Opinion Piece Examines Role of Health IT in HIV/AIDS Care

"In any given month, about 40% of the approximately 1,900 clients actively enrolled" in Washington, D.C.'s AIDS Drug Assistance Program are "not utilizing antiretroviral medications," Christopher Keeys -- president of the district's Drug Utilization Review Board and Clinical Pharmacy Associates, as well as a professor at Howard University -- writes in a Washington Times opinion piece. "However, almost all of these 'nonutilizers' have active prescriptions for antiretroviral drugs written by their physicians, nurse practitioners or physician's assistants," Keeys writes, adding, "The experience in the District of Columbia may not be unique. ADAP programs across the country report similar rates of 'nonutilizers.'"

Keeys writes, "Coordination of pharmacy services and drug benefits for patients between their health care providers ... and health care organizations ... is complex and fragmented." He adds that the "public health concerns regarding HIV/AIDS care and treatment adherence need to be highlighted for the benefit of all stakeholders in the health care system." According to Keeys, the drug utilization board last month "began an exploration of the challenges impeding effective treatment of the diverse population of D.C. residents living with HIV/AIDS." He adds that the board is focusing on an "ongoing pilot quality-improvement project initiated by a clinical pharmacy group in cooperation with the D.C. HIV/AIDS Administration." The project "combines concurrent (real-time) drug utilization reviews from a physicians' electronic outpatient prescriptions (e-prescribing) and patients' electronic medical records with clinical pharmacy services to identify 'nonutilizing'" HIV-positive patients, Keeys writes, adding that the project also "establishes measures for adherence interventions from the providers, including physicians and treatment specialists. The ultimate goal for patients is to improve health outcomes through improved treatment adherence."

Keeys concludes that "[i]nnovations in information technology in health care, combined with advanced pharmacy services and concurrent drug-utilization review, have joined the fight to improve coordination of care and reduce the community burden of HIV/AIDS" (Keeys, Washington Times, 4/14).