Racing for results: lessons learnt in improving the efficiency of HIV viral load and early infant diagnosis result delivery from laboratory to clinic

ABSTRACT

Introduction: In pursuit of the 90–90–90 goals, emphasis has been placed on accelerating centralized-laboratory HIV viral load testing of a population that is largely rural and decentralized. Successful outcome requires effective specimen transport, laboratory testing, and results delivery. This paper focuses on the methods currently employed for results delivery. New innovations in this area are yielding mixed results; we analyze different approaches and estimate the impact of each on achieving the third ‘90.’

Areas covered: Strategies employing electronic or mobile health platforms, such as online portals, SMS, and SMS printers are showing potential to deliver results in significantly improved turnaround times but are not without challenges. Also, merely delivering a result to the clinic is not sufficient; results need to be actioned to ensure improved patient linkage and retention. Innovative solutions that not only support real-time reporting but monitor receipt of results and address infrastructure constraints faced by limited-resource settings are discussed.

Expert commentary: There is tremendous opportunity to inform better patient care and directly contribute to ‘90–90–90ʹ progress by developing digital systems for result delivery. Besides infrastructure and technical challenges, systems should address the entire cascade of care from initial diagnosis to monitoring treatment response.

KEYWORDS:

• Digital reporting
• early infant diagnosis
• eHealth
• HIV
• laboratory
• mHealth
• result delivery

Declaration of interest

N Gous, J Takle and A Oppenheimer are employees of SystemOne LLC, a connected diagnostics company currently operating in the industry and a developer of a digital reporting solution. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

Part of the work presented in this paper was funded through USAID (Grant #: AID-OAA-A-15-00070).