Accepted for/Published in: JMIR Formative Research
Date Submitted: Nov 3, 2020
Date Accepted: Mar 16, 2022
Feasibility of Using Electronic Health Records (EHR) for cascade monitoring and cost estimates in implementation science studies in the Adolescent Trials Network for HIV/AIDS Interventions (ATN)
ABSTRACT
Background:
One of the most difficult areas in the fight against HIV/AIDS is reaching youth age 13-24. The proportion of youth living with HIV/AIDS (YLH) on ART and virally undetectable is low, highlighting significant challenges for reaching the Joint United Nations Program on HIV targets.
Objective:
To assess the feasibility of assessing the youth HIV treatment cascade among those linked to care within the ATN using EHR downloads.
Methods:
EHR data was systematically obtained from multiple clinical sites and utilized to meaningfully capture the CDC’s four continuum of care measures. Additionally, this study used standard cost values attached to CPT codes to estimate cost per visit.
Results:
Largely, the sites were able to provide information for the required data. The use of EHR data works well for assessing patterns of completed visits. However, in most cases these data are not sufficient for identifying patterns of missed appointments because such misses are not captured in the EHR record. Sites with good access to data management resources can work more efficiently for Cascade Monitoring study purposes.
Conclusions:
Site data management resources should be a part of the selection process when looking for site partners for clinical studies that plan to use EHR data. Study planners should determine the feasibility of additional funding for those organizations in need of additional IT or data management resources.
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