David Alain Wohl, MD, Discusses Strategies to Improve HIV Management

David Alain Wohl, MD, associate professor, division of infectious diseases, University of North Carolina at Chapel Hill, suggests that quality management of HIV has, for the most part, been self-regulated. He says that when it comes to HIV management, there is a lack of feedback or “quality improvement mechanisms” outside the managed care setting.

While many managed care organizations provide metrics for practitioners, Dr Wohl says that feedback varies greatly depending upon a given system. The benefit of HIV management is that providers know exactly which types of guideline-based metrics to employ that work to combat those variations.

“We know what we’re supposed to do. We know that people are supposed to be started on HIV medicine, certainly at certain CD4 cell counts, if not everyone,” Dr Wohl says. “We know about vaccines, we know about cancer screening. There’s a bunch of stuff that we exactly know where the x’s in the box and that we should be doing it, so it lends itself to quality improvement measures.”