Information needs of case managers caring for persons living with HIV

1. Information needs of case managers caring forpersons living with HIV Rebecca Schnall, James J Cimino, Leanne M Currie, Suzanne Bakken JAMIA Published Online First January 2011

2. Introduction • many healthcare workers have questions about how to care for their patients and that most questions go unanswered • Few studies have evaluated the information needs of case managers

3. Introduction • Electronic access to information resources at the point of care has the potential to improve information • It is important to determine the information needs experienced by the healthcare worker while interacting with the system • The purpose of this study was to identify the information needs of case managers who provide services to persons living with HIV

4. MethodsRecruitment • Case managers were recruited through direct contact by telephone, email, and distribution of invitational flyers • Upon completion of the survey, participants were asked to refer their colleagues to participate in the survey

5. MethodsSample and setting • The survey was completed by a voluntary convenience sample of 94 case managers employed at a COBRA or a DAC in NY • COBRA case-management programs include certified home health agencies, community health centers, and other community-based organizations • DACs are hospital-based programs that serve as the hubs for a continuum of hospital and community-based care for HIV/AIDS patients

6. MethodsProcedures • Case managers were asked to report their demographic information – • age, gender, ethnicity, race, internet usage, and computer experience • Respondents were asked to – • think back to three clients they saw on the day of survey completion • recall information needs that they had experienced during case management

7. MethodsData Analysis • Participant characteristics were summarized using descriptive statistics • Case managers’ information needs were categorized using a coding framework, the Information Needs Event Taxonomy – • previously developed to study the information needs of physicians and nurses • Information needs were categorized by one investigator and reviewed by a second

8. Results • 131 surveys, 94 completed –71.8% response rate • 4 COBRAs – 77.5%4 DACs – 59.5% • The highest response rates (94.1% and 100%) were in agencies in which recruitment was facilitated by a visit of an investigator and research assistant

9. ResultsDemographics • 80% females • 41% Black, 34% White • 44% Case Managers, 17% social workers • 79% use the Internet at least once a day(all per month) • 94% has been using computers more than 2 years

10. Result

11. Result • education resources (33%) • Drug information • Adherence • Substance abuse • patient’s data (23%) • Lab result • Medications • Appointment • Referral resource(22%) • Housing • Public assistance

12. Discussion & Conclusion • Support the applicability of the Information Needs Event Taxonomy in case management domain • Extended Information Needs Event Taxonomy by a new generic question – referral resources • Education resource ranked first and patient data ranked second, in contrast to the study on cardiovascular nurses, present the differences in role

13. Discussion & Conclusion • Information needs clustered into only a few generic questions suggests that a targeted set of resources may meet most needs • This study also contributes methodologically to studies of information needs – • earlier studies: focus group, observations, literature reviews, interviews, questionnaires • The study adds to the literature regarding addressing information needs in community-based settings for HIV services

14. Conclusion • To ensure high quality of care, it is essential to – • characterize case managers’ information needs • design informatics-based solutions to address those needs