San San Fr Francisc ancisco Eligible Eligible Met Metropol opolitan an Ar Area ea 2017 2017 Quality uality Manag Managemen ement Pr Program & Perf rform ormance ance Measur Measures es Pre Presentat tation SAN SAN FRANC FRANCISC SCO HIV HIV COMMUNI MMUNITY TY PLANN PLANNING NG CO COUNCIL P R E PA R E D BY: D E D E A N G O O G O O D WI N , A D A D M I N M I N I S T R A S T R ATO R , R , S F D P S F D P H ‐ H I V H I V H E H E A L A LT H T H S E R S E RV I C I C ES J O J O H N AY AY N S L E Y, Q U Q UA L I T Y A L I T Y M A M A N A G E M E N T G E M E N T CO O R D O O R D I N ATO R , R , S F D P S F D P H ‐ H I V H I V H E H E A L A LT H T H S E R S E RV I C I C ES A D D I T I O N A L D ATA P R E PA R AT I O N BY: K E V I K E V I N L E E , L E E , P L A N N E R / E V A N N E R / E VA L A LUATO R , R , M A M A R I N D H D H & H S – H – H I V/A I D S S E R S E RV I C I C ES M A M AT T G E L G E LT M A K E K E R , R , S T D S T D / H I V H I V P R P R O G R A R A M S E S E C T I O C T I O N , S A N S A N M A M AT EO H E H E A L A LT H T H S E R S E RV I C I C ES R E V I E W E D BY: B I L L B I L L B L B LU M , U M , D I R D I R EC TO R O R , S F D P S F D P H ‐ H I H I V H E H E A L A LT H T H S E R S E RV I C I C ES S F H S F H C P C S T E E R I N G S T E E R I N G CO M M I M M I T T E E 1
Presen esentation tion Outline tline I. Purpose, Goals, & Activities II. Considerations & Measures III. Data Overview IV. Analysis V. Questions & Feedback 2
Quality ality Ma Managemen nagement Pu Purpose • Information • Reporting • Evaluation 3
Quality ality Ma Managemen nagement Pr Program ‐ Goals Goals o Analyze HRSA HAB Clinical indicators across all three counties. o Utilize data to improve quality of care and health outcomes. o Report to State, Federal, and City funders on key indicators. 4
2017 2017 QM QM Activities Activities o Increased integration with the eClinicalWorks electronic medical record o State Office of AIDS ARIES HAB QM report improvements o Increased frequency of uploads into ARIES o Food and Nutrition Services linkage and retention QM program implemented o Multiple trainings on a variety of topics 5
Quality ality Assur Assurance nce Da Data Con Consider ideratio ions Data Perspective and Considerations ◦ This presentation uses the ARIES database, which is programmed to comply with all State and Federal grant reporting requirements. ◦ This presentation is designed to address CQI thresholds not to compare models of care. 6
Quality ality Assur Assurance nce Da Data Pa Para rameters rs 7
Quality ality Assur Assurance nce Da Data Pa Para rameters rs Total San Francisco 16,000 7,000 Total HHS ARIES 3,000 Primary Care 2017 DATA 8
Quality ality Assur Assurance nce Pe Performance Me Meas asur ures es • Retention in Care • % of clients with a medical visit in the first half of the year and the second half of the year • ART Prescription • % of clients with HIV/AIDS who are prescribed ART. • Viral Load Suppression • % of patients with a viral load test result of <200. 9
Quality Assurance – Retention in Care 2017 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% San Francisco San Mateo Marin County SF EMA County County UDC 130 3195 334 3659 ART 86.9% 84.4% 80.5% 84.1% Local Threshold 85% 85% 85% 85% National Threshold 90% 90% 90% 90% 10
Quality Assurance – ART Prescription 2017 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% San Francisco San Mateo Marin County SF EMA County County UDC 143 2327 398 2868 ART 94.4% 85.0% 94.5% 86.8% Local Threshold 85% 85% 85% 85% National Threshold 80% 80% 80% 80% 11
Quality Assurance – Viral Load Suppression 2017 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Marin County San Francisco County San Mateo County SF EMA UDC 143 3681 398 4222 Viral Load Suppression 89.5% 78.8% 88.7% 80.1% Local & National Threshold 90% 90% 90% 90% 12
SF SF EM EMA QA QA – C – County Pe Performance Summa mmary 2017 2017 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Medical Visits ART Prescription Viral Load Suppression Marin County 86.9% 94.4% 89.5% San Francisco County 84.4% 85.0% 78.8% San Mateo County 80.5% 94.5% 88.7% SF EMA 84.1% 86.8% 80.1% 13
