98104, USA.
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P. K. Crane
  • P. K. Crane
  • Center for AIDS Research, University of Washington, Box 359931, 325 9th Avenue, Seattle, WA, 98104, USA.
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J. Tufano
  • J. Tufano
  • Medical Education, University of Washington, Box 357240, 325 9th Avenue, Seattle, WA, 98104, USA.
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J. Ralston
  • J. Ralston
  • Center for Health Studies, School of Public Health, University of Washington, Box 358085, Seattle, WA, 98195, USA.
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S. Schmidt
  • S. Schmidt
  • Center for AIDS Research, University of Washington, Box 359931, 325 9th Avenue, Seattle, WA, 98104, USA.
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T. Brown
  • T. Brown
  • Center for AIDS Research, University of Washington, Box 359931, 325 9th Avenue, Seattle, WA, 98104, USA.
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D. Layman
  • D. Layman
  • Center for AIDS Research, University of Washington, Box 359931, 325 9th Avenue, Seattle, WA, 98104, USA.
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R. D. Harrington
  • R. D. Harrington
  • Allergy and Infectious Disease, University of Washington, Box 359930, 325 9th Avenue, Seattle, WA, 98104, USA.
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S. Dhanireddy
  • S. Dhanireddy
  • Allergy and Infectious Disease, University of Washington, Box 359930, 325 9th Avenue, Seattle, WA, 98104, USA.
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T. Stone
  • T. Stone
  • Allergy and Infectious Disease, University of Washington, Box 359930, 325 9th Avenue, Seattle, WA, 98104, USA.
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W. Lober
  • W. Lober
  • Biomedical and Health Informatics, University of Washington, 1959 NE Pacific, Seattle, WA, 98195, USA.
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M. M. Kitahata
  • M. M. Kitahata
  • Center for AIDS Research, University of Washington, Box 359931, 325 9th Avenue, Seattle, WA, 98104, USA.
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H. M. Crane
  • H. M. Crane
  • Center for AIDS Research, University of Washington, Box 359931, 325 9th Avenue, Seattle, WA, 98104, USA.
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  •  Accepted: 08 December 2011
  •  Published: 28 February 2012

Abstract

Providers routinely under diagnose at risk behaviors and outcomes, including depression, suicidal ideation, substance abuse, and poor medication adherence. To address this, we developed a web-based, self-administered patient-reported assessment tool and integrated it into routine primary care for HIV-infected adults. Printed results were delivered to providers and social workers immediately prior to patient appointments. The assessment included brief, validated instruments measuring clinically relevant domains including depression, substance use, medication adherence, and HIV transmission risk behaviors. Utilizing the Institute for Healthcare Improvement’s Plan-Do-Study-Act (PDSA) approach to quality improvement, we addressed issues with clinic flow, technology, scheduling, and delivery of assessment results with the support of all levels of clinic staff. We found web-based patient-reported assessments to be a feasible tool that can be integrated into a busy multi-provider HIV primary care clinic. These assessments may improve provider recognition of key patient behaviors and outcomes. Critical factors for successful integration of such assessments into clinical care include: strong top-level support from clinic management, provider understanding of patient-reported assessments as a valuable clinical tool, tailoring the assessment to meet provider needs, communication among clinic staff to address flow issues, timeliness of delivery, and sound technological resources.

 

Key words: Patient-reported outcomes, quality improvement, HIV-infection, patient-provider communication, plan-do-study-act (PDSA) cycle.

Copyright © 2024 Author(s) retain the copyright of this article.

This article is published under the terms of the Creative Commons Attribution License 4.0

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