A unified eligibility application and determination system to increase Ryan White linkage to care and retention in care by reducing structural barriers and facilitating client engagement

Groupware Technologies, Llc, Milwaukee WI

Investigators

Abstract

Project Summary Over 500,000 people diagnosed with HIV in the United States received health care and support services through the RWHAP, including AIDS Drug Assistance (ADAP) programs in 2021. These services are critical for attaining optimal HIV health outcomes among people with HIV, preventing further transmission of the virus, and ultimately, ending the HIV epidemic in the United States. Unfortunately, nationwide, only 81% of Ryan White eligible clients attended an HIV medical care visit within 1 month of HIV diagnosis. Additionally, 22% of RWHAP participants are not retained in care, resulting in suboptimal individual healthcare outcomes and ongoing virus transmission. This is due, in part, to the difficulties associated with determining and maintaining eligibility for these programs, the lack of a system to share eligibility status across the hundreds of HIV care providers across each state, and an inability to share data that is critical to retention and adherence efforts. This creates delays in access to care, clients falling out of care, and staffing inefficiencies caused by duplicate data entry. Additionally, the fragmentation and unavailability of data makes it difficult for staff to identify and re-engage clients that are falling out of care. In this Direct to Phase II application, Groupware Technologies proposes to develop a new collaborative eligibility platform that will support the application, determination, recertification, and enrollment for all HIV service providers while also supporting the unique needs of the different programs and individual providers. This will allow a client to complete a single eligibility application to gain access to multiple programs while providing each program with the control that they need. It will also integrate information from all agencies across the state so they can easily see, share, and manage applications from all clients statewide, accelerate access to care, and coordinate client retention efforts. To achieve these goals, this project has the following aims: (Aim 1) Develop a web-based collaborative eligibility, enrollment, and ADAP management platform that is more functional and usable than currently used methods; (Aim 2) Validate a decrease in the time required to determine eligibility when using the platform; and (Aim 3) Validate an improvement in Linkage to Care, Retention in Care, Viral Suppression, and Loss of Service Due to an Inability to Confirm Eligibility. By achieving these aims, we will demonstrate that a collaborative eligibility, enrollment, and ADAP/RWHAP management platform will improve key steps in the HIV care continuum while addressing the state and local ADAP and RWHAP programmatic needs. We will validate this impact with 2 statewide RWHAP Part B, including ADAP, implementations.