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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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Overview

Through the data validation process, valuable information is gained that can then be used to improve performance around patient care or quality of care metrics.  Improving quality performance may take the form of improving data collection processes, better identifying patients who need additional interventions, or decreasing missed opportunities to provide patients appropriate interventions, among other possibilities. This section includes guidance on leveraging Health IT to improve quality performance including change packages for recommended approaches related to various quality of care measures.

Improving Performance Resources
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.

Nationwide HIV-related Care Interactive Infographics
Nationwide HIV-related Care Interactive Infographics

Nationwide HIV-related Care Interactive Infographics

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.

Bright Spots in HIV Screening
Bright Spots in HIV Screening

Bright Spots in HIV Screening

Since 2020, health centers have reported the HIV Screening clinical quality measure on the UDS. HITEQ hosted discussions with health centers in fall of 2021 to find out how they have made progress on this clinical quality measure and gleaned tips from these participants which can be found within.
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.

Implementing Opt-Out HIV Screening in Your Health Center
Implementing Opt-Out HIV Screening in Your Health Center

Implementing Opt-Out HIV Screening in Your Health Center

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. 

State-level HIV-related Infographics
State-level HIV-related Infographics

State-level HIV-related Infographics

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. 

TelePrEP for Health Centers
TelePrEP for Health Centers

TelePrEP for Health Centers

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.

TelePrEP
TelePrEP

TelePrEP

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.

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.

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? Join this HITEQ webinar to learn 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.

HITEQ Highlights: Improve the Collection and Respectful Use of Sexual Orientation and Gender Identity (SOGI)
HITEQ Highlights: Improve the Collection and Respectful Use of Sexual Orientation and Gender Identity (SOGI)

HITEQ Highlights: Improve the Collection and Respectful Use of Sexual Orientation and Gender Identity (SOGI)


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.

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.

PrEP Checklist for Providers
PrEP Checklist for Providers

PrEP Checklist for Providers

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.

Strategies for Capturing Outside HIV Test Results for Your Health Center
Strategies for Capturing Outside HIV Test Results for Your Health Center

Strategies for Capturing Outside HIV Test Results for Your Health Center

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. 

Health Information Technology support for HIV Screening and Prevention Services
Health Information Technology support for HIV Screening and Prevention Services

Health Information Technology support for HIV Screening and Prevention Services

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. 

HIV Pre-Exposure Prophylaxis (PrEP) for Patients with Substance Use Disorders
HIV Pre-Exposure Prophylaxis (PrEP) for Patients with Substance Use Disorders

HIV Pre-Exposure Prophylaxis (PrEP) for Patients with Substance Use Disorders

PrEP is a highly effective biomedical intervention that prevents HIV. Despite the established association between HIV risk and substance use, PrEP access as well as uptake and persistence among persons with substance use disorders remains low. To fully realize HIV prevention efforts across health systems, and as substance use/healthcare-seeking patterns evolve with COVID-19, person-centered PrEP service delivery needs to involve renewed and coordinated efforts involving substance use treatment providers. This webinar helped clinicians overcome PrEP implementation challenges, assess PrEP eligibility, and identify strategies for addressing side effect and adherence concerns.

Acknowledgements

This resource collection was compiled by the HITEQ Center staff with guidance from HITEQ Advisory Committee members and collaborators of the HITEQ Center.