Clinical Information System:
Use the Registry to Generate Reminders and Care Planning Tools for Individual Patients
- Use patient treatment record forms that include services needed at time of visit:
- Include a flow sheet to help monitor clinical data and track trends.
- Insert screening alerts for providers (e.g., for Pap smears, PPDs).
- Before a visit, print out current information from the registry.
- Periodically, use the registry to generate lists of patients who have missed or are overdue for a service. Database queries might include the following:
- Patients due for annual assessments
- Patients due for Pap smear or PPD placement
- Patients needing nutritional assessments
- Patients missing prescription referrals
- Patients overdue for immunizations
- Use the registry to generate lists of high-risk patients for specialized care and follow-up. Database queries might include the following:
- Patients hospitalized in past month
- Patients with CD4 counts under 200
- Patients on HAART with detectable viral loads
- Women with abnormal Pap smears
- Patients with hepatitis B or C co-infection
- Patients with tuberculosis co-infection
- Patients with chemical dependency
- Divide the population of people living with HIV/AIDS disease into categories (e.g., HAART-naïve or experienced, ethnicity, language, insurance, needs/limits, homelessness) to identify special needs.
- Decide how to handle patients with missing services. Consider using planned visits in the group and individual settings, and fitting HIV/AIDS disease care into acute care visits. (See Delivery System Design.)
- Use the registry to identify the underinsured population to solicit for special services and medical assistance programs.
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