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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

Conducting an SRA in accordance with HIPAA policy is a complex task, especially for small to medium providers such as community health centers. The HIPAA Security Rule mandates security standards to safeguard electronic Protected Health Information (ePHI) maintained by electronic health record (EHR) technology, with detailed attention to how ePHI is stored, accessed, transmitted, and audited. This rule is different from the HIPAA Privacy Rule, which requires safeguards to protect the privacy of PHI and sets limits and conditions on it use and disclosure. Meaningful Use supports the HIPAA Security Rule. In order to successfully attest to Meaningful Use, providers must conduct a security risk assessment (SRA), implement updates as needed, and correctly identify security deficiencies. By conducting an SRA regularly, providers can identify and document potential threats and vulnerabilities related to data security, and develop a plan of action to mitigate them.

Security vulnerabilities must be addressed before the SRA can be considered complete. Providers must document the process and steps taken to mitigate risks in three main areas: administration, physical environment, and technical hardware and software. The following set of resources provide education, strategies and tools for conducting SRA.

Security Risk Analysis Resources

Sensitive Information and the Electronic Patient Record

HITEQ Center, June 2023

Molly Rafferty 0 6502

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

HITEQ Center, June 2023

Molly Rafferty 0 6070

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

Curated PrEP resources for health centers, compliation in 2022.

HITEQ Center 0 9615
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

Jamal Refuge 0 21700

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

Developed by NASTAD, updated in 2023

HITEQ Center 0 16743

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 Webinar

Jodie Albert 0 3128

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

Health HIV Medical Education

Caila Kilson-Kuchtic 0 9021
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

HITEQ Highlights Webinar

HITEQ Center 0 13847

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

A checklist from NC HIV Training & Education Center (NCHTEC)

HITEQ Center 0 15109

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.

Level Up: Leveraging Your EHR to End the HIV Epidemic

HITEQ Highlights Webinar

Molly Rafferty 0 17999

What if we told you your electronic health record (EHR) was one of the keys to ending the HIV epidemic (EHE)? Your EHR is a powerful tool that can support increases in HIV testing, access to pre-exposure prophylaxis (PrEP) for people at risk for HIV, and so much more! View our HITEQ Highlights webinar on June 8th to learn more about leveraging your EHR through the use of digital tools and innovative strategies!

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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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