scholarly journals Patient and System Factors Related to Missed Opportunities for Screening in an Electronic Medical Record-driven, Opt-out HIV Screening Program in the Emergency Department

2017 ◽  
Vol 24 (11) ◽  
pp. 1358-1368 ◽  
Author(s):  
Janet Lin ◽  
Sara Baghikar ◽  
Cammeo Mauntel-Medici ◽  
Sara Heinert ◽  
Daven Patel
Keyword(s):  
Emergency Department ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Screening Program ◽  
Hiv Screening ◽  
Missed Opportunities ◽  
Opt Out ◽  
System Factors

scholarly journals 845. Impact of the COVID-19 Pandemic on Routine HIV Screening in an Emergency Department

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S513-S513
Author(s):  
Elizabeth A Aguilera ◽  
Gilhen Rodriguez ◽  
Gabriela P Del Bianco ◽  
Gloria Heresi ◽  
James Murphy ◽  
...  
Keyword(s):  
Emergency Department ◽  
Screening Program ◽  
Medical Center ◽  
Hiv Infections ◽  
Hiv Screening ◽  
Opt Out ◽  
Number Of Patients ◽  
Confirmatory Tests ◽  
Routine Hiv Screening ◽  
The Impact

Abstract Background The Emergency Department (ED) at Memorial Hermann Hospital (MHH) - Texas Medical Center (TMC), Houston, Texas has a long established screening program targeted at detection of HIV infections. The impact of the COVID-19 pandemic on this screening program is unknown. Methods The Routine HIV screening program includes opt-out testing of all adults 18 years and older with Glasgow score > 9. HIV 4th generation Ag/Ab screening, with reflex to Gennius confirmatory tests are used. Pre-pandemic (March 2019 to February 2020) to Pandemic period (March 2020 to February 2021) intervals were compared. Results 72,929 patients visited MHH_ED during the pre-pandemic period and 57,128 in the pandemic period, a 22% decline. The number of patients tested for HIV pre-pandemic was 9433 and 6718 pandemic, a 29% decline. When the pandemic year was parsed into first and last 6 months interval and compared to similar intervals in the year pre pandemic, 39% followed by 16% declines in HIV testing were found. In total, 354 patients were HIV positives, 209, (59%) in the pre-pandemic and 145 (41%) in the pandemic period.The reduction in new HIV infections found was directly proportional to the decline in patients visiting the MHH-ED where the percent of patients HIV positive was constant across intervals (2.21% vs 2.26%). Demographic and outcome characteristics were constant across the compared intervals. Conclusion The COVID -19 pandemic reduced detection of new HIV infections by screening in direct proportion to the reduction in MHH-ED patient visits. The impact of COVID-19 pandemic decreased with duration of the pandemic. Disclosures All Authors: No reported disclosures

Missed Opportunities for Earlier HIV Diagnosis in an Emergency Department Despite an HIV Screening Program

2009 ◽  
Vol 23 (4) ◽  
pp. 245-250 ◽  
Author(s):  
Douglas A.E. White ◽  
Otis U. Warren ◽  
Alicia N. Scribner ◽  
Bradley W. Frazee
Keyword(s):  
Emergency Department ◽  
Screening Program ◽  
Hiv Screening ◽  
Hiv Diagnosis ◽  
Missed Opportunities

scholarly journals Automated HIV screening in the emergency department –earlier diagnosis, improved clinical outcomes

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
I Vaz Pinto ◽  
M Guimaraes ◽  
V Castro ◽  
C Santos ◽  
A Galiano ◽  
...  
Keyword(s):  
Public Health ◽  
Emergency Department ◽  
Screening Program ◽  
Public Health Problem ◽  
Undetectable Viral Load ◽  
Late Presentation ◽  
Screening Tests ◽  
Treatment As Prevention ◽  
Hiv Screening ◽  
Opt Out

Abstract Background HIV/AIDS is a public health problem worldwide because undiagnosed patients maintain onward transmission. To stop viral transmission an upscale in diagnostics is needed so that more patients start treatment; patients on treatment and with undetectable viral load do not transmit the virus to other persons (“Treatment as Prevention”). Objectives We aimed at identifying more HIV infections in the emergency Department (ED) and at doing so earlier in the course of disease. Methods we designed an automated and clinician independent HIV screening project in the ED. Electronic Medical Record (EMR) automatically generates a request for HIV antibody (HIV Ab) test when a patient: a) is 18-65 years of age and has a request for any blood test; b) is not identified in the EMR as being HIV infected; c) does not have an HIV Ab in the EMR in the previous year. Nursing staff receive a visual warning of patients' eligibility for screening and an extra tube label is printed out for HIV testing. The patient is informed of screening at the moment of blood drawing and an <<opt-out >> strategy is applied (optional verbal informed consent or <<opt-out >> of screening). Results In 16 months, a total of 21.487 people were eligible for screening. 18.072 HIV Ab screening tests were done. The opt-out rate was 6.3% and there were 44 new HIV diagnostics (prevalence rate 0.24%). Late presenting patients (baseline CD4 counts <350) dropped from an average of 56% in the previous 6 years at our institution to 36.3%. Median CD4 count at diagnostics went up from 192 to 388 cells/mm³. Conclusions An automated and clinician independent HIV screening program in the ED proved to be successful at identifying more HIV patients and at tackling the problem of late presentation. Diagnosing early in the course of infection is beneficial for the individual patient, but also represents a gain in general public health because onward transmission is stopped by starting antiretroviral treatment. Key messages Early diagnosis through universal screening. Treatment as prevention.

Assessment of Nurse Perspectives on an Emergency Department-Based Routine Opt-Out HIV Screening Program

2017 ◽  
Vol 28 (3) ◽  
pp. 316-326 ◽  
Author(s):  
Sara Heinert ◽  
Julius Carter ◽  
Cammeo Mauntel-Medici ◽  
Janet Lin
Keyword(s):  
Emergency Department ◽  
Screening Program ◽  
Hiv Screening ◽  
Opt Out

scholarly journals Using a configurable EMR and decision support tools to promote process integration for routine HIV screening in the emergency department

2015 ◽  
Vol 23 (2) ◽  
pp. 396-401 ◽  
Author(s):  
Robert McGuire ◽  
Eric Moore
Keyword(s):  
Emergency Department ◽  
Decision Support ◽  
Hiv Testing ◽  
Screening Program ◽  
Safety Net ◽  
Hiv Screening ◽  
Decision Support Tools ◽  
Opt Out ◽  
Safety Net Hospital ◽  
Support Tools

Abstract Given the clinical and public health benefits of routine Human Immunodeficiency Virus (HIV) testing in the emergency department (ED) and Centers for Disease Control and Prevention recommendations, Maricopa Medical Center, as part of Maricopa Integrated Health System, started Test, Educate, Support, and Treat Arizona (TESTAZ) and became the first and, to-date, only hospital in Arizona to implement routine, non-targeted, opt-out, rapid HIV screening in the ED. The authors describe the implementation of a universal, routine, opt-out HIV screening program in the adult ED of an urban safety-net hospital serving under-served populations, including the uninsured and under-insured. Through a controlled and collaborative process, the authors integrated custom documentation elements specific to HIV screening into the triage/intake process, implemented and utilized clinical decision support tools to guide clinicians in each step of the process, and used electronic data collection and reporting to drive new screening protocols that led to a significant increase in overall HIV testing rates.

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