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Article ; Online: Electronic Patient Portal Use Among People Living With HIV.

Hall, André / Devlin, Samantha / Won, Joshua / Schmitt, Jessica / P Ridgway, Jessica

2023 Volume 25, Page(s) e47740

MeSH term(s)	Humans ; HIV Infections ; Patient Portals ; Electronic Health Records ; Patient Satisfaction ; Quality Improvement
Language	English
Publishing date	2023-11-21
Publishing country	Canada
Document type	Letter
ZDB-ID	2028830-X
ISSN	1438-8871 ; 1438-8871
ISSN (online)	1438-8871
ISSN	1438-8871
DOI	10.2196/47740
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: "There hasn't been a push to identify patients in the emergency department"-Staff perspectives on automated identification of candidates for pre-exposure prophylaxis (PrEP): A qualitative study.

Devlin, Samantha A / Johnson, Amy K / Stanford, Kimberly A / Haider, Sadia / Ridgway, Jessica P

PloS one

2024 Volume 19, Issue 3, Page(s) e0300540

Abstract: Automated algorithms for identifying potential pre-exposure prophylaxis (PrEP) candidates are effective among men, yet often fail to detect cisgender women (hereafter referred to as "women") who would most benefit from PrEP. The emergency department (ED) ...

Abstract	Automated algorithms for identifying potential pre-exposure prophylaxis (PrEP) candidates are effective among men, yet often fail to detect cisgender women (hereafter referred to as "women") who would most benefit from PrEP. The emergency department (ED) is an opportune setting for implementing automated identification of PrEP candidates, but there are logistical and practical challenges at the individual, provider, and system level. In this study, we aimed to understand existing processes for identifying PrEP candidates and to explore determinants for incorporating automated identification of PrEP candidates within the ED, with specific considerations for ciswomen, through a focus group and individual interviews with ED staff. From May to July 2021, we conducted semi-structured qualitative interviews with 4 physicians and a focus group with 4 patient advocates working in a high-volume ED in Chicago. Transcripts were coded using Dedoose software and analyzed for common themes. In our exploratory study, we found three major themes: 1) Limited PrEP knowledge among ED staff, particularly regarding its use in women; 2) The ED does not have a standardized process for assessing HIV risk; and 3) Perspectives on and barriers/facilitators to utilizing an automated algorithm for identifying ideal PrEP candidates. Overall, ED staff had minimal understanding of the need for PrEP among women. However, participants recognized the utility of an electronic medical record (EMR)-based automated algorithm to identify PrEP candidates in the ED. Facilitators to an automated algorithm included organizational support/staff buy-in, patient trust, and dedicated support staff for follow-up/referral to PrEP care. Barriers reported by participants included time constraints, hesitancy among providers to prescribe PrEP due to follow-up concerns, and potential biases or oversight resulting from missing or inaccurate information within the EMR. Further research is needed to determine the feasibility and acceptability of an EMR-based predictive HIV risk algorithm within the ED setting.
MeSH term(s)	Male ; Humans ; Female ; Pre-Exposure Prophylaxis/methods ; HIV Infections/prevention & control ; HIV Infections/drug therapy ; Anti-HIV Agents/therapeutic use ; Qualitative Research ; Emergency Service, Hospital
Chemical Substances	Anti-HIV Agents
Language	English
Publishing date	2024-03-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0300540
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Article ; Online: Population-Level Portal-Based Anxiety and Depression Screening Perspectives in HIV Care Clinicians: Qualitative Study Using the Consolidated Framework for Implementation Research.

Zimmer, Daniela / Staab, Erin M / Ridgway, Jessica P / Schmitt, Jessica / Franco, Melissa / Hunter, Scott J / Motley, Darnell / Laiteerapong, Neda

JMIR formative research

2024 Volume 8, Page(s) e48935

Abstract: Background: Depression and anxiety are common among people with HIV and are associated with inadequate viral suppression, disease progression, and increased mortality. However, depression and anxiety are underdiagnosed and undertreated in people with ... ...

