Journal Article

Routine HIV Screening as a Standard of Care

Harvey, Blair, Roche, Laura, Reitan, Karen A., Taylor, Raekiela D., Zepeda, Saul

2018

Overview

Objective: We implemented routine HIV screening as part of the 4-year Care and Prevention in the United States Demonstration Project, whose aim was to reduce HIV/AIDS–related morbidity and mortality among racial/ethnic minority groups in the United States. We describe the capacity-building efforts to implement routine HIV screening and provide lessons learned and implications for practice. Methods: From January 2013 through September 2015, the Public Health Institute of Metropolitan Chicago (PHIMC) implemented routine HIV screening in 7 health care systems in Illinois by providing capacity-building assistance focused on systems and operational infrastructure, staff member skills and organizational structure, and clinic culture. Each site received funding to integrate routine HIV screening into the existing clinic flow, engage the entire health care team in the process, and transform the system and shift clinic culture to sustain HIV screening. Results: All 7 systems established policies and procedures to implement routine screening, 5 systems integrated HIV test ordering and documentation into their electronic health records, and 4 systems established a third-party billing and reimbursement process for testing. The 7 systems conducted a total of 49 285 tests and identified 160 people living with HIV. The number of tests increased by more than 40% each year. Conclusions: PHIMC identified the following practices for consideration when implementing routine HIV screening in general medical settings: create a culture that supports HIV screening, use champions in clinics, integrate HIV screening into clinic flow and electronic health records, and train clinic staff members on HIV messaging. Incorporating these practices can help other clinical settings build capacity to make routine HIV screening a standard of care.

• Publisher: SAGE,SAGE Publications,SAGE PUBLICATIONS, INC
• Subject: Acquired immune deficiency syndrome / AIDS / Ambulatory Care Facilities - economics / Ambulatory Care Facilities - organization & administration / Ambulatory Care Facilities - standards / Archives & records / Capacity Building - economics / Capacity Building - organization & administration / Capacity Building - standards / Capacity building approach / Capacity development / Charges / Chicago / Clinical Protocols / Clinics / Computerized medical records / Construction standards / Culture / Disease management / Disease prevention / Documentation / Electronic health records / Electronic Health Records - organization & administration / Electronic medical records / Ethnic groups / Health care / Health care access / Health care policy / Health records / Health services / HIV / HIV Infections - diagnosis / Human immunodeficiency virus / Humans / Implementation / Infrastructure / Insurance, Health, Reimbursement / Mass Screening - economics / Mass Screening - organization & administration / Mass Screening - standards / Medical records / Medical screening / Minority & ethnic groups / Minority groups / Morbidity / Mortality / Organizational aspects / Organizational Culture / Organizational structure / Policy / Prevention / Primary care / Public health / Skills / Social Stigma / Standard of care / Standard of Care - organization & administration / Standard of Care - standards / Tests / United States / Work Engagement