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Is it worth connecting HIV service providers through a computer network and the Internet?

Is it worth connecting HIV service providers through a computer network and the Internet?. John Milberg Office of Science and Epidemiology HRSA- HIV/AIDS Bureau. Recommendation From the National Academy of Science, Committee on Enhancing the Internet for Health Applications.

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Is it worth connecting HIV service providers through a computer network and the Internet?

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  1. Is it worth connecting HIV service providers through a computer network and the Internet? John Milberg Office of Science and Epidemiology HRSA- HIV/AIDS Bureau

  2. Recommendation From the National Academy of Science, Committee on Enhancing the Internet for Health Applications • The Dept. of Health and Human Services should fund pilot projects and larger demonstration programs to develop and demonstrate interoperable, scalable internet applications for linking many health organizations. (2000) Source: Networking Health: Prescriptions for the Internet. National Research Council. National Academy Press, Washington, D.C. 2000.

  3. The Day Ahead • Big Benefits: Improve the quality, management and coordination of HIV careImprove ability to efficiently monitor, evaluate and report • Bigger Challenges?Data security, confidentiality: Gaining the trust of consumers • Running a secure network; • Can you use the data? (data analysis skills) • Introducing just one more MIS in clinics doing many other things and beholden to other funders • What about providers not participating in the network (sometimes the biggest providers)?

  4. The Day Ahead • Current tales and experience: Lessons from the field • How can you pay for it? • What about all those providers who lack internet access?

  5. Who Benefits and How? (and can you demonstrate it…) • Consumers/PLWHA • Providers of HIV Care • Grantees • HRSA/HAB

  6. Who Benefits and How? (and can you demonstrate it…) For Consumers/PLWHA • Better clinical management, receipt of preventive services--improved outcomes? • Network/shared database yields administrative efficiency-reduced burden to register and enroll • Improved coordination of services, referrals and follow-up • Can electronic access to medical record promote client buy-in to treatment regimen? Quick way to send messages and updates to client? What are your evaluation criteria?

  7. Who Benefits and How? (and can you demonstrate it…) Providers of HIV Care • Centralized network means reduced database administration (now you just have to worry if your network connection is up or too slow…) • Improved coordination of services, referrals and follow-up within network participants • Improved access to patient data for clinical decision-making • More efficient reporting (now the grantee can run your CADR!) What are your evaluation criteria?

  8. Who Benefits and How? (and can you demonstrate it…) Grantees • All the data are at your electronic fingertips • Improved coordination of services, referrals and follow-up within network participants; • Dramatically improved ability to assess the quality of care within your jurisdiction, in real-time, and with unduplicated data(just think how easy grant-writing will be now…) • More efficient reporting (now you can run the CADRs and produce one merged report across all providers) Evaluation criteria:

  9. Who Benefits and How? (and can you demonstrate it…) HRSA/HAB • Data gathered from network systems are unduplicated and more reliable, standardized. Therefore: HAB in a much improved position to report more accurately and efficiently on who is receiving care and quality of services funded by the CARE Act Evaluation criteria:

  10. Challenges-TrustData Security • Must gain the trust and “buy-in” from people whose very sensitive data you will be storing and sending over the network(How do you do this?) • If no one agrees to allow their personal health info to be stored and shared over the network, then the system loses utility

  11. Data Security and Confidentiality • Computers:Technological methods User Ids, Passwords, authentication, encryption, audit trails and logs, firewalls • Human component:Establish clear rules and roles: Who’s responsible in your agency (see HIPAA)?

  12. Evaluate IT • Does all this help you provide and manage your HIV care; Can you better evaluate and understand the services you provide (at specific agencies, overall)? Are you using the data fully? **How much of a network of care already exists in your area? Are we superimposing an electronic grid over a group of generally disconnected agencies? • Think ahead about ways of showing the utility of your network system

  13. So: Is it worth connecting HIV service providers through a computer network and the Internet? • Benefits clearly outweigh the challenges and costs, but a panacea it is not. Source: Me Sites must develop technical capacity, health service analysis skills

  14. So: Is it worth connecting HIV service providers through a computer network and the Internet? • Other Sources: • Medical Informatics, 2nd ed. Shortliffe and Perreault, eds. Springer, New York. , 2001. • American Medical Informatics Assn. and their journal: http://www.amia.org/index.html

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