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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


  1. 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

  2. Presen esentation tion Outline tline I. Purpose, Goals, & Activities II. Considerations & Measures III. Data Overview IV. Analysis V. Questions & Feedback 2

  3. Quality ality Ma Managemen nagement Pu Purpose • Information • Reporting • Evaluation 3

  4. 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

  5. 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

  6. 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

  7. Quality ality Assur Assurance nce Da Data Pa Para rameters rs 7

  8. 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

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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

  21. 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

  22. 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

  23. QUESTIONS & FEEDBACK 23

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