Emergency department (ED) screenings alone are not enough to help identify people who have been previously diagnosed with HIV and may need care reengagement, according to study findings presented at IDWeek 2025.
Jacob Manteuffel, MD, of Henry Ford Hospital in Detroit, Michigan, discussed the results of the retrospective cross-sectional study that compared the identification of out-of-care (OOC) patients previously diagnosed with HIV using an electronic health record algorithm (EHRa) versus an ED HIV screening program.
ED screening programs often find patients with HIV who have been OOC rather than newly diagnosed patients, which the authors noted is “a potential missed opportunity—as many more OOC people previously diagnosed with HIV likely go undetected if identification relies solely on repeat testing via screening programs.”
Over 6 months, Dr. Manteuffel and colleagues conducted the study at two EDs (Henry Ford Health and Alameda Health System in Oakland, California) with existing HIV screening programs. An EHRa was developed at each site using historical lab data and keyword-based medical history to identify patients admitted to the ED who were previously diagnosed with HIV. Infectious disease or research staff reviewed the data and classified patients as in care or OOC, and site-level databases maintained by HIV navigators were used to gather HIV screening data.
Patients were a mean age of 47 years, and most were men (69%). A greater number of Black patients made up the study population (73%), followed by Hispanic (14%) and White (11%) patients. Nine percent of patients didn’t speak English.
During the 6-month period, 14,212 ED screenings identified 42 new diagnoses and 136 previous HIV diagnoses. Of the patients who had a prior diagnosis, 84 were IC and 52 were OOC.
Compared with ED HIV screening alone, the EHRa identified all 136 patients detected via ED screening, as well as 121 more OOC patients previously diagnosed with HIV. The algorithm detected a total of 763 people living with HIV—590 IC and 173 OOC.
Re-engaging patients with HIV who have been out of care is critical, and by integrating EHR tools into ED workflows, health care providers can enhance efforts to end the HIV epidemic, the researchers shared.
Reference
White D, Manteuffel J, Burns M, et al. Beyond screening: leveraging electronic health record data to
identify out-of-care people living with HIV in the emergency department. P-264. Presented at: IDWeek 2025, Oct. 19-22, 2025, Atlanta, GA.
