HIV/STI Data Integration for Improved Ryan White Program Outcomes

Georgetown University’s Center for Global Health Practice and Impact is a global, multi-disciplinary team of committed faculty experts, public health practitioners, partners, and affiliates, serving throughout the world. The team supporting this cooperative agreement consists of experts in HIV surveillance and programs with decades of experience implementing comprehensive HIV/AIDS programs including collaborating with U.S. public health departments to improve public health surveillance broadly.

Project evaluation was provided by Abt Associates.

Rationale

The synchronization of STI and HIV surveillance data will be used to improve the capacity of health departments and RWHAP clinics to prioritize resources for linking and re-engaging people with HIV into care. Improved data linkage and synchronization will lead to more data accuracy and will ultimately inform timely review of client-level care status. Data accuracy and synchronization have been documented to lead to better care outcome activities, such as increased linkage to care, increased engagement and re-engagement in care, and ultimately, increased viral suppression among people with HIV. Enhanced synchronization of disparate data systems assists in confirming residence and care patterns among persons diagnosed with HIV, including persons lost to follow-up and/or in care in other jurisdictions. These efforts are critical for re-engagement and other client level intervention activities. Moreover, enhanced data synchronization increases the ability of public health departments and HIV providers to better assess risk behaviors, repeat STI infections, and other critical markers of relevance in addressing co-infections of STIs in people with HIV.

The goal of this project is to enhance the integration of HIV and STI surveillance data with RWHAP data in order to improve linkage, re-engagement in care, and health outcomes for people with HIV. 

Approach to Technical Assistance

GU CGHPI has taken a tiered and tailored TA approach to implementation design, due to the drastically different situations in each state. Each jurisdiction has a tailored data integration implementation plan as well as Technical Working Groups (TWGs) that meet regularly organized around the three focal areas. Additionally, in order to promote knowledge exchange and diffusion of knowledge and best practices, GU created Communities of Practices (CoP) to engage participating and non-participating jurisdictions in critical knowledge exchange, best practices benchmarking and collaborative learning. 

Specific activities include:

• Assessment of jurisdiction needs from data systems, data integration, and data end-user perspectives
• Development of tailored data integration implementation plans based on unique jurisdiction needs
• Translation of data integration and data-to-care action plans into programmatic improvement and policy decisions

Focus Areas

GU CGHPI, working collaboratively with the jurisdictions, identified three key focal areas for TA provision: Business Process Development, Data Integration, and Data to Care. Each guided support within each participant jurisdiction. The TWGs were also organized around these areas. Enhancing communication and collaboration within the health departments was also a key component of this project.

Learn more about the goals and approaches taken by the four participating jurisdictions in this Project Overview and the more detailed jurisdiction profiles.

These infographics describe an approach to the three core focal areas that guided the provision of technical assistance. These infographics are also contained in the HIV/STI Data Integration Manual and Toolkit under the Implementation section.

Business Process Development (BPD) is often lacking for key surveillance and client engagement activities – and is a crucial first step prior to developing or updating data systems processes and integration of data flows.

Download the BPD Guideline

Data Integration looks different in each jurisdiction, depending on what systems are currently being used, what processes surround each system, and what the end-goal is for data storage, access, and utilization.

Download the Data Integration Guideline

Data to Care processes depend heavily on organizational structure within a jurisdiction, as well as how data are stored and accessed. Data utilization for enhanced care outcomes is a core goal within this project. There must be careful consideration of how business processes and data integration strategies can be utilized to better enable effective, efficient client outreach—for re-engagement and retention in care.

Download the Data to Care Guideline

The three phases to implementing a data linkage and integration project are design, implementation, and evaluation.

• Design: The first step of any project is the careful design of project goals, targets, and interventions. 
• Implementation: After establishing a plan, the next step is to implement. It is important to stay on track and meet deadlines, while also allowing for iterative adjustments due to unforeseen challenges and continuous learning. 
• Evaluation: It is important to define measurable outcomes that can be used to define project success. 

Access the Manual and Toolkit