Using Electronic Medical Record Data to Improve HIV Primary Care

Study Overview
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Brief Summary
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This cluster randomized control trial examines whether an audit and feedback study improves care of patients living with HIV/AIDS in a family health team setting.

Detailed Description
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This cluster randomized control trial will use electronic medical record (EMR) data from the St. Michael's Hospital Academic Family Health Team to examine whether the quality of HIV care provided to patients can be improved through an audit and feedback (A&F) intervention. Our objective is to examine whether A&F targeting family physicians caring for people living with HIV/AIDS (PHLA) using EMR data can improve laboratory monitoring, engagement in primary care and the uptake of preventive interventions.

Official Title
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Using Electronic Medical Record Data to Improve HIV Primary Care: An Audit and Feedback Study

Conditions
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Quality of Health Care, HIV/AIDS, Electronic Health Records

Intervention / Treatment
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* Behavioral: Audit and Feedback


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Family physicians at the St. Michael's Hospital Academic Family Health Team who have at least 20 PLHA. Exclusion Criteria: None
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br>Audit and feedback directed at family physicians, including reports a one-on-one meeting. | Behavioral: Audit and Feedback<br>* Charts for enrolled physicians will be audited and they will receive feedback, consisting of tailored reports and one-on-one meeting with colleague to review at baseline, 3 months and 6 months<br>|
| No Intervention: Control<br>Usual care; may receive the intervention at the end of the study if successful | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Up to date viral load | Percentage of HIV infected patients who have an up to date HIV viral load | Within six months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Clinic visit | To assess engagement in care | Within the last 6 months | 
| Up-to-date cancer screenings | Presence of cancer monitoring for colorectal, breast and cervical cancers | 1-3 years | 
| Vaccinations | Up-to-date for both pneumococcal vaccines and seasonal influenza vaccine | Since 2013 | 
| Screening for diabetes | For those 40 or older, the presence of either a fasting blood glucose or HbA1c in the chart | Within 1 year | 
| Screening for hypercholesterolemia | For those 40 or older. the presence of an LDL or non-HDL in the chart | Within 1 year | 
| Screening for osteoporosis | For patients 50 years and older, the presence of a bone mineral density report | Within 5 years |