Since 2004, the Highland Hospital Emergency Department (ED) has been committed to providing universal, rapid HIV screening to all patients. The program expanded its public health reach in 2014, with the addition of Hepatitis C Virus (HCV) screening. In 2019, this highly successful program expanded across all Alameda Health System campuses, including the EDs at Highland, San Leandro, and Alameda Hospitals. Integrated into the system-wide electronic health record, this program is the largest provider of blood-based viral screening in Alameda County and diagnoses more patients with new HIV and HCV infection than any other health care venue.
The HIV and HCV screening program is led by Douglas White, MD, a Highland Emergency Physician, Assistant Residency Director, and a Levitt Center Senior Scientist, who is an international authority on ED-based screening and linkage to care. Dr. White’s research and clinical care interests are centered on advancing the diagnosis of HIV and HCV infection through integrated and streamlined ED-based testing. He has pioneered a model of opt-out screening utilizing the electronic health record to automatically link screening to standard blood orders, a model being rapidly adopted by EDs both nationally and internationally. His team of linkage professionals work to ensure all ED patients with HIV and HCV infection are engaged in care and receive treatment.
The screening program has received grant support from a variety of funders, including the Centers for Disease Control and Prevention, California State Office of AIDS, Gilead Sciences, and the National Institutes of Health. This work has resulted in over 50 abstract presentations at national meetings and 30 peer-reviewed publications. Current research projects include a pilot program evaluating the role of pre-exposure prophylaxis (PrEP) for ED patients at risk of acquiring HIV; a multi-centered collaboration to further investigate rapid test diagnostics in the ED setting; capacity building projects to improve linkage to care for newly-diagnosed HIV positive patients in San Francisco and Oakland; and participation in a National Institutes of Health clinical trial evaluating HCV screening outcomes.