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 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.

In the 2022 UDS, United States health centers reported 7,328,565 of their 16,835,841 eligible medical patients (43.53%) were tested for HIV at least once after their 15th birthday and before their 66th birthday.

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.

HIV testing is one of the many ways we can End the HIV Epidemic. HITEQ's latest blogs offers strategies for leveraging your EHR to make HIV screening a breeze at your health center. 

These interactive infographics include HIV Indicators as well as information about underserved populations and patients who may be at increased risk of acquiring HIV, at the state level. Select your state in the upper right to get started. 

This brief presents an overview of how health centers can utilize telehealth for PrEP access, or TelePrEP, for comprehensive care, and includes innovations and resources that health centers can utilize to extend these services to their patient populations.

According to the Rural health Information Hub, the risk of contracting HIV can be greatly reduced through Pre-Exposure Prophylaxis (PrEP), but the medication must be taken every day and patients need follow-up appointments every 3 months. Some patients often don't have access to it due to stigma, distance from the nearest specialist, and a shortage of primary care providers willing to prescribe and monitor PrEP.

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.

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.

Collecting sensitive patient information, including data related to Sexual Orientation and Gender Identity (SOGI), is a critical part of operations for many health centers, especially FQHCs. Though required by many funding and reporting systems, for example, Ryan White HIV/AIDS Program Services, integrating how to capture these data in respectful and consistent ways may be a challenge. Based on  experience from an FQHC in Washington, DC with special expertise in LGBTQ+ and HIV Care, the process of training staff and implementing SOGI data-related workflows will be described, including subsequent measurement and Quality Improvement initiatives. Details include examples of registration forms, staff training materials, EMR workflows, and patient-facing resources. The importance of creating affirming spaces to help support effective medical care was also discussed.

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.

As health centers integrate PrEP for HIV prevention into their primary care services, it is important to align with the latest guidance and research. The PrEP checklist from UNC School of Medicine's North Carolina HIV Training & Education Center offers step-by-step detailed guidance for providing PrEP. This checklist can be used to inform workflow, EHR, and other health IT updates including order sets and clinical decision support. It can also be used as a reference for providers who are newer to providing PrEP who are prompted or alerted to a patient's potential need for HIV prevention services.

We can only End the HIV Epidemic if we work together, and that includes data sharing. Sharing important information, such as HIV test results, can help ensure optimal care for people at risk for or living with HIV coming to or from different health centers. Check out these strategies and tools to learn some tried and true strategies for data-sharing between health centers. 

HIV testing is one of the many ways we can End the HIV Epidemic. HITEQ's latest blog post offers strategies for leveraging your EHR to make HIV screening a breeze at your health center. 

In the 2019-2020 contract year, as part of the Ending the HIV Epidemic initiative HITEQ conducted an environmental scan to determine the role of EHRs and health IT in health center capacity and ability to expand HIV screening and prevention. The full report is available for download.