Published May 29, 2014

Boston, MA, USA - About 1.1 million individuals are living with HIV in the United States and it is estimated that approximately 15-20% are currently unaware of their status. To increase HIV testing rate, the Veterans Health Administration (VHA), the single largest health care system in the United States, has removed the requirement for formal pretest and posttest counseling and has substituted verbal consent for written informed consent prior to HIV testing.  In addition, many sites have installed clinical reminders to promote routine-based testing. Dr. Kee Chan, PhD, Assistant Professor of Health Science at Boston University and investigator at the Center for Healthcare Organization and Implementation Research at the Veterans Affairs Medical Centers in Boston and Bedford, led a group of researchers to conduct a comparative cost analysis for three alternative strategies for HIV testing:  1) physician-based traditional HIV testing and counseling in the absence of clinical reminders; 2) clinical reminders and nurse-based stream-lined counseling with telephone notifications for negative results; and 3) clinical reminders without pre-test counseling and with telephone notifications for negative results Dr. Chan highlights, "My Boston research group collaborated with VA Greater Los Angeles to evaluate the annual total costs and costs per new case. The cost of a clinical reminder system with pre-test counseling was $81,726 compared to $109,208 for traditional HIV testing in one year.  A clinical reminder system without counseling had the most cost-savings per case identified of $57.69, compared to traditional testing at $120.93. The findings support the current implementation of the clinical reminder system to promote HIV testing in the VA." This study, "Comparative Cost Analysis of Clinical Reminder for HIV Testing at the Veterans Affairs Healthcare System," is published inValue in Health.

---