The Improving Ryan White HIV/AIDS Program (RWHAP) Outcomes Using a Tiered Technical Systems Approach to HIV-STI Data Linkages Initiative is supported by the RWHAP Special Projects of National Significance (SPNS) Program of the Health Resources and Services Administration (HRSA). This initiative funds a cooperative agreement through Georgetown University’s (GU) Center for Global Health Practice and Impact (CGHPI), to provide technical assistance (TA) to public health departments and RWHAP Part A recipients in the United States to create and improve data sharing across their sexually transmitted infection (STI) and HIV surveillance systems.
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
GU CGHPI, working collaboratively with the jurisdictions, has identified three key focal areas for TA provision, which guide support within each participant jurisdiction. The TWGs are also organized around these areas. Enhancing communication and collaboration within the health departments is also a key component of this project.
- Business Process Development
- Data Integration
- Data to Care Process Improvement
Learn more about the goals and approaches taken by the four participating jurisdictions:
- Enhance and automate centralized HIV-STI data warehouse
- Coordinate disparate data systems and processes
- Coordinate strategic data sharing with six independent county level RWHAP Part A programs
- Enhancing HIV and STI data sharing and collaboration through the implementation of centralized data.warehouse and programmatic systems and business process development (TWG A/B)
- Enhancing data-to-dare coordination via state-county-RWHAP Part A program collaboration and data sharing (TWG C)
- Develop a centralized warehouse to integrate HIV and STI data
- Develop internal dashboards to inform prevention/outreach
- Improve collaboration between ADPH, RWHAP facilities, providers, and county health departments
- Development of Central Linkage Data Warehouse to enhance availability of timely, comprehensive HIV/STI data (TWG A)
- Design, Test, Implement, and Utilize Data Dashboards to inform program monitoring, prevention, outreach, and education efforts (TWG B)
- HIV/RWHAP Provider Collaboration Building to enhance care provision, retention, and reengagement capacity (TWG C)
- Improve business process documentation
- Develop routine data sharing between surveillance and care
- Establish coordinated and synergized data to care activities between departments
- Data System Business Process Documentation and Development to streamline HIV and STI surveillance and case management processes into fully integrated DC Public Health Information System (DC PHIS) (TWG A)
- Defining Parameters and Mechanisms for Data Sharing between Strategic Information (SID) and Care and Treatment (CTD) Divisions (TWG B)
- Developing Synergy in Data to Care Efforts between SID and CTD (TWG C)
- Integrate HIV data into current STI data systems
- Document and streamline departmental data processes
- Enhance care data accessibility within the LDH care outreach system
- Synchronize HIV Data between eHARS and PRISM Systems, including historical batch uploads and routine data transfers (TWG A)
- Comprehensive STD/HIV/Hepatitis Program (SHHP) Business Process Documentation for identification of opportunities for further systems integration (TWG B)
- Incorporate RWHAP Care and Services Data in routine linkage to care efforts (TWG C)
Program Focus Area Best Practice Guides
This infographic set discusses the three core focal areas that guide TA provision within participating jurisdictions.
- Business Process Documentation 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.
- 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.
- 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.
Evaluation is a critical component of assessing the successes of this initiative. A comprehensive program evaluation for this cooperative agreement is being conducted by Abt Associates. GU CGPHI and Abt Associates collaborate closely in the assessment of program impact via data end-user surveys, policy stakeholder interviews, document review, and aggregate statistics data analysis.
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.