Business Intelligence (BI): A System to Improve HIV Surveillance and Care

Background:  More than half of all HIV-infected individuals in Colorado live in Denver.  Approximately 45% of all new HIV-infected cases are diagnosed in Denver.  Over 90% of these are successfully linked to care through a dedicated linkage program.  Despite this, hundreds of Denverites are poorly retained in care. To target programing across the continuum of care, Denver Public Health (DPH) recognized a business need for a robust IT solution to successfully manage multiple complex data sources to support comprehensive HIV surveillance and treatment, starting with diagnosis and following through to receipt of care and the achievement of an undetectable viral load.

Methods:  A series of HIV requirements gathering sessions were conducted with stakeholders in order to gain a better understanding of current and future HIV surveillance data needs.  The requirements document allowed users to define priorities and served as the basis for developers who created an online web portal.

Results:  The resulting BI solution integrated multiple data sources including eHARS, expanded CD4 and viral load laboratory result data, HIV positive registry data, and EMR data from one healthcare provider.   Users have real-time access to data and information in the form of charts, graphs, and GIS mapping tools to monitor disease burden and linkage and retention in care.  A user-designed dashboard aggregates and then allows viewers to filter and drill into specific reports.

Conclusions:  A BI tool has been implemented to monitor the epidemic and direct targeted public health interventions. While substantial planning and investment is required, the resulting HIV BI solution allows assessment and monitoring across the spectrum of HIV disease, creating opportunities for prevention practitioners and policy makers to better understand current and future needs, and better direct local resources.