Suzi Birz, principal, HiQ Analytics, LLC
Oct. 16, 2009 - You, or your patient, have just been exposed to HIV. Quick! What do you do?
Instead of panicking in this situation, health care workers can access a new computer tool, developed for New York clinicians, to help them take immediate action that might keep the exposed person from becoming infected with the virus that causes AIDS.
HIV post-exposure prophylaxis (PEP) is a potentially preventative treatment using antiretroviral drugs to treat individuals within 72 hours of a high-risk exposure to HIV. PEP can reduce the rate of infection by helping the body's immune system to stop the virus from multiplying in the infected cells of the body.
While still being studied in non-work-related incidents, it has been found that PEP can reduce the rate of infection in health care workers exposed to HIV by 79 percent. PEP has been the standard of care for health care workers since 1998 and in 2005 the CDC stated that the treatment also should be used for non-work-related exposures.
Getting this treatment to exposed persons, even those that present in an emergency room, has proven to be a challenge. There is a wide range of knowledge levels among emergency room clinicians. What was needed was a way to educate medical providers about HIV/AIDS post-exposure prevention and treatment.
Saint Vincent Catholic Medical Centers in New York and the New York State Department of Health (NYDOH) recently unveiled the CEI (Clinical Education Initiative) PEP Widget, a web-based technology to rapidly instruct health care providers throughout New York State about HIV diagnosis and prevention.
New York State currently has the highest prevalence and incidence of HIV/AIDS in the United States, with a reported 230,661 cases since the beginning of the HIV epidemic. The state’s health commissioner, Richard F. Daines, M.D., praised the new technology when it was unveiled in September 2009, saying, “This Web-based computer program will provide invaluable support and instruction to health care providers to ensure that patients receive the most up-to-date care.”
The CEI PEP Widget was developed by a team from St. Vincent’s Comprehensive HIV Center in Manhattan and Web Flow Solutions with a grant from the NYDOH’s AIDS Institute.
A widget, short for “window gadget,” is a graphic program that interacts with computer-stored information. This particular widget can be downloaded as a desktop application that will then contain the latest information in video and text format, specifically about treating patients who have been exposed to HIV.
The widget features include:
- A series of brief streaming videos by experts instructing health care providers to implement and monitor PEP and to diagnose and manage acute HIV infection.
- A New York State AIDS clock on the opening screen that ticks forward one new case every hour and 50 minutes; this is the number of people the New York State Department of Health estimates are infected each day in New York.
- Consent forms for HIV testing (New York State requires separate consent procedures for HIV screening). Quick reference guides for PEP, acute HIV infection, and hepatitis B and C.
Another important feature is that the desktop program is updated each time someone using the program accesses the Internet. The New York State DOH staff regularly updates all materials to reflect the latest New York State AIDS Institute guidelines. These changes are then made to the program on the NYDOH server. The next time someone using the widget accesses the internet, the changes are loaded to the desktop widget ensuring that the most up-to-date information is available.
The HIV/AIDS widget instructs health care providers on when to test for the virus and how to administer a highly effective 28-day course of post-exposure prophylaxis (PEP) to prevent HIV infection from taking hold in the patient who has recently experienced a high risk exposure to HIV. Information includes PEP treatment for occupational and non-occupational as well as pediatric exposures.
The physician behind this idea, Antonio Urbina, M.D., medical director of Saint Vincent’s HIV/AIDS training and education, believes that there are many potential uses of the widget. As he explained in a recent statement, “With the same technology and different information, the widget can also be used to teach about infectious diseases or a broad variety of other health concerns.”
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