Vi Viral Load Load Suppr Suppressi ession on by by Demogr Demographi aphic – 0 – 0% ‐ 100% 100% 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 2010 2011 2012 2013 2014 2015 2016 2017 Transgender MTF 75.9% 77.4% 79.1% 78.9% 80.9% 81.2% 81.2% 79.2% Asian & Pacific Islander 81.9% 86.9% 87.4% 86.5% 86.5% 89.1% 89.3% 89.0% Black & African American 72.2% 74.8% 75.6% 75.7% 76.2% 77.1% 78.1% 78.4% Hispanic & Latino/a 80.7% 81.6% 82.0% 83.0% 83.6% 85.7% 84.5% 84.4% White 76.1% 77.1% 77.9% 78.5% 80.1% 81.2% 81.0% 80.7% All 76.6% 78.2% 78.8% 79.3% 80.4% 81.8% 81.7% 81.7% 14
Vi Viral Load Load Suppr Suppressi ession on by by Demogr Demographi aphic – 7 – 70% ‐ 90% 90% 90% 88% 86% 84% 82% 80% 78% 76% 74% 72% 70% 2010 2011 2012 2013 2014 2015 2016 2017 Transgender MTF 75.9% 77.4% 79.1% 78.9% 80.9% 81.2% 81.2% 79.2% Asian & Pacific Islander 81.9% 86.9% 87.4% 86.5% 86.5% 89.1% 89.3% 89.0% Black & African American 72.2% 74.8% 75.6% 75.7% 76.2% 77.1% 78.1% 78.4% Hispanic & Latino/a 80.7% 81.6% 82.0% 83.0% 83.6% 85.7% 84.5% 84.4% White 76.1% 77.1% 77.9% 78.5% 80.1% 81.2% 81.0% 80.7% All 76.6% 78.2% 78.8% 79.3% 80.4% 81.8% 81.7% 81.7% 15
Bl Black ack Health Health Cen Center ers of of Ex Excelle llence 2010 2010 ‐ 17 17 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% N/A 2011 (n=167) 2012 (n=197) 2013 (n=198) 2014 (n=193) 2015 (n=180) 2016 (n=225) 2017 (n=204) Viral Load Supression 67.1% 71.1% 73.7% 75.6% 74.4% 74.2% 66.2% Retention in Care 79.3% 74.0% 79.6% 79.6% 85.0% 79.9% ART Prescription 91.6% 95.9% 93.9% 85.5% 86.7% 78.2% 95.1% 16
CCHAM CCHAMP Cen Center ers of of Ex Excelle llence 2010 2010 ‐ 17 17 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 2016 2010 (n=627) 2011 (n=624) 2012 (n=701) 2013 (n=739) 2014 (n=612) 2015 (n=822) 2017 (n=906) (n=1218) Viral Load Supression 65.1% 70.8% 71.6% 70.6% 65.7% 78.1% 81.0% 77.3% Retention in Care 84.1% 83.0% 76.3% 70.8% 70.2% 85.3% 82.2% 80.2% ART Prescription 93.1% 95.0% 96.0% 93.4% 90.5% 86.0% 78.5% 95.5% 17
Mi Mission Cen Center er of of Ex Excelle llence 2010 2010 ‐ 17 17 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 2010 (n=221) 2011 (n=274) 2012 (n=306) 2013 (n=318) 2014 (n=347) 2015 (n=298) 2016 (n=312) 2017 (n=298) Viral Load Supression 75.1% 80.3% 85.3% 76.7% 79.3% 89.6% 89.4% 90.3% Retention In Care 86.4% 90.0% 90.0% 90.7% 85.0% 91.6% 89.4% 88.9% ART Prescription 91.0% 92.3% 95.4% 94.7% 92.2% 96.3% 97.4% 97.3% 18
Na Nati tive Ameri American an Cen Center ers of of Ex Excelle llence 2010 2010 ‐ 17 17 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 2010 (n=46) 2011 (n=49) 2012 (n=52) 2013 (n=44) 2014 (n=47) 2015 (n=47) 2016 (n=20) 2017 (n=19) Viral Load Supression 56.4% 79.6% 73.1% 86.4% 68.1% 76.6% 55.0% 68.4% Retention in Care 91.9% 94.9% 82.9% 71.8% 78.4% 73.7% 70.0% 80.0% ART Prescription 93.5% 93.9% 94.2% 95.5% 95.7% 95.7% 95.0% 100.0% 19
Te Tenderloin Ar Area ea Cen Center ers of of Ex Exce celle llence 2010 2010 ‐ 17 17 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 2015 2010 (n=338) 2011 (n=282) 2012 (n=198) 2013 (n=132) 2014 (n=86) 2016 (n=166) 2017 (n=176) (n=141) Viral Load Supression 51.5% 61.0% 64.1% 62.1% 62.8% 75.2% 72.9% 71.0% Retention in Care 84.4% 81.6% 83.1% 82.7% 69.2% 70.8% 86.9% 83.1% ART Prescription 85.5% 84.0% 85.4% 86.4% 86.0% 78.7% 74.1% 71.6% 20
Wo Women’s Cen Center ers of of Ex Excelle llence 2010 2010 ‐ 17 17 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 2015 2010 (n=303) 2011 (n=319) 2012 (n=309) 2013 (n=279) 2014 (n=252) 2016 (n=179) 2017 (n=161) (n=155) Viral Load Supression 70.3% 77.1% 79.3% 77.8% 82.1% 76.1% 85.5% 83.2% Retention in Care 81.7% 85.7% 82.2% 83.9% 77.6% 81.3% 83.3% 89.7% ART Prescription 92.4% 95.3% 96.1% 96.8% 96.8% 94.8% 88.3% 96.3% 21
SF SF EM EMA – Q – Quality In Indicators 2010 2010 ‐ 17 17 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 2010 2011 2012 2013 2014 2015 2016 2017 Retention in Care 85.9% 85.2% 83.9% 85.2% 76.0% 84.7% 83.5% 84.1% ART Prescription 76.6% 85.2% 86.8% 87.1% 83.9% 80.8% 80.3% 86.8% Viral Load Supression 58.9% 71.2% 74.5% 75.0% 74.0% 81.2% 80.3% 80.1% 22
QUESTIONS & FEEDBACK 23
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