The document discusses the development of a "Data to Care Tool" by Denver Public Health to help monitor and respond to the local HIV epidemic. It merges HIV surveillance and lab data into a centralized data warehouse to create visualizations for local program planning, outreach, and patient management. The tool allows users to view summaries of HIV diagnoses, linkage to care, retention in care, community viral load, and care outcomes to better understand the local epidemic and intervene at the patient level. A multidisciplinary team approach was used in its iterative development.

1. © 2014 Denver Public Health
Localizing HIV: the Data to Care Tool
2014 National HIV Surveillance Grantees’ Meeting
Dec. 5, 2014
Lauren Snyder, MPH
Applied Public Health Informatics Fellowship Program
Denver Public Health
Mark Thrun, MD
Associate Professor, University of Colorado
Division of Infectious Diseases
Director, HIV/STD Prevention and Control
Denver Public Health
Director, Denver Prevention Training Center

2. © 2014 Denver Public Health
Opportunity and Need
• Mandatory reporting of HIV labs – CD4/VL – and
increasing adoption of EHRs means more robust
data available to help monitor epidemic
• Democratized data puts tools in hands of those
most in need of it, but a user interface needed
• Real-time, local data more useful for both
program planning and intervening at patient
level

3. © 2014 Denver Public Health
Development Process - Phased Planning
HIV 1
• Requirements document
• What do we want and how does it back translate with data being collected
HIV 2
• Merging of primary data into one warehouse
• Common variable names, etc
HIV 3
• Visualization process
• Translating the data for web consumption
HIV4
• Redefining requirements and modifying visualized output

4. © 2014 Denver Public Health
eHARS
CD4/VL
DH Labs
Eval Web
Staging
Data
Warehouse
Invision
Web page access
points
Diagnoses
Linkage
Retention/Re-
engagement
Other:
CVL
Care, etc

5. © 2014 Denver Public Health
eHARS
CD4/VL
DH Labs
Eval Web
Staging
Data
Warehouse
Invision
Web page access
points
Diagnoses
Linkage
Retention/Re-
engagement
Other:
CVL
Care, etcHIV 2

6. © 2014 Denver Public Health
eHARS
CD4/VL
DH Labs
Eval Web
Staging
Data
Warehouse
Invision
Web page access
points
Diagnoses
Linkage
Retention/Re-
engagement
Other:
CVL
Care, etcHIV 3

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Program
Planning
Outreach

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HIV Surveillance Summary

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Diagnosis HIV Summary – Denver County
Residence at Diagnosis, Denver,1/1/2012-12/31/2012

13. © 2014 Denver Public Health
Linkage to Care Summary – Denver County

14. © 2014 Denver Public Health
Retention in Care Summary

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HIV Care Summary – Denver Health

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Community Viral Load

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Data to Care: Uses of the Tool
Program planning
• Improved understanding of
the nuances of the local
epidemic
• Improve communication
regarding prevention needs
• Better allocation of staffing
resources/needs
– Within the HD
– In the community
• Greater efficiency in
evaluation of program
Patient management
• Improved linkage
assessment
• Real-time assessment of
retention and
reengagement efforts by
subpopulations
– Develop NIC lists
– Allow for outreach
interventions
• Assess clinical outcomes :
OI’s, STD screening, etc

19. © 2014 Denver Public Health
• Additional slides, as needed/not for
distribution

20. © 2014 Denver Public Health
Team approach
• Prep team
– What are we talking about as an end result
– How does that back translate to current data
• Very specific – Date of certain test; Need to merge or
limit variables, etc
• Build team
– IT experts creating code and software
• Test team/Data reconciliation
– Validate Build team’s output with known data

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Next steps: 2a1- Incidence

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Next steps: 2b1- Linkage to Care

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Next steps: 2c1- Retention in Care

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Next steps: 2e1- Community Viral Load

27. © 2014 Denver Public Health
Next steps: 1a1: Surveillance Summary