Description de l'événement
Conférencière: Laura Derksen
Invité par : Catherine Michaud-Leclerc
Titre : "Privacy at What Cost? Using Electronic Medical Records to Recover Lapsed Patients into HIV Care" avec Anita McGahan et Leandro Pongeluppe
Résumé: We show that Malawian healthcare staff save lives by tracking down HIV patients lapsed from care -- even against their wishes -- using data made accessible with the implementation of an electronic medical records (EMR) system. HIV patients in Malawi receive antiretroviral therapy (ART), a highly effective treatment that also prevents transmission, for free at clinics. Yet patients frequently lapse from care, resulting in increased community transmission and unnecessary deaths. The introduction of EMR allowed health providers to manage patient information, trace lapsed patients, and encourage lapsed patients to reinitiate treatment. We implement an event study analysis using data from 106 clinics that adopted EMR between 2007 and 2019 and find that the introduction of EMR leads to an immediate increase in the number of patients actively in care and to a decline in patient deaths over time. After five years of implementation, facilities with EMR have approximately 30 percent more patients in care and 35 percent fewer patient deaths than facilities without EMR. These effects are concentrated among patients under 50, and are larger among young children. Effects are also concentrated among patients with a higher preference for privacy. These patients are more likely to lapse from care and require tracing. Robust to additional specifications and supported by interview findings, the results demonstrate that an initial preference for privacy gives way to patient reinstatement in care when the health consequences are critical.