Clinical Scorecard: Automated ED alert system identifies undiagnosed HIV

At a Glance

Key Highlights

• 176 patients with previously undiagnosed HIV identified over 6 years.
• 67% of diagnoses resulted from automated testing prompts.
• 59% linked to care within 90 days of diagnosis.
• Median time to ART initiation was 9 days.
• Test positivity rate was 0.23%, exceeding CDC's 0.1% threshold.

Guideline-Based Recommendations

Diagnosis

• Utilize automated best practice advisories for HIV testing.

Management

• Link patients to care and initiate ART promptly after diagnosis.

Monitoring & Follow-up

• Assess viral load and CD4 counts at baseline and follow-up.

Risks

• Consider barriers to care, including homelessness and substance use.

Patient & Prescribing Data

Predominantly Black males aged 33 years.

ART initiation occurred within 9 days for most patients.

Clinical Best Practices

• Implement collaborative workflows between ED and ID teams.
• Ensure patients are informed about HIV testing and have the option to decline.
• Follow up with patients who test positive to facilitate care linkage.

Related Resources & Content

• Open Forum Infectious Diseases