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A feasibility study for a clinical decision support system prompting HIV testing.

D R Chadwick1, C Hall2, C Rae3

  • 1James Cook University Hospital, Middlesbrough, UK.

HIV Medicine
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Summary

A new application prompts healthcare workers to order HIV tests during routine blood work. This risk-based system is feasible and acceptable, showing a modest increase in HIV testing rates.

Keywords:
HIVclinical decision supportindicator conditionspromptedscreeningtesting

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Area of Science:

  • Medical Informatics
  • Public Health
  • Infectious Disease

Background:

  • Undiagnosed HIV infection and late presentation remain significant global health challenges.
  • Current HIV testing strategies have not fully overcome these persistent issues.

Purpose of the Study:

  • To evaluate a prototype risk-based application designed to prompt HIV testing during routine blood tests.
  • To assess the feasibility and acceptability of a clinical decision support tool for increasing HIV testing.

Main Methods:

  • Modified two computer physician order entry (CPOE) systems with a prototype application to prompt HIV testing based on patient risk factors.
  • Implemented the application in a London hospital and general practices for three months.
  • Interviewed healthcare workers (HCWs) on usability and acceptability; compared HIV testing rates before and after implementation in general practices.

Main Results:

  • The CPOE-based HIV testing prompt system was found to be usable and acceptable to hospital doctors, general practitioners, and nurse practitioners.
  • Prompt timing within consultations presented some challenges for discussion and consent.
  • In general practices, approximately 1 in 10 prompts were accepted, leading to a 6% increase in HIV testing rates over the study period.

Conclusions:

  • A CPOE-based clinical decision support application is a feasible and acceptable method for prompting HIV testing among healthcare workers.
  • Further refinement of the application for more accurate risk stratification is recommended to enhance its effectiveness in increasing HIV testing rates.