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The Quadruple Aim
Quadruple Aim

A Conceptual Framework

Improving the U.S. health care system requires four aims: improving the experience of care, improving the health of populations, reducing per capita costs and improving care team well-being. HITEQ Center resources seek to provide content and direction aligned with the goals of the Quadruple Aim

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Resource Overview

  • Rationale
  • Challenges
  • Approach

Mobile health (mHealth) tools have the potential to play a pivotal role in fostering a sense of greater patient engagement within underserved populations. By facilitating patient use of mHealth applications in collaboration with electronic health record (EHR) and personal health record (PHR) systems there is an opportunity to empower individuals to take a more active role toward managing their health conditions.

The proliferation of consumer mobile health applications and devices is creating new opprotunities for engaging patients in their care and leaves little doubt as to the impact that these tools will have on the way that people manage their health, health information, and health communications with their care providers, family and friends. This shift to increased self-management of health by consumers will change a patient’s relationship with their doctor and the way healthcare is practiced.
The current laws and standards in place to ensure patient’s privacy and health information security will need further review to determine whether mobile health technologies create unique situations that are not yet addressed. This poses many challenges for health centers as to how best to support patient use of these tools and ways in which to incorporate them into their own clincial support systems.

Mobile health characterizes a shift in the point of care for the patient. The point of care has classically been located at the hospital or clinic. Mobile health is beginning to shift this model so that the point of care is more frequently a matter of where the person happens to be located at that time, consequently providing opportunities for more timely care. It is also important to note that these tools help to increase the accessibility of Healthcare to populations where direct access to Healthcare professionals is limited and so health management is more frequently left in the hands of the consumer.

The tools provide in this resource cover a range of different mobile health tools, strategies, and guidelines for consideration as Health Centers seek to leverage these technologies to better engage and activate their patients.

Mobile Health Resources

PrEP Process Map Example
PrEP Process Map Example

PrEP Process Map Example

This resource is an example of a Pre-Exposure Prophylaxis (PrEP) Process Map. Process maps can be used to document health center workflows.
 

Sensitive Information and the Electronic Patient Record
Sensitive Information and the Electronic Patient Record

Sensitive Information and the Electronic Patient Record

With nearly 100% of community health centers utilizing electronic health records (EHR) to care for patients, focus has pivoted from implementation and new workflow development to enhancement in order to drive value and reflect patient needs and population trends. EHR technology presents potential opportunities and significant constraints. Providers frequently document and share potentially sensitive information in the EHR, such as risk for intimate partner violence (IPV), consistent offers of pre-exposure prophylaxis (PrEP), or patient sexual orientation and gender identity (SOGI). Capturing such information can be immensely helpful in providing care tailored to individuals’ needs, but additionally challenges teams to develop workflows that keep the data private rather than risk harm to patients through improper or unintended disclosure.

Health IT Optimization for Effective PrEP Services
Health IT Optimization for Effective PrEP Services

Health IT Optimization for Effective PrEP Services

Health centers are increasingly interested in embedding oral Pre-Exposure Prophylaxis (PrEP) programs into primary care, which calls for the embedding of PrEP care processes into electronic health record (EHR) systems. Health centers have had success with automation in HIV testing, and are looking to apply automated algorithms, order sets, and templates to the development of PrEP programs. This resource outlines EHR and health information technology (IT) configurations and tools that support PrEP care processes and provides examples of successful implementation from health centers and primary care settings.

Resources for Expanding PrEP Services in your Health Center
Resources for Expanding PrEP Services in your Health Center

Resources for Expanding PrEP Services in your Health Center

HITEQ compiled this resource library for health centers, which houses actionable PrEP resources including checklists, pocket guides, and billing guidance. This curated set of resources aims to assist health centers in accessing those resources that directly address current PrEP challenges.
Using Your EHR to Identify Patients Who May Benefit from PrEP at Your Health Center
Using Your EHR to Identify Patients Who May Benefit from PrEP at Your Health Center

Using Your EHR to Identify Patients Who May Benefit from PrEP at Your Health Center

Identifying candidates for PrEP can be challenging but not impossible. The first step to finding the right candidates involves understanding the criteria for PrEP. Not everyone is a great candidate for PrEP or can adhere to the frequent testing and monitoring required of PrEP patients. Some patients are comfortable using condoms and other HIV prevention methods, and providers should respect and affirm their decision.

