1. eHIVQUAL 2013 Adult Review: Overview and New Features
Date: Tuesday, June 24, 2014
Time: 12:30 to 1:30 P.M. EDT
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2. Survey Questions New v. experienced users Role NYS v. other
Director
Coordinator
Security Coordinator
NYS v. other
Primary objective
“Look and feel” of new version
Sampling
Indicator data entry
Data import
Reporting features

3. Sampling/Eligibility
Up to three review “buckets”
Core review no longer requires visit in each half of the year
Optional sampling of supplemental “two-visit” patients
Robust sample that is compatible with previous reviews
Three types of new patients
Newly diagnosed
Other new to clinic
Newly reengaged
Don’t eliminate new patients from core review (or two-visit review)!
Web-based sampling tool:

4. Sampling (continued)

6. Import Options
Excel files can now be used instead of XML (but XML still supported)
Updated documentation
Data dictionary
Data import guide
Sample files
Import data after establishing review parameters but before keying in any other patient data
One (and only one) import per review “bucket”
Besides essential patient identifying information, you can import as many or as few fields as desired/available
Examine the imported data
Additional information can then be entered “by hand”

7. Import Options (continued)

8. Clinical Indicators: Eliminations
Dropped Indicators
Adherence Assessment
Health Literacy Screening
Hypertension Screening & Management
Influenza Vaccination
Latent TB Infection Screening
Lipid Screening
MAC Prophylaxis
Oral Health Exam
Patient Education
Prevention Education
Urinalysis

9. Clinical Indicators: Retained & Revised
Retained Indicators
ARV Medications
Colon Cancer Screening
Digital Rectal Exam
Gynecology Care – Pap Test
Latent TB Infection Screening
Mammography
Mental Health Screening
PCP Prophylaxis
Tobacco Use Screening
Updated Indicators
Anal Pap Smear
Baseline Resistance
Care Coordination
Clinical Visits
Colon Cancer Screening
Hepatitis C Screening
HIV Monitoring
Sexual History Taking
STI Testing
Substance Use Screening

10. Required Indicators Vary by Review Type

11. Patient Profile

12. Reports Default is to run seamlessly across concurrent reviews
Can be filtered in many ways, including patient sample
Can and should be exported and shared with your team
New and updated reports
Expanded set of dashboards
Additional patient-level reporting
Expanded viral load suppression and patient retention reporting

13. (And…longitudinal reports coming soon!)
49 CLINICAL REPORTS
Within the 10 categories of reports I mentioned, there are 49 reports based on the clinical information collected in eHIVQUAL. Following this slide I’m going to briefly spotlight ten of them, but just wanted to give the group a sense of how many we have developed for use.
Again, longitudinal reports, allowing you to compare your data between the years you have submitted eHIVQUAL data, are in development and should be available soon.
Before I begin showing the reports, I also wanted to add a quick disclaimer that these are mockups of the reports we sent to our programmer, but the will look very similar to what you will see when you have real data.
(And…longitudinal reports coming soon!)

14. HIVQUAL DASHBOARD
This is the updated HIVQUAL Dashboard. It is comprised of six sections each highlighting clinical areas of importance – these are the retention indicators, the viral load suppression, ART therapy, and baseline resistance test indicators, a Sexually Transmitted Infections section, a Hepatitis C section, smoking cessation, diabetes screening, and cervical pap indicators, and results from the mental health screening indicator.

15. EXECUTIVE DASHBOARD
New this year we also have an executive dashboard. This features your overall clinic retention score, followed by a facility level “continuum of care” depicted numerically and graphically – highlighting your HIV caseload on ART, those retained in care, those suppressed at last viral load, and those always suppressed.

16. VLS RATES: BY THRESHOLD
As many of you will remember discussing, our revised Viral Load Suppression indicators will allow us to report scores by threshold. In this table, you can see a breakdown of your scores on last Viral Load, and always suppressed, by <20 copies/mL, <50 copies/mL, <200 copies/mL, and finally < the level of detectability for the assay used for each patient.
Underneath, there is also a graph depicting your viral load results on last viral load.

17. RETENTION DASHBOARD
Another new report is the “Retention Dashboard.” Although we include the filters in the report generator I described earlier, in this report we highlight your scores on the retention score in a variety of ways – by gender, by risk factor, by language, by housing status, by race, and by age. There is a companion report for your Viral Load Suppression scores as well.

18. PATIENT CHARACTERISTICS
This is another new report with a series of pre-selected filters, and allows you to see pie charts of some of your patient characteristics, including Gender, Race, Risk Factor, and Age.

19. COLON CANCER SCREENING
As many of you remember our Colon Cancer Screening indicator has been revised to now include flexible sigmoidoscopy and fecal occult blood testing as additional screening options, and the report has been updated to reflect this.
The graph breaks down your screening results by age group, and the report also features how many patients who received a positive screening from one of the newly added options received a follow-up colonoscopy within 60 days.

20. DIABETES SCREENING & MGMT
Finally, here is the revised diabetes screening and management report. Those of you here will remember our long discussion to change the indicator eligibility for screening to patients with a random blood sugar >100 during the review period, and you will also notice the report includes HbA1c results among existing diabetic patients, a new feature this year.
Given emerging research discussed in this committee which suggests Hemoglobin A1c in HIV patients is an underestimate, the report also identifies patients with a result greater than 5.8 as compared to 6.5 the typical cutoff.
I’ll now turn it over to her, and ask that you listen to her slide briefly before providing any feedback or asking questions.

21. Data Submission and Beyond…
NYS deadline is 8/22/2014
Run validation reports!
NYS submissions will require director’s “signature” and feedback on quality improvement plans
Benchmark Report(s)
Health.data.ny.gov