Expanded HIV Testing Strategy Leveraging the Electronic Medical Record Uncovers Undiagnosed Infection Among...

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Health Informatics

Background:

• Routine Human Immunodeficiency Virus (HIV) testing is recommended for hospitalized patients.
• Limited strategies exist to expand HIV screening within hospital settings.
• Electronic Medical Record (EMR) systems offer potential for implementing new testing protocols.

Purpose of the Study:

• To assess the impact of an EMR prompt on HIV testing rates among hospitalized patients.
• To evaluate changes in patient demographics and new HIV diagnoses following EMR prompt implementation.

Main Methods:

• A pre-post study design was employed across three hospitals in the Bronx, NY.
• Compared HIV testing proportions, patient characteristics, and new diagnosis rates between periods with inactive and active EMR prompts.
• The EMR prompt targeted patients with no prior HIV test or a high-risk diagnosis.

Main Results:

• HIV testing increased from 9.5% to 21.8% of admissions when the EMR prompt was active.
• The prompt significantly boosted testing across all patient groups, including those with no prior test or a previous negative result.
• New HIV diagnoses via screening rose from 8.2 to 37.0 per 100,000 admissions.

Conclusions:

• EMR prompts are effective in substantially increasing HIV testing among hospitalized individuals.
• This intervention led to broader patient testing and a higher yield of new HIV diagnoses.
• Implementing EMR-based prompts is a viable strategy to enhance HIV screening in acute care settings.