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Keeping Track of HIV Care

May 14, 2012

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By Eva Westley

In Chicago, as elsewhere in the country, more people depend on HIV-related care, case management, housing, food vouchers and mental health services than ever before.

But how do you track all of that? How do you measure the success of an integrated system of care and supportive services for thousands of people?

 

In a time when increasingly limited funding depends on evidence of success, data management has become one of the AIDS Foundation of Chicago’s most important contributions to the AIDS sector in Chicago. Since 2009, the AIDS Foundation of Chicago (AFC) has worked to build out ClientTrack, a client-level database, as a tool to create, manage, and analyze information about the people we serve.

Simply put, ClientTrack holds service-delivery information about people who receive assistance through AFC’s funded partner agencies. And it offers a unique window into what’s working and what needs to be improved.

“In our role as a program administrator, AFC works closely with our delegate agencies and their employees to achieve the greatest possible health improvements for people enrolled in the prevention, care and housing programs we fund and coordinate,” said David Ernesto Munar, AFC President/CEO (at right).

“Promoting improved quality is at the heart of all we do,” Munar said. “Clients can reasonably expect that their health and lives will improve as a result of the AFC-funded serviced they receive.” 

Because AFC administers many grants to multiple agencies, ClientTrack manages confidential service records on more than 5,000 people accessing HIV-related assistance across metropolitan Chicago. That number includes HIV-positive pregnant women in the Pediatric AIDS Chicago Prevention Initiative (PACPI), ex-offenders from AFC’s re-entry housing program, and all the clients who receive medical and supportive case management from any one of AFC’s 37 partner agencies. 

Here’s how it works: Case managers enter information into the encrypted database when they have any interaction with a client — from initial in-take assessments to phone calls and appointments. The data includes demographic information, mental health histories, substance use history, medical appointments, housing application statuses and case notes.

We also ask our case managers to collect health data from their clients and from the medical providers, including clinical information about the clients’ viral loads – how much HIV is in a person’s system. We plan to track this information over time. By monitoring health indicators, case managers can see how well a client’s disease is being managed

Protecting individuals’ confidential medical information is at the core of the trusting relationship case managers and the system established with clients. Using ClientTrack, AFC layers checks and balances to ensure that only case managers and supervisors have access to detailed records of their assigned clients.

Extracting useful morsels of information from this mass of data can be tricky.

AFC’s Data Services Team has worked to customize ClientTrack so that case managers and agency supervisors can easily track data on their performance, and so that AFC can analyze the system as a whole.

The power of ClientTrack lies in its ability to be customized. “ClientTrack’s flexibility allows us to evolve in terms of what we collect and report on with the ability to build custom tables, fields and forms,” said Hal Barnett, AFC’s Database Analyst.

For example, ClientTrack is now being used as a performance management tool for partner agencies and for AFC. The data system has been customized to generate reports that show an individual case manager’s case load. With a single click, a case manager see if common care components, like client assessments, visits, and housing or ADAP applications, are up to date. Before ClientTrack, this could take hours of manual review.

In addition, agency supervisors can easily track performance through automated reports. This allows for easy tracking of quality indicators for all of their case managers.

While it’s beneficial to partner agencies, ClientTrack also provides AFC with useful data for system evaluation and advocacy.

Having that birds-eye view of the network provides answers to many questions: What neighborhoods are most heavily affected by HIV? Are people with HIV accessing food? Housing? Mental health services? Are certain age groups, racial groups, or income group more heavily impacted?

AFC staff can view patterns for clients who are 18 or under, for people of color, for clients who received services in the past six months, for clients who live in a certain zip code, or myriad other indicators.

And that information allows AFC to more effectively advocate for people living with HIV, and fight for the programs and services that they need most.

“On the policy side, AFC was able to run data on the numbers of clients likely to be impacted by proposed policy changes,” said Keri Rainsberger, AFC’s director of quality assurance and supportive services (at left). “This helped make our policy efforts more successful and also allowed us to better train case managers.”

(To read a more in-depth interview with Rainsberger, click here.)

As AFC continues to fight for the health and rights of people living with HIV, having the most accurate, up-to-date information at its fingertips is critical.

“We can identify areas where it’s not working,” Rainsberger said, “and get that back to the program teams who can then change things to make sure that the system’s working better.”

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For more information on ClientTrack, check out this presentation .

Categorized under Inside Story.

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