1. HAART and Viral Load Comparison Report Tamarra Jones, DrPH, CHES Orange County Health Care Agency HIV Planning and Coordination Manager

2. Background Orange County Health Care Agency initiated “Balanced Scorecard” planning and management project in 2010. Performance measures for each mission-critical service were developed. HIV Performance Measure: – Percent of patients placed on Highly Active Anti-Retroviral Therapy (HAART) who achieve an undetectable Viral Load.

3. Need for ARIES Report Quality Improvement (QI) measures used in the past relied on random chart review. Previous Viral Load indicator measured any decrease or maintenance in Viral Load. HAB QM Indicators Report provides the percentage of clients with AIDS who are prescribed HAART in a reporting period. Using ARIES allows for a larger sample size and more accurate information regarding client care to be collected for analysis.

4. Uses for Report Identify individuals who are on HAART with a undetectable Viral Load (Orange County Balance Scorecard Measure) Identify individuals who may need to be on HAART Identify individuals who are on HAART but are not responding well Identify individuals who appear to be on HAART, based on Viral Load, but HAART information is missing (Data entry issue)

5. ARIES Reports HAART and Viral Load Comparison – Long: For clients served within a date range, the report shows whether the client has EVER been on HAART, whether the client is CURRENTLY on HAART, the HAART Start Date (only if still on HAART), the number of months on HAART (only if still on HAART), the lowest EVER Viral Load, and the MOST RECENT Viral Load. HAART and Viral Load Comparison – Long HAART and Viral Load Comparison – Short: For clients served within a date range, the report shows whether the client is Currently on HAART, the HAART Start Date, the number of months on HAART, and the Current Viral Load. HAART and Viral Load Comparison – Short

6. ARIES Report-Long Version Enter service date Choose display greater than 1,000 if necessary based on patient population

7. ARIES Output Output: HAART and Viral Load Comparison - Long 1682 records, generated 5/24/2011 1:12:42 PM Criteria: Service Line Item Service Date BETWEEN '1/1/2010' AND '12/31/2010'

8. ARIES Report-Short Version Enter service dates Choose display greater than 1,000 if necessary based on patient population

9. ARIES Output Output: HAART and Viral Load Comparison - Short 10 records, generated 5/24/2011 1:23:39 PM Criteria: Service Line Item Service Date BETWEEN '1/1/2010' AND '12/31/2010'

10. ARIES Output Export data into Excel spreadsheet Sort by “Ever on HAART” or “Currently on HAART” Viral Load of 48 is undetectable Identify total number of patients seen in service date range Identify total number of patients on HAART (Currently on HAART “yes”) Create formula to identify number on HAART with undetectable Viral Load (=COUNTIF(F1:F983,"48")) Percent undetectable (undetectable /total on HAART)

11. ARIES Output

12. Outcomes 1,659 patients seen in 2010 982 on HAART Of which, 813 with undetectable Viral Load (VL) Additional 245 with undetectable VL Orange County baseline identified: 83% on HAART have undetectable VL Goal: 90% on HAART have undetectable VL Data entry errors identified

13. Limitations Clients on HAART may have just begun treatment Data entry errors and missing data Service date: The report provides information on clients served in a given date range. The HAART/Viral Load information provided is the most current data in the system, not the data from the date range.