Background:  The delivery of high-quality primary care to HIV-infected patients has been difficult owing to the inherent psychosocial challenges of the population and the complexities of the overall care plan that make compliance with continuous quality improvement (CQI) parameters difficult.

Methods:  We introduced a computerized data system for the management of HIV-infected patients (QuickData) in 1997 and have expanded it to include fields for all aspects of HIV and adult primary care. The program is fully integrated into patient care with real-time succinct data availability in summary form that prompts providers to adhere to a strict practice protocol and facilitates data entry at the point of care. QuickData is programmed to generate quarterly CQI reports for 11 CQI parameters and 1 outcome measure. We report on our results for calendar year 2006 in comparison with published results from the EQUIV Study for 5 CQI parameters and 1 outcome measure. We did statistical comparisons for the 4 CQI parameters for which we had adequate data from EQUIV using chi-square, SAS 9.1.

Results: A total of 1170 patients were cumulatively entered into QuickData as of December 31, 2006. An average of 141.25 patients were evaluated quarterly over 4 calendar quarters representing 20% of active patients per quarter totaling 565 patients. n comparison with the EQUIV Intervention Clinic group totaling 3216 patients, we achieved significantly better results for influenza vaccination (80.9% vs 59.5%, p<0.001), tuberculin skin testing (88.0% vs 52.3%, p <0.0001), and hepatitis C serology testing (98.6% vs 90.0%, p <0.0001) while results for completed Pap smears were not statistically different (70.4% vs 65%, p = 0.28). Our results for appropriate use of antiretroviral therapy (94.1% vs 80.5%) and viral load <400 (76.7% vs 51.7%) could not be compared statistically due to the lack of specific EQUIV data.

Conclusions:  Our method of using a computerized data system with real-time data availability and facilitated data entry at the point of care and automated generation of quality reports has resulted in the delivery of measurably high quality care when compared to the largest published trial to report on quality care measures for HIV-infected patients. We believe our techniques and our software tool represent a significant improvement in care delivery of this population and can serve as a model for the development of a standardized approach to HIV care that can be widely adopted.