Abstract	Background: Depression and anxiety are common among people with HIV and are associated with inadequate viral suppression, disease progression, and increased mortality. However, depression and anxiety are underdiagnosed and undertreated in people with HIV owing to inadequate visit time and personnel availability. Conducting population-level depression and anxiety screening via the patient portal is a promising intervention that has not been studied in HIV care settings. Objective: We aimed to explore facilitators of and barriers to implementing population-level portal-based depression and anxiety screening for people with HIV. Methods: We conducted semistructured hour-long qualitative interviews based on the Consolidated Framework for Implementation Research with clinicians at an HIV clinic. Results: A total of 10 clinicians participated in interviews. In total, 10 facilitators and 7 barriers were identified across 5 Consolidated Framework for Implementation Research domains. Facilitators included advantages of systematic screening outside clinic visits; the expectation that assessment frequency could be tailored to patient needs; evidence from the literature and previous experience in other settings; respect for patient privacy; empowering patients and facilitating communication about mental health; compatibility with clinic culture, workflows, and systems; staff beliefs about the importance of mental health screening and benefits for HIV care; engaging all clinic staff and leveraging their strengths; and clear planning and communication with staff. Barriers included difficulty in ensuring prompt response to suicidal ideation; patient access, experience, and comfort using the portal; limited availability of mental health services; variations in how providers use the electronic health record and communicate with patients; limited capacity to address mental health concerns during HIV visits; staff knowledge and self-efficacy regarding the management of mental health conditions; and the impersonal approach to a sensitive topic. Conclusions: We proposed 13 strategies for implementing population-level portal-based screening for people with HIV. Before implementation, clinics can conduct local assessments of clinicians and clinic staff; engage clinicians and clinic staff with various roles and expertise to support the implementation; highlight advantages, relevance, and evidence for population-level portal-based mental health screening; make screening frequency adaptable based on patient history and symptoms; use user-centered design methods to refine results that are displayed and communicated in the electronic health record; make screening tools available for patients to use on demand in the portal; and create protocols for positive depression and anxiety screeners, including those indicating imminent risk. During implementation, clinics should communicate with clinicians and clinic staff and provide training on protocols; provide technical support and demonstrations for patients on how to use the portal; use multiple screening methods for broad reach; use patient-centered communication in portal messages; provide clinical decision support tools, training, and mentorship to help clinicians manage mental health concerns; and implement integrated behavioral health and increase mental health referral partnerships.
Language	English
Publishing date	2024-01-11
Publishing country	Canada
Document type	Journal Article
ISSN	2561-326X
ISSN (online)	2561-326X
DOI	10.2196/48935
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Article ; Online: No-show Prediction Model Performance Among People With HIV: External Validation Study.

Mason, Joseph A / Friedman, Eleanor E / Rojas, Juan C / Ridgway, Jessica P

Journal of medical Internet research

2023 Volume 25, Page(s) e43277

Abstract: ... appointments (P<.001). Features identified as important in the alternate model included lead time, appointment ...

Abstract	Background: Regular medical care is important for people living with HIV. A no-show predictive model among people with HIV could improve clinical care by allowing providers to proactively engage patients at high risk of missing appointments. Epic, a major provider of electronic medical record systems, created a model that predicts a patient's probability of being a no-show for an outpatient health care appointment; however, this model has not been externally validated in people with HIV. Objective: We examined the performance of Epic's no-show model among people with HIV at an academic medical center and assessed whether the performance was impacted by the addition of demographic and HIV clinical information. Methods: We obtained encounter data from all in-person appointments among people with HIV from January 21 to March 30, 2022, at the University of Chicago Medicine. We compared the predicted no-show probability at the time of the encounter to the actual outcome of these appointments. We also examined the performance of the Epic model among people with HIV for only HIV care appointments in the infectious diseases department. We further compared the no-show model among people with HIV for HIV care appointments to an alternate random forest model we created using a subset of seven readily accessible features used in the Epic model and four additional features related to HIV clinical care or demographics. Results: We identified 674 people with HIV who contributed 1406 total scheduled in-person appointments during the study period. Of those, we identified 331 people with HIV who contributed 440 HIV care appointments. The performance of the Epic model among people with HIV for all appointments in any outpatient clinic had an area under the receiver operating characteristic curve (AUC) of 0.65 (95% CI 0.63-0.66) and for only HIV care appointments had an AUC of 0.63 (95% CI 0.59-0.67). The alternate model we created for people with HIV attending HIV care appointments had an AUC of 0.78 (95% CI 0.75-0.82), a significant improvement over the Epic model restricted to HIV care appointments (P<.001). Features identified as important in the alternate model included lead time, appointment length, HIV viral load >200 copies per mL, lower CD4 T cell counts (both 50 to <200 cells/mm Conclusions: For both models among people with HIV, performance was significantly lower than reported by Epic. The improvement in the performance of the alternate model over the proprietary Epic model demonstrates that, among people with HIV, the inclusion of demographic information may enhance the prediction of appointment attendance. The alternate model further reveals that the prediction of appointment attendance in people with HIV can be improved by using HIV clinical information such as CD4 count and HIV viral load test results as features in the model.
MeSH term(s)	Humans ; Female ; Appointments and Schedules ; Ambulatory Care ; Ambulatory Care Facilities ; HIV Infections
Language	English
Publishing date	2023-03-29
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2028830-X
ISSN	1438-8871 ; 1438-8871
ISSN (online)	1438-8871
ISSN	1438-8871
DOI	10.2196/43277
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Article ; Online: Population-Level Portal-Based Anxiety and Depression Screening Perspectives in HIV Care Clinicians

