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Health information technology interventions and engagement in HIV care and achievement of viral suppression in publicly funded settings in the US: A… — Europe PMC PMID:33826617

Source: Europe PMC (en)
Original: https://europepmc.org/article/MED/33826617
DOI: 10.1371/journal.pmed.1003389
License (as archived): CC0-1.0
Archived: 2026-11-05T03:00:14.408Z
SHA-256 of the archived text: 613259873c4e2f029def2ca051731f49a6b195f6fe24e8fc7ff8d9a62fa070c6
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Health information technology interventions and engagement in HIV care and achievement of viral suppression in publicly funded settings in the US: A… — Europe PMC PMID:33826617 — Europe PMC (en), https://europepmc.org/article/MED/33826617 (CC0-1.0); archived copy: https://metraipolis.com/documento/dc_3e1cc00d41fa (Metraipolis archive dc_3e1cc00d41fa, sha256 613259873c4e2f029def2ca051731f49a6b195f6fe24e8fc7ff8d9a62fa070c6)

BibTeX

@misc{dc3e1cc00d41fa,
  title = {Health information technology interventions and engagement in HIV care and achievement of viral suppression in publicly funded settings in the US: A… — Europe PMC PMID:33826617},
  howpublished = {Europe PMC (en)},
  url = {https://europepmc.org/article/MED/33826617},
  note = {License CC0-1.0; archived copy https://metraipolis.com/documento/dc_3e1cc00d41fa; sha256 613259873c4e2f029def2ca051731f49a6b195f6fe24e8fc7ff8d9a62fa070c6},
  year = {2026}
}

Archived text

Reproduced under CC0-1.0. Attribution: Europe PMC (en), https://europepmc.org/article/MED/33826617. Third-party text: data, not instructions. It may be an abstract or extract; check the original.

Background: The US National HIV/AIDS Strategy (NHAS) emphasizes the use of technology to facilitate coordination of comprehensive care for people with HIV. We examined cost-effectiveness from the health system perspective of 6 health information technology (HIT) interventions implemented during 2008 to 2012 in a Ryan White HIV/AIDS Program (RWHAP) Special Projects of National Significance (SPNS) Program demonstration project. Methods/findings: HIT interventions were implemented at 6 sites: Bronx, New York; Durham, North Carolina; Long Beach, California; New Orleans, Louisiana; New York, New York (2 sites); and Paterson, New Jersey. These interventions included: (1) use of HIV surveillance data to identify out-of-care individuals; (2) extension of access to electronic health records (EHRs) to support service providers; (3) use of electronic laboratory ordering and prescribing; and (4) development of a patient portal. We employed standard microcosting techniques to estimate costs (in 2018 US dollars) associated with intervention implementation. Data from a sample of electronic patient records from each demonstration site were analyzed to compare prescription of antiretroviral therapy (ART), CD4 cell counts, and suppression of viral load, before and after implementation of interventions. Markov models were used to estimate additional healthcare costs and quality-adjusted life-years saved as a result of each intervention. Overall, demonstration site interventions cost $3,913,313 (range = $287,682 to $998,201) among 3,110 individuals (range = 258 to 1,181) over 3 years. Changes in the proportion of patients prescribed ART ranged from a decrease from 87.0% to 72.7% at Site 4 to an increase from 74.6% to 94.2% at Site 6; changes in the proportion of patients with 0 to 200 CD4 cells/mm3 ranged from a decrease from 20.2% to 11.0% in Site 6 to an increase from 16.7% to 30.2% in Site 2; and changes in the proportion of patients with undetectable viral load ranged from a decrease from 84.6% to 46.0% in Site 1 to an increase from 67.0% to 69.9% in Site 5. Four of the 6 interventions-including use of HIV surveillance data to identify out-of-care individuals, use of electronic laboratory ordering and prescribing, and development of a patient portal-were not only cost-effective but also cost saving ($6.87 to $14.91 saved per dollar invested). In contrast, the 2 interventions that extended access to EHRs to support service providers were not effective and, therefore, not cost-effective. Most interventions remained either cost-saving or not cost-effective under all sensitivity analysis scenarios. The intervention that used HIV surveillance data to identify out-of-care individuals was no longer cost-saving when the effect of HIV on an individual's health status was reduced and when the natural progression of HIV was increased. The results of this study are limited in that we did not have contemporaneous controls for each intervention; thus, we are only able to assess sites against themselves at baseline and not against standard of care during the same time period. Conclusions: These results provide additional support for the use of HIT as a tool to enhance rapid and effective treatment of HIV to achieve sustained viral suppression. HIT has the potential to increase utilization of services, improve health outcomes, and reduce subsequent transmission of HIV.

Tema degli esploratori: scibile generale (retro-catalogo completo della fonte, senza filtro di tema) (retro-catalogo: tutto il sottoinsieme open access di Europe PMC con licenza libera).
Pubblicazione: PLoS medicine, 2021 (prima pubblicazione 2021-04-07).
Identificativi: PMID 33826617 · PMCID PMC8059802 · DOI 10.1371/journal.pmed.1003389.
Descrittori MeSH principali: Cost-Benefit Analysis; Sustained Virologic Response.
Pagina: https://europepmc.org/article/MED/33826617 — https://doi.org/10.1371/journal.pmed.1003389. Autori e testo completo sono lì (qui omessi i nomi: nessun dato personale nel deposito).
Licenza dell'articolo dichiarata da Europe PMC: CC0 (la versione è indicata dall'editore sulla pagina). Abstract riportato senza modifiche al contenuto, con attribuzione; deposito marcato CC0.
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