Exploring the Feasibility of an Electronic Tool for Predicting Retention in HIV Care: Provider Perspectives

TL;DR

This study explores healthcare providers' views on using an electronic tool to predict which HIV patients are at risk of falling out of care, finding strong support for its implementation.

Contribution

The paper introduces provider perspectives on an EHR-based tool for predicting HIV care retention and highlights factors they believe should be included.

Findings

Most providers (91%) are willing to implement an EHR tool to predict lapses in HIV care.

Prescribers believe the tool would be less biased than personal judgment and suggest community health workers for interventions.

Providers emphasized the importance of including social factors like transportation, housing, and employment in the tool.

Abstract

Retention in care for people living with HIV (PLWH) is important for individual and population health. Preemptive identification of PLWH at high risk of lapsing in care may improve retention efforts. We surveyed providers at nine institutions throughout Chicago about their perspectives on using an electronic health record (EHR) tool to predict the risk of lapsing in care. Sixty-three percent (20/32) of providers reported currently assessing patients’ risk for lapsing in care, and 91% (29/32) reported willingness to implement an EHR tool. When compared to those with other job roles, prescribers agreed (vs. neutral) that the tool would be less biased than personal judgment (OR 13.33, 95% CI 1.05, 169.56). Prescribers were also more likely to identify community health workers as persons who should deliver these interventions (OR 10.50, 95% CI 1.02, 108.58). Transportation, housing, substance use, and employment information were factors that providers wanted to be included in an EHR-based tool. Social workers were significantly more likely to indicate the inclusion of employment information as important (OR 10.50, 95% CI 1.11, 98.87) when compared to other participants. Acceptability of an EHR tool was high; future research should investigate barriers and evaluate the effectiveness of such a tool.