Pre-Exposure Prophylaxis (PrEP), Post-Exposure Prophylaxis (PEP), and Other HIV Prevention Strategies: Billing and Coding Guide
Pre-Exposure Prophylaxis (PrEP), Post-Exposure Prophylaxis (PEP), and Other HIV Prevention Strategies: Billing and Coding Guide

Pre-Exposure Prophylaxis (PrEP), Post-Exposure Prophylaxis (PEP), and Other HIV Prevention Strategies: Billing and Coding Guide

The goal of this guide is to provide up-to-date information and best practices for coding, billing, and denial resolution for PrEP and PEP services. Health department staff are encouraged to share this resource with grantees, community partners, and other health care providers billing for HIV prevention services.

Closing the PrEP Care Gap with TelePrEP
Closing the PrEP Care Gap with TelePrEP

Closing the PrEP Care Gap with TelePrEP

In this session, attendees learned from the HITEQ Center and Housing Works about the TelePrEP model. It also showcased the successes and challenges Housing Works faced with regards to their TelePrEP program.


HITEQ Highlights: PrEP Process Mapping Team Toolkit Demonstration
HITEQ Highlights: PrEP Process Mapping Team Toolkit Demonstration

HITEQ Highlights: PrEP Process Mapping Team Toolkit Demonstration

Is your health center currently in the process of implementing or revamping your pre-exposure prophylaxis (PrEP) workflow? This HITEQ webinar taught participants how to use our PrEP Process Mapping Toolkit, which is designed to support team-based learning, reflection, and action on the use of process mapping as a tool to document PrEP clinical and EHR workflows. Your health center team can follow the steps outlined in the toolkit to develop a process map of an existing or planned PrEP service workflow and to identify opportunities to streamline and improve that workflow.

Opportunities and Strategies to Optimize PrEP Uptake in Key Communities

Opportunities and Strategies to Optimize PrEP Uptake in Key Communities

Activity Description: PrEP continues to be underused by people who could benefit from it, especially those who face health disparities. Of the 1.2 million people in the U.S. who can benefit from taking PrEP, only about 23% have used PrEP. Data on PrEP coverage shows that racial/ethnic minorities, sexual minorities, youth, and women access PrEP at even lower rates. The interactive live webinar will feature perspectives of multiple diverse HIV prevention experts on PrEP uptake among relevant consumer/patient communities, including Black women, same-gender-loving (SGL) Black and Latinx men, and transgender individuals. Presenters will consider both challenges and opportunities for PrEP use among these communities,specific access issues, and strategies and model practices for providers and healthcare teams to address the unique barriers.
Improving UDS Clinical Quality Measure Performance: Increasing HIV Prevention in Primary Care
Improving UDS Clinical Quality Measure Performance:  Increasing HIV Prevention in Primary Care

Improving UDS Clinical Quality Measure Performance: Increasing HIV Prevention in Primary Care

Primary care plays a key role in ending the HIV epidemic. The Ending the HIV Epidemic initiative launched across HHS in 2019, setting forth four key strategies also called the “four pillars” of ending the HIV epidemic. Primary care in federally qualified health centers figures centrally into these efforts, evidenced by the addition of several HIV screening and prevention measures and metrics in the Uniform Data System (UDS) reporting. This webinar reviewed the outcomes of the first year of HIV Screening and Prevention reporting on the UDS, highlight opportunities for quality improvement, and discussed funding opportunities.

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Acknowledgements

This resource collection was cultivated and developed by the HITEQ team with valuable suggestions and contributions from HITEQ Project collaborators.

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