The Use of Mobile Technology in Linkage and Retention in HIV Care

Introduction

The Positive Pathways Project (PP) is an evidenced-based intervention by Washington AIDS Partnership, administered by the Institute for Public Health Innovation (IPHi). Positive Pathways utilizes Community Health Workers (CHWs) to help link and retain People living with HIV/AIDS in HIV medical care. Oftentimes it is necessary for CHWs to collect data for assessments for the project in the community. In order to ensure that secure and real-time data is being collected by the often-mobile CHW, the Institute for Public Health Innovation (IPHi) utilizes the iForm Builder mobile platform on iPod Touch handheld devices. iForm Builder provides flexible form building, maximum security with data encryption and “Cloud” technology, instant data updates, and offline data collection capability.

Methods

Prior to implementing mobile technology the paper assessment tools were converted into forms in Form Builder. Each CHW has iForm ES application downloaded on their iPod touch device and the assessment forms are dispatched to the device in real time. The CHW is now able to capture data on enrolled clients such as: HIV viral load, CD4 count, medical visits, stigma, barriers to linkage and retention in care. CHWs collect data from clients, and enter that information via iForm ES application that contains all assessment forms connected with the project.  Once the data is submitted, the completed form is emailed directly to the evaluation team. A team member checks the form for quality, and contacts the CHWs with questions or corrections within 48 hours of submission. The data is stored on a secure, password-protected, and encrypted server, which can be accessed only by the 4-member evaluation team.

Results

IPHi’s 18 CHWs across the District of Columbia and Northern Virginia simultaneously engage and support over 300 clients, and collect vital client data in a confidential and HIPAA-compliant manner using iPod touch’s. This mobile technology has allowed for greater efficiency, the elimination of paper forms and faster access to data by the evaluation team.  In regards to evaluation, IPHi has the ability to quantify the effectiveness of CHWs in linkage and retention in HIV care.

Conclusion

The iForm Builder application on handheld devices such an iPod Touch is a promising technology for projects that utilize a mobile workforce. This technology is highly recommended for peer-based public health strategies in order to show programmatic and cost effectiveness.