Peter Gordon|Eli Camhi|Ron Hesse|Michelle Odlum|Rebecca Schnall|Martha Rodriguez|Esmerlin Valdez|Suzanne Bakken
Processes and outcomes of developing a continuity of care document for use as a personal health record by people living with HIV/AIDS in New York City
Presbyterian Hospital|New York Hospital Queens|Columbia University|NewYork–Presbyterian Hospital|Presbyterian Healthcare Services|Presbyterian Healthcare Services|CUNY School of Law|Columbia University|Columbia University|Presbyterian Hospital|New York Hospital Queens|NewYork–Presbyterian Hospital|Columbia University
describe processes outcomes developing implementing continuity care document ccd health profile personal health record persons living hiv plwh hivaids special needs plan new york city multiple qualitative quantitative data sources used describe processes outcomes implementing health profile including focus groups audio computer assisted self interview acasi surveys administrative databases chart abstraction usage logs project management records qualitative data thematically analyzed quantitative data analytic methods included descriptive multivariate statistics data triangulated synthesized using reach efficacyeffectiveness adoption implementation maintenance reaim framework reach snp members predominantly african american hispaniclatino onethird female larger proportion african americans smaller proportions hispanicslatinos whites trained use health profile efficacyeffectiveness ccds produced 8249 unique members updated monthly basis 509 members trained use health profile total number member logins 112 active users 1808 longest duration use 1008 days significant differences users nonusers health profile clinical outcomes perceptions quality medical care health service utilization adoption health profile wellmatched organizational mission values priorities related coordination care highrisk population plwh implementation preimplementation focus group participants identified potential barriers use health profile including functional computer literacy privacy confidentiality concerns potential reluctance use technology cognitive challenges key strategies addressing barriers included dedicated bilingual coach recruitment training support basic computer health profile training transparent audit trail revealing clinician case manager access health profile timelimited passwords sharing health profile others point need emergency access mechanism maintenance health profile integrated routine operational activities sustainability facilitated foundation standards health information exchange hie although potential barriers exist use personal health records phrs health profile plwh complex medical needs low socioeconomic status limited computer experience use tools sufficient level user support provided privacy confidentiality concerns addressed