to your health

This Widget Will Decide If You’re Elligible for HIV PrEp Drugs. Bad Idea?


Doctors hate because it lets patients grill them about medical decisions the average person might otherwise have no clue about. But now that Microsoft is trying to digitize medical records, the future of the industry will live on a computer. Which explains why hospital emergency rooms will begin turning to a freakin’ computer widget to find out whether patients are eligible for PrEp drugs to fight a possible HIV infection.

Indeed, possible life-and-death decisions will now be made by a web tool initially created to deliver local weather info and stock quotes. Today across New York State, emergency rooms will begin using a widget-based computer guideline system to see whether patients should begin a PrEp (or post-exposure prophylactic, sometimes called PEP) regimen, useful if you accidentally have unprotected sex. Doctors will go through the widget’s screening questions to see if a patient should get the drugs.

The guidelines come in the form of a computer application, or widget, developed by a team of doctors from St. Vincent’s Hospital in Manhattan with financing from the state’s AIDS Institute. They are to be given to more than 200 emergency departments this week and distributed more widely over time.

The doctors who developed the widget call it a “one-stop shopping” approach to PEP, or post-exposure prophylactic treatment. It walks users through a screening process to determine whether they are candidates for treatment, provides specific information about the 28-day course of antiretroviral drugs, and even links to consent forms in 22 languages, including Creole, Laotian and Yoruba.

The widget is continually updated with the latest medical recommendations, and the home page includes a counter that keeps track of the number of new H.I.V. infections in the state.

For all our sarcasm, we’re actually excited about this thing. These days, health care is about technological tools as much as it is about skilled doctors. (Okay, one cannot exist without the other.) So long as the PrEp widget permits overrides by doctors on a case-by-case basis (some docs may disagree with the guidelines, and should be free to provide the meds if they want), let’s roll this thing out en masse.

Then again, rigid screenings from the widget could, theoretically, be used to dictate who needs PrEp drugs bad enough for them to be covered by Medicare and Medicaid. That is: If a patient doesn’t qualify for the drugs because they were