Evaluating Health Information Technology:Provider Satisfaction with an HIV-Specific,Electronic Clinical Management and Reporting System

Manya Magnus, Ph.D., M.P.H., Jane Herwehe, M.P.H., Laura Andrews, M.P.H., R.N.,Laura Gibson, M.B.A., Nathan Daigrepont, Jordana M. De Leon, M.P.H.,Newton E. Hyslop, Jr., M.D., Steven Styron, M.B.A., M.P.H., Ronald Wilcox, M.D., Ph.D.,Michael Kaiser, M.D., and Michael K. Butler, M.D., M.H.A., C.P.E.12009AIDS PATIENT CARE and STDs

Introduction

Health information Technology:increase adherence and ultimate patient care outcomes

identify patients out of care or non-adherent to medication refillsimprove routine preventive care

Introduction

Provider satisfaction –one barrier to maximal benefit of HIT

inability to integrate HIT into clinic flowconfusion regarding the intended user of the HITalteration in social norms related to the HITperception that the system and its tools are not correctly applied to each patientsystem characteristics

Methods

Customized version of Lab Tracker(LSU HCSD) – an HIV-specific, electronic clinical management and reporting system

improve the quality of HIV outpatient care being deliveredimprove morbidity and mortality outcomes

Methods

Surveycharacterize provider perception of the systemSatisfactionperception of its association with care delivery and outcomes

three time pointspreimplementation, and two within 1 year postimplementation

Result

ResultProvider self-reports of time to complete critical functions decreased for all tasks

find current CD4 count – 3.9 [SD 5.8], 2.9 [2.3], 2.1 [2.6]current viral load – 4.0 [SD 5.6], 2.9 [2.5], 1.8 [2.6]current antiretroviral status – 3.9 [SD 4.7], 2.9 [3.7], 1.5 [1.1]history of antiretroviral –15.1 [SD 21.9], 6.0 [5.4], 5.4 [7.2]

average 16.1 minutes per patient visit

Result

Result

physicians were less likely to agree with some statementno significant increase in statements which indicate a negative effect of the HIT

Discussion

Overall satisfaction with systems in place to track patient information improved Physicians reported less satisfaction with the system on several indicators than non-physiciansLT use was associated with time-savings on five common patient-related tasks

DiscussionLimitation

The two follow-up time points had lower-than-expected response ratesAs respondents were self-selected, there may be volunteer bias in this study

Conclusion

Providers in publicly funded, statewide, HIV-clinics can be satisfied with HIT and perceive an association between HIT use and improvements in patient care deliveryHIT may be successfully adopted by HIV care providers in the future