InfoHIV: Clinical Informatics for Optimizing HIV Prevention and Care

PROJECT SUMMARY My NIH-funded patient-oriented research program focuses on improving patient outcomes across the HIV prevention and care continua through implementation of clinical informatics interventions. For HIV prevention, I have developed and implemented electronic medical record (EMR)-based algorithms to identify patients eligible for pre-exposure prophylaxis (PrEP). I am currently PI for POWER Up, an R01 that utilizes clinical informatics as part of an overarching implementation science strategy to improve PrEP uptake in community health clinic settings. I have developed clinical informatics tools to identify people with HIV (PWH) in need of resources to prevent them from falling out of care. I am currently PI of the ePORTAL HIV-S study, an R01 utilizing electronic patient portals as part of a population health approach to screening for substance use disorder (SUD) among PWH. My preliminary research has shown that relying on EMR data alone is often imperfect for predicting PrEP and HIV care continuum outcomes, and that incorporation of social drivers of health and patient-reported data is crucial. However, additional research is needed to understand how to best incorporate patient reported data from individuals vulnerable to HIV and PWH into clinical informatics tools to improve PrEP and HIV care outcomes. I have a strong track record of mentoring junior faculty and trainees, and I am committed to expanding my mentorship program in patient-oriented HIV informatics. I will work with my mentees to carry out two specific aims. Aim 1: Pilot the implementation of electronic patient-reported sexual health data into the EMR to identify individuals who would benefit from PrEP. Guided by the Consolidated Framework for Implementation Research (CFIR) 2.0, we will interview key stakeholders, including both patients and providers/staff, regarding barriers and facilitators. We will then pilot the implementation of an electronic sexual health questionnaire, incorporating questionnaire results into an EMR-based algorithm to identify PrEP candidates. We will refine Clinical Decision Support tools to guide providers to discuss and prescribe PrEP for patients identified by the algorithm. Aim 2: Implement electronic patient portal-based screening for social needs among people with HIV. We will use CFIR 2.0 as a framework as we interview key stakeholders about barriers and facilitators to population health portal-based social needs screening among PWH. Based on these results, we will then incorporate social needs screening into the population health portal-based SUD screening program among PWH. Evaluation will be performed using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. These aims will be integrated into my existing research program, including my two current R01s. This K24 award will provide the opportunity and infrastructure to build and expand my mentorship program in patient-oriented HIV-related clinical informatics research and address current gaps in clinical informatics interventions for HIV prevention and care.