Daniela Zimmer / Erin M Staab / Jessica P Ridgway / Jessica Schmitt / Melissa Franco / Scott J Hunter / Darnell Motley / Neda Laiteerapong

JMIR Formative Research, Vol 8, p e

Qualitative Study Using the Consolidated Framework for Implementation Research

2024 Volume 48935

Abstract: BackgroundDepression and anxiety are common among people with HIV and are associated with inadequate viral suppression, disease progression, and increased mortality. However, depression and anxiety are underdiagnosed and undertreated in people with HIV ... ...

Abstract	BackgroundDepression and anxiety are common among people with HIV and are associated with inadequate viral suppression, disease progression, and increased mortality. However, depression and anxiety are underdiagnosed and undertreated in people with HIV owing to inadequate visit time and personnel availability. Conducting population-level depression and anxiety screening via the patient portal is a promising intervention that has not been studied in HIV care settings. ObjectiveWe aimed to explore facilitators of and barriers to implementing population-level portal-based depression and anxiety screening for people with HIV. MethodsWe conducted semistructured hour-long qualitative interviews based on the Consolidated Framework for Implementation Research with clinicians at an HIV clinic. ResultsA total of 10 clinicians participated in interviews. In total, 10 facilitators and 7 barriers were identified across 5 Consolidated Framework for Implementation Research domains. Facilitators included advantages of systematic screening outside clinic visits; the expectation that assessment frequency could be tailored to patient needs; evidence from the literature and previous experience in other settings; respect for patient privacy; empowering patients and facilitating communication about mental health; compatibility with clinic culture, workflows, and systems; staff beliefs about the importance of mental health screening and benefits for HIV care; engaging all clinic staff and leveraging their strengths; and clear planning and communication with staff. Barriers included difficulty in ensuring prompt response to suicidal ideation; patient access, experience, and comfort using the portal; limited availability of mental health services; variations in how providers use the electronic health record and communicate with patients; limited capacity to address mental health concerns during HIV visits; staff knowledge and self-efficacy regarding the management of mental health conditions; and the impersonal approach to a sensitive ...
Keywords	Medicine ; R
Subject code	360
Language	English
Publishing date	2024-01-01T00:00:00Z
Publisher	JMIR Publications
Document type	Article ; Online
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Article ; Online: Risk of coronavirus disease 2019 (COVID-19) acquisition among emergency department patients: A retrospective case control study.

Ridgway, Jessica P / Robicsek, Ari A

Infection control and hospital epidemiology

2020 Volume 42, Issue 1, Page(s) 105–107

MeSH term(s)	COVID-19/epidemiology ; COVID-19/prevention & control ; COVID-19/transmission ; Case-Control Studies ; Disease Transmission, Infectious/prevention & control ; Disease Transmission, Infectious/statistics & numerical data ; Emergency Service, Hospital/statistics & numerical data ; Emergency Service, Hospital/trends ; Female ; Humans ; Infection Control/organization & administration ; Male ; Middle Aged ; Risk Assessment/methods ; Risk Assessment/statistics & numerical data ; Risk Management/organization & administration ; SARS-CoV-2/isolation & purification ; SARS-CoV-2/pathogenicity ; United States/epidemiology
Keywords	covid19
Language	English
Publishing date	2020-09-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2020.1224
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Article ; Online: Rates of COVID-19 Among Unvaccinated Adults With Prior COVID-19.

Ridgway, Jessica P / Tideman, Samuel / Wright, Bill / Robicsek, Ari

JAMA network open

2022 Volume 5, Issue 4, Page(s) e227650

MeSH term(s)	Adult ; COVID-19 ; Humans ; SARS-CoV-2 ; Vaccination
Language	English
Publishing date	2022-04-01
Publishing country	United States
Document type	Journal Article
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2022.7650
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Article ; Online: Adherence to stewardship recommendations for antibiotic discontinuation reduces antibiotic-associated adverse drug events.

Mulligan, Patrick / Ismail, Nader / Shah, Nirav / Ridgway, Jessica P / Ravichandran, Urmila / Grant, Jennifer / Acree, Mary Ellen

Antimicrobial stewardship & healthcare epidemiology : ASHE

2024 Volume 4, Issue 1, Page(s) e36

Abstract: Inappropriate antibiotic use may lead to increased adverse drug events (ADEs). This study assessed whether an antimicrobial stewardship recommendation to discontinue antibiotics in patients with low likelihood for bacterial infection reduced antibiotic ... ...

