Enhancing Anxiety Screening Through EMR Integration in a Family-Focused HIV Care Program: A Quality Improvement Initiative
1
Department of Psychiatry, Bronx Care Health System, New York, United States
2
Family Focused Healthcare for Women (FFHC), Center for Comprehensive Care Clinic, BronxCare Health System, Bronx, New York, United States
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
ABSTRACT:
Anxiety disorders are highly prevalent in primary care settings but often remain underrecognized and undertreated, contributing to significant morbidity and impaired quality of life. Early detection through standardized tools such as the Generalized Anxiety Disorder-7 (GAD-7) enables timely intervention and improved outcomes. The Family-Focused HIV Care (FFHC) Program at the Center for Comprehensive Care Clinic (CCC) provides integrated, co-located medical case management, primary, prenatal, and pediatric care for HIV-positive women, HIV-positive men with dependent children, and their families. To strengthen behavioral health integration within this population, a quality improvement (QI) initiative was developed to standardize anxiety screening among FFHC participants.
METHODS:
A retrospective chart review compared anxiety screening rates across two time periods: January 1–June 30, 2022 (pre-intervention) and July 1–December 31, 2024 (post-intervention). During the pre-intervention phase, completion of the GAD-7 screening tool was performed at the discretion of individual providers. During the post-intervention phase, the GAD-7 was embedded as a mandatory field within the electronic medical record (EMR) for all FFHC patient assessments and reassessments. The primary outcome measure was the proportion of patients completing GAD-7 screening during each period.
RESULTS:
In the pre-intervention period, 46 patient charts were reviewed, of which only 9 (20%) had documented GAD-7 screenings. In the post-intervention period, 30 patient charts were reviewed, and all 30 (100%) completed the GAD-7 assessment, reflecting an 80-percentage-point absolute improvement in screening rates following EMR integration.
CONCLUSIONS:
Mandating the GAD-7 screening tool within the EMR substantially improved anxiety screening rates among HIV-positive adults and families enrolled in the FFHC Program. This initiative highlights how simple, system-level interventions can enhance behavioral health detection and promote integrated, family-centered HIV care. Continued provider training and performance monitoring will support sustained improvement and inform future mental health initiatives.
Anxiety disorders are highly prevalent in primary care settings but often remain underrecognized and undertreated, contributing to significant morbidity and impaired quality of life. Early detection through standardized tools such as the Generalized Anxiety Disorder-7 (GAD-7) enables timely intervention and improved outcomes. The Family-Focused HIV Care (FFHC) Program at the Center for Comprehensive Care Clinic (CCC) provides integrated, co-located medical case management, primary, prenatal, and pediatric care for HIV-positive women, HIV-positive men with dependent children, and their families. To strengthen behavioral health integration within this population, a quality improvement (QI) initiative was developed to standardize anxiety screening among FFHC participants.
METHODS:
A retrospective chart review compared anxiety screening rates across two time periods: January 1–June 30, 2022 (pre-intervention) and July 1–December 31, 2024 (post-intervention). During the pre-intervention phase, completion of the GAD-7 screening tool was performed at the discretion of individual providers. During the post-intervention phase, the GAD-7 was embedded as a mandatory field within the electronic medical record (EMR) for all FFHC patient assessments and reassessments. The primary outcome measure was the proportion of patients completing GAD-7 screening during each period.
RESULTS:
In the pre-intervention period, 46 patient charts were reviewed, of which only 9 (20%) had documented GAD-7 screenings. In the post-intervention period, 30 patient charts were reviewed, and all 30 (100%) completed the GAD-7 assessment, reflecting an 80-percentage-point absolute improvement in screening rates following EMR integration.
CONCLUSIONS:
Mandating the GAD-7 screening tool within the EMR substantially improved anxiety screening rates among HIV-positive adults and families enrolled in the FFHC Program. This initiative highlights how simple, system-level interventions can enhance behavioral health detection and promote integrated, family-centered HIV care. Continued provider training and performance monitoring will support sustained improvement and inform future mental health initiatives.
| eISSN: | 2654-1459 |
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