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Agenda  June 30, 20212


Desired Outcome: CDS Design Team understands desired functionality, requirements, and challenges to building a CDS tool that can be integrated into EHR systems.


  1. Statement of Purpose for the CDS Tool

  2. Partner Introductions

  3. Questions from CDS Design Team



Slide 1

                                                             





Partner Talking Points


Desired Outcome: CDS Design Team understands desired functionality, requirements, and challenges to building a CDS tool that can be integrated into EHR systems.

  1. Introduce your team - 1 min

  2. Tell your health center’s story - where you are, whom you serve - 1min

  3. Talk to us about your system and your data - (How are these captured [e.g. POC, patient-input, MA/PA/Nurse/NP/Physician)? How is the data stored[e.g. structured, unstructured, paper-based, electronic abstraction?] Where is the data stored? - 3 min

    1. HIV test refusal

    2. External history of HIV test

    3. PrEP counseling and/or referrals

Slide 2





Tip
titleLinks to Workflows and CDS Planning Worksheets



Clinical & Data WorkflowsCDS Worksheet
AllianceChicagoWorkflowsTemplate
El RioWorkflowsCompleted Worksheet
FenwayPlaceholderTemplate
MontefioreWorkflowsTemplate
OhioWorkflowsCompleted Worksheet






Project Teams

Roles are:

    1. Clinician SME advisor (clinical decision maker with training in HIV that also sees patients)
    2. Person familiar with the EHR and how to integrate new content into it (also hopefully knowledgeable about the lab system interface if it is separate from the EHR)
    3. Data analyst familiar with the HIV data
    4. HIV care coordinator to represent the care management component
    5. Other - Project Manager, IT Specialist, Admin, etc.


NACHC Informatics TeamAlphoraAllianceChicagoEl RioFenwayMontefioreOhio ACHC

Julia Skapik Clinician SME, familiar with EHR

Pedro B Carneiro Data Scientist familiar with EHR, HIV Data 

Raymonde Uy Physician SME on Informatics

John Gresh   Data Management

Andrea Price Project Manager

Bryn RhodesYou can copy from Item #3 on the CDS Worksheet AllianceChicago HIV ePrompt CDS Worksheet

Sudha Nagalingam, MD- Clinician SME, Familiar with EHR

Greg Raglow, MD- Physician SME Informatics

Dustin Holloway, MPH- Data Management/Analytcis

Erin Dougherty, MPH- Grants Management

Erika Solis- HIV Care Coordinator 


You can copy from Item #3 on the CDS Worksheet AllianceChicago HIV ePrompt CDS Worksheet

Lower Lights CHC

Dr. Lynnette Palmer, Quality Director, familiar with EHR

Richard Harris, Data Analyst, familiar with EHR

Southeast CHC

Nick Nelson, MPH, NP-C SME advisor, familiar with the EHR



Discussion Questions 
Anchor
#Qs
#Qs


QItemNotesAction Items
1.What would you like a Clinical Decision Support routine to do?

2.

Discussion with the technical ppl on what their protocols are for integrating the CDS into their system

  1. What is the process to implement a change in your EHR?
    1. Can your internal team make changes to the EHR? Are they limited or not?
    2. What is the timeframe to deploy?
    3. What approvals and tests are needed?
    4. Do you have to rely on the vendor to make changes?
  2. Does your EHR currently support Fast Healthcare Interoperability Resources or some other software portal? If not, do you have another way to integrate new software tools into the EHR?


3.

Data form and manner including whether you capture:

      1. HIV test refusal
      2. External history of HIV test
      3. PrEP counseling and/or referrals






















Partner Profiles in Brief - (These are estimates and do not need to match the data pulls. The timeframe is any time frame that is convenient for you)


HIV Prevalence/New Infections per year/percent of pop that lives with HIVDemographics (however you define them - your categories)



Substance Abuse Profile/Rate


RaceEthnicity Gender IdentitySex Assigned at BirthSexual Orientation
AllianceChicago






El Rio

Percent of Health Center Population Living with HIV/AIDS: 1.5% (2019) 


New HIV Diagnoses in 2019: 62 

(this number includes new infections diagnosed within the organization and outside referrals to El Rio SIA upon a positive HIV diagnosis outside of our El Rio system) 


2% - Asian

0.08% - Native Hawaiian 

0.16% - Other PI 

4.45% - African American

7.26% - American Indian

80.87% - White 

0.99% - More than one Race

4.38% - Unreported/Refused 


All Race Data: UDS, 2019

57% Hispanic/Latinx (UDS, 2019) 

42% Non-Hispanic (UDS, 2019) 

1% Refused (UDS, 2019) 


0.55% - Transgender (UDS, 2019)

41%- Male (UDS, 2019) 

59%- Female (UDS,2019) 

3.1%- Lesbian, Gay, Bisexual (UDS, 2019)

1.7% -Other/Something Else (UDS, 2019) 

3.95% 

Other Substance-related Disorders (excluding tobacco) and Alcohol-related Disorders (UDS, 2019) 

Fenway






Montefiore






Ohio

Lower Lights CHC

Health Center Patients living with HIV - 0.19% (21 pts)


New HIV Dx: 



UDS 2020 


Southeast CHC

Health Center Patients living with HIV - 0.46% (37 pts)


New HIV Dx: 10 (HIV Linkage to Care measure)


2020 UDS Data

Lower Lights CHC

2% Asian

1% Other PI

22% Black/AA

49% White

14% more than one race

12% Unreported/Refused


2020 UDS Data


Southeast CHC

0.8% Asian

0.05% Native Hawaiian

0.05% Other PI

30.8% Black/AA

0.4% AI/AN

62.2% White

3.1% More than one race

2.6% Unreported/Refused


2020 UDS Data

Lower Lights CHC

15% Hispanic/Latino

77% Non Hispanic Latino

8% Unreported/Refused




2020 UDS Data


Southeast CHC

2.2% Hispanic/Latino

97.5% Non Hispanic Latino

0.3% Unreported/Refused


2020 UDS Data

Lower Lights CHC

0.18% Transgender 


2020 UDS Data


Southeast CHC

0.73% Transgender


2020 UDS Data

Lower Lights CHC

3894 (36%) Male, 5664 (53%) Female  



2020 UDS Data


Southeast CHC

3977 (50.2%) assigned male

3737 (49.7%) assigned female


2020 UDS Data

Lower Lights CHC

Lesbian/gay (1%) 

Bisexual (0.8%) 

Something else /don’t know (15%)




2020 UDS Data


Southeast CHC

3.1% Lesbian/gay

4.6% Bisexual

1.1% Something else/don't know


2020 UDS Data

Lower Lights CHC

6.0% Other Substance-related disorders (excluding tobacco use and alcohol-related disorders)


Southeast CHC

26.2%

Other Substance-related disorders (excluding tobacco use and alcohol-related disorders)


2020 UDS Data