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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.,
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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.1 2009 AIDS PATIENT CARE and STDs
Introduction • Health information Technology:increase adherence andultimate patient care outcomes • identify patients out of care or non-adherent to medication refills • improve routine preventive care
Introduction • Provider satisfaction –one barrier to maximal benefit of HIT • inability to integrate HIT into clinic flow • confusion regarding the intended user of the HIT • alteration in social norms related to the HIT • perception that the system and its tools are not correctly applied to each patient • system 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 delivered • improve morbidity and mortality outcomes
Methods • Survey • characterize provider perception of the system • Satisfaction • perception of its association with care delivery and outcomes • three time pointspreimplementation, and two within 1 year postimplementation
Result • Provider 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 • physicians were less likely to agree with some statement • no 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-physicians • LT use was associated with time-savings on five common patient-related tasks
DiscussionLimitation • The two follow-up time points had lower-than-expected response rates • As 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 delivery • HIT may be successfully adopted by HIV care providers in the future