Abstract	Inappropriate antibiotic use may lead to increased adverse drug events (ADEs). This study assessed whether an antimicrobial stewardship recommendation to discontinue antibiotics in patients with low likelihood for bacterial infection reduced antibiotic duration and antibiotic-associated ADEs. At a 4-hospital system, hospitalized adult patients receiving empiric antibiotics for suspected infection were identified between May 2, 2016 and June 30, 2018. For those patients who were deemed unlikely to have a bacterial infection, a note was left by an infectious diseases physician recommending antibiotic discontinuation. Patient cases were considered "adherent" to recommendations if antibiotics were discontinued within 48 hours of the note and "non-adherent" to recommendations if antibiotics were continued beyond this. Duration of antibiotics and potential antibiotic-associated ADEs were collected retrospectively. Attribution of the adverse event to the antibiotic was decided upon by the investigators. The incidence of ADEs and duration of antibiotics between the adherent and non-adherent groups were compared. Of 253 patients deemed unlikely to have a bacterial infection, 114 (45%) treatment teams stopped antibiotics within 48 hours of the recommendation, and 139 (55%) continued antibiotics. The total number of ADEs was significantly higher in the non-adherent group compared to the adherent group (34 ADEs vs 9 ADEs,
Language	English
Publishing date	2024-03-18
Publishing country	England
Document type	Journal Article
ISSN	2732-494X
ISSN (online)	2732-494X
DOI	10.1017/ash.2024.29
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Article ; Online: Association between patient-reported barriers and HIV clinic appointment attendance: A prospective cohort study.

Judd, Ryan T / Friedman, Eleanor E / Schmitt, Jessica / Ridgway, Jessica P

AIDS care

2021 Volume 34, Issue 5, Page(s) 545–553

Abstract: The association between patients' confidence in their ability to attend appointments and future retention in care has not previously been studied in a general HIV clinic. A survey of potential and known risk factors for poor retention was developed using ...

Abstract	The association between patients' confidence in their ability to attend appointments and future retention in care has not previously been studied in a general HIV clinic. A survey of potential and known risk factors for poor retention was developed using validated screening tools and administered to 105 patients at an HIV clinic. Retention in care was assessed prospectively using two definitions: (1) two appointments at least three months apart within one year ("HRSA/HAB retention") and (2) no missed appointments within one year ("missed visits retention"). Most patients were African American (86%) and male (59%). Although most patients were confident they could keep their HIV appointments (89%), fewer were retained (HRSA/HAB: 73%; missed visits: 56%). Patients' confidence in their ability to keep future appointments was not associated with retention. Employment was associated with lower odds of HRSA/HAB retention (aOR 0.26 [95% CI 0.09-0.77]), and childcare was a common barrier that was associated with lower odds of missed visits retention (aOR 0.06 [95% CI 0.006-0.62]). Other known risk factors for poor retention were inconsistently associated with retention in care.
MeSH term(s)	Ambulatory Care Facilities ; Appointments and Schedules ; HIV Infections ; Humans ; Male ; Patient Reported Outcome Measures ; Prospective Studies
Language	English
Publishing date	2021-03-28
Publishing country	England
Document type	Journal Article
ZDB-ID	1012651-x
ISSN	1360-0451 ; 0954-0121
ISSN (online)	1360-0451
ISSN	0954-0121
DOI	10.1080/09540121.2021.1906401
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Article: Decreased Risk of Coronavirus Disease 2019-Related Hospitalization Associated With the Omicron Variant of Severe Acute Respiratory Syndrome Coronavirus 2.

Ridgway, Jessica P / Tideman, Samuel / Wright, Bill / Robicsek, Ari

Open forum infectious diseases

2022 Volume 9, Issue 7, Page(s) ofac288

Abstract: Among 134 223 patients with coronavirus disease 2019 (COVID-19), we assessed how risk of hospitalization changed at different intervals in the pandemic, controlling for prior COVID-19 immunity. In multivariable analysis, outpatients with COVID-19 during ... ...

Abstract	Among 134 223 patients with coronavirus disease 2019 (COVID-19), we assessed how risk of hospitalization changed at different intervals in the pandemic, controlling for prior COVID-19 immunity. In multivariable analysis, outpatients with COVID-19 during the Omicron-predominant time period had significantly lower odds of hospitalization compared to pre-Delta (adjusted odds ratio, 0.26 [95% confidence interval, .22-.32]).
Language	English
Publishing date	2022-06-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2757767-3
ISSN	2328-8957
ISSN	2328-8957
DOI	10.1093/ofid/ofac288
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