Implementation Plan HIV CDS – Documentation

Briefly describe HIV testing and identification of sexual health risk in your health system (pre-CDS)

HIV screening is in included in a SmartSet that Howard Brown uses for patient annual screenings. Howard Brown discusses risk factors and PrEP with most patients at their annual visits. HIV Screening health maintenance topic uses only rudimentary logic to determine patients at high risk.

Baseline Measure:

**The below baseline measures were sent directly to NACHC and we do not have these numbers.

Patient Population (13-64 yo): n =
Lifetime HIV testing % (UDS measure) =
Number of patients on PrEP (Aug 2022 – Jan 2023) =

Implementation Project Management:

Tools/Documentation/Approach for managing the QI plan: With only one clinic implementing we will use Microsoft teams to communicate and track milestones over time.
Project Director: Stacie Carney, MD Chief Medical Informatics Officer is PI and Michael Lieberman, MD is Informatics Lead
Project Manager: Seren Karasu, MPH
Timeline: April-July 2023
Proposed Sites (name and brief description, include the local project champion role and name): SA214 Howard Brown Health in Chicago, IL. Our local project champion is Maya Green, MD, MPH, their Chief Medical Officer.
Howard Brown Health was founded in 1974 and is now one of the nation’s largest lesbian, gay, bisexual, transgender, and queer (LGBTQ+) organizations. They serve more than 40,000 adults and youth in its diverse health and social service delivery system focused around seven major programmatic divisions: primary medical care, behavioral health, research, HIV/STI prevention, youth services, elder services, and community initiatives. Howard Brown serves men, women, trans and gender non-conforming folks, infants, youth, and children through a multi-site operation based in Chicago that includes a main health and research center in the Uptown neighborhood, Howard Brown Health Sheridan, and their other seven clinics.
Target Users [ e.g., physicians/NPs, MAs, patients]: Care teams including primary care providers and MAs

Briefly describe CDS implementation

Start Date : April 2023

Scope (all patients? Limited scope?): All Patients

Describe new process(post CDS): The new process will include:
- Improved Health Maintenance (HM) Topic that better identifies patients at high risk for HIV
  - The ability to order an HIV test from the HM topic overdue alert (with one click)
- Best Practice Advisory that keys off of the HM topic and presents the user with the option to order an HIV test or open a Smartset
- SmartSet for PrEP

We will train the CHC on the use of this toolset with an interactive session and provide them with a job aid.

Greatest Barriers to Implementation:
- Competing organizational priorities
  - This includes clinical quality priorities as well as general institutional priorities
- General issues:
  - Training all the team members on the toolset
  - Keeping the care team trained on the toolset with staff turnover
  - Overcoming alert fatigue

Feedback Plan [how will you find out about problems or issues, e.g. help desk or emails]:

We plan to have regular monthly check ins with the member and to encourage care team to submit Jira tickets (OCHIN help desk) when something is broken.