Data to Care Karen Surita, Data to Care Coordinator Allyson Morris, - - PowerPoint PPT Presentation

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Data to Care Karen Surita, Data to Care Coordinator Allyson Morris, - - PowerPoint PPT Presentation

Apr 18, 2023 378 likes •600 views

Data to Care Karen Surita, Data to Care Coordinator Allyson Morris, Data to Care Epidemiologist Background A public health strategy which aims to identify people living with HIV (PLWH) who have been diagnosed but are not in care, and to

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Data to Care

Karen Surita, Data to Care Coordinator Allyson Morris, Data to Care Epidemiologist

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Background

A public health strategy which aims to identify people living with HIV (PLWH) who have been diagnosed but are not in care, and to engage or re-engage these individuals in medical care Addresses the first two goals of the National HIV/AIDS strategy:

  • Reduce the number of people who

become infected with HIV

  • Increase access to care and
  • ptimize health outcomes for people

living with HIV

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Goals

  • Increase the proportion of PLWH

engaged in HIV medical care

  • Increase the proportion of PLWH linked

to HIV medical care within 12 months

  • f their HIV diagnosis
  • Increase the proportion of PLWH

retained in HIV medical care

  • Prioritize re-linkage to care services

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Data to Care and the Cascade of Care

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Data to Care identifies PLWH who may be out of care and attempts to link them to care

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Evolution of Data to Care

2012

  • Data to Care began under HIV Prevention:

Category C

2014 • HIV Prevention: Category C funding ended 2015

  • Data to Care continued utilizing HIV

Prevention and general revenue funds

2016

  • Data to Care expanded to four project sites

around Texas

2019

  • Expand program by partnering with new

providers

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Methods

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Data Sources

  • Electronic Lab Reporting
  • Ryan White
  • AIDS Drugs Assistance Program (ADAP)

Care

  • Addresses on labs and prescriptions
  • Accurint
  • Texas Department of Criminal Justice

Locating

  • Texas Vital Statistics
  • National Death Index
  • Social Security Death Index

Vital Status

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What defines someone as out of care?

  • A newly-diagnosed individual not

receiving care within 6 months of diagnosis

  • A PLWH who has previously been in

care but has not received any type

  • f care within the last 12 months
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Types of Follow-Up

There are 2 paths by which we identify those out of care

  • Surveillance Initiated Follow-Up
  • Provider Initiated Follow-Up
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Surveillance Initiated Follow-Up

Generate a file containing individuals not incarcerated and living in the project jurisdiction Filter individuals who were never in care or who have been out of care for more than 12 months Create a list of individuals and send to participating local health departments

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Provider Initiated Follow-Up

Providers review their medical records Identify patients who have missed more than two medical appointments or have not been seen in 6 months Provider sends most current locating information to the local health department to locate the out of care patients

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How do we Engage/Re-engage PLWH into Care?

  • Perform record searches
  • Conduct a minimum of 3 phone calls

and/or field visits to locate the person

  • Verify the person is living in the

jurisdiction and not already engaged in care

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How do we Engage/Re-engage PLWH into Care?

  • Assess reasons out of care/ refuse

services

  • Schedule intake and/or medical

appointments

  • Assists in preparing paperwork
  • Arrange transportation
  • Referrals to social or community

services

  • Confirms the person attended the

medical appointment and is engaged in care

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Outcomes

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963 852 543 572 487 93 117 76

200 400 600 800 1000 1200 Unable to Locate Already in Care Linked to Care Moved Refused Services Incarcerated Deceased Other

Outcomes of Data to Care Investigations 2012-2018

(26%) (2%) (3%) (3%) (13%) (15%) (15%) (23%)

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N=3703 investigations completed by the Data to Care program

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19.7% 4.9% 3.5% 18.6% 13.4% 26.9% 11.9% 1.2% 11.8% 1.0% 2.9% 25.6% 16.8% 25.5% 14.0% 2.4%

0% 5% 10% 15% 20% 25% 30% Linked to Care Incarcerated Deceased Already in Care Moved Unable to Locate Refused Services Other

Provider vs Surveillance Initiated Investigations 2012-2018

Provider Surveillance

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N=3654 records for which initiation source information is available

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13.4% 2.6% 3.0% 23.9% 16.1% 26.4% 13.0% 1.5%

Male Patients

Linked to Care Incarcerated Deceased Already in Care Moved Unable to Locate Refused Other

6/26/2018 17 20.3% 2.3% 3.9% 19.3% 12.5% 23.7% 13.8% 4.3%

Female Patients

N=3703 patients for whom sex at birth was available

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Top 5 Reported Reasons for Being Out of Care

1.Other life issues more important 2.Client feels good 3.Cost of HIV care 4.Clinic is inconvenient (tied) 5.Client doesn’t know where to go (tied)

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Local Health Department Contacts

  • Gabriela Torre, Program Supervisor
  • Gabriela.Torre@austintexas.gov

Austin Public Health

  • Shelley Cabrera, Operations Manager
  • Shelley.Cabrera@dallascounty.org

Dallas County HHS

  • Crystal Garza, Field Operations Manager
  • Crystal.Garza@sanantonio.gov

San Antonio Metropolitan HD

  • Joseph Lirette, First Line Supervisor
  • JPLirette@tarrantcounty.com

Tarrant County Public HD

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Thank you

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Karen Surita Karen.Surita@dshs.texas.gov Allyson Morris Allyson.Morris@dshs.texas.gov