Extending functionality of and demonstrating integrated surveillance for public health within a prototype regional health information exchange.

At the HIMSS 2008 conference we demonstrated how multi-jurisdictional public health surveillance and monitoring processes could be supported and expedited through integration with a prototype health information exchange.

Routine collection of patient-reported outcomes in an HIV clinic setting: the first 100 patients.

BACKGROUND: Information from patient-reported outcomes (PROs) can enhance patient-provider communication and facilitate clinical research. However, there are barriers to collecting PROs within a clinic. Recent technological advances may help overcome these barriers. We examined the feasibility of using a web-based application on tablet PCs with touch screens to collect PROs in a busy, multi-provider, outpatient HIV clinical care setting. METHODS: Patients presenting for routine care were asked to complete a touch-screen-based assessment containing 62 to 111 items depending on patient responses. The assessment included instruments measuring body morphology abnormalities, depression, symptom burden, medication adherence, drug/alcohol/tobacco use, and health-related quality of life. RESULTS: Of 136 patients approached to participate in the study, 106 patients (78%) completed the assessment, 6 (4%) started but did not complete it, and 24 (18%) refused. Of those who completed the assessment, the mean age was 48 years, and 29% reported a history of injection drug use. The median time to complete the assessment was 12 minutes. The prevalence of lipoatrophy was 51%, the prevalence of lipohypertrophy was 69%, and the prevalence of moderate or severe depression was 51%. We found that 25% of those receiving highly active antiretroviral therapy noted missing a dose of their antiretroviral medications in the prior 4 days. CONCLUSIONS: Collection of PROs using touch-screen-based, internet technology was feasible in a busy HIV clinic. We found a high prevalence of body morphology abnormalities, depression, and poor adherence. Touch-screen-based collection of PROs is a promising tool to facilitate research and clinical care.