Using a report card to increase HIV screening in a large primary care group practice.

Abstract

Despite increased efforts to promote HIV screening, a large proportion of the US population have never been tested for HIV. To determine whether provider education and personalised HIV screening report cards can increase HIV screening rates within a large integrated healthcare system. This quality improvement study provided a cohort of primary care physicians (PCPs) a brief educational intervention and personalised HIV screening report cards with quarterly performance data. Participants included a volunteer cohort of 20 PCPs in the department of adult and family medicine. Per cent of empaneled patients screened for HIV by cohort PCPs compared with PCPs at the Kaiser Permanente Oakland Medical Center (KPOAK) and the non-Oakland Medical Centers in Northern California region (Kaiser Permanente Northern California (KPNC)). Of the 20 participating PCPs, 13 were female and 7 were male. Thirteen were internal medicine and seven family medicine physicians. The average age was 40 years and average practice experience was 9 years after residency. During the 12-month intervention, the estimated increase in HIV screening in the cohort PCP group was 2.6% as compared with 1.9% for KPOAK and 1.8% for KPNC. These findings suggest that performance-related report cards are associated with modestly increased rates of HIV screening by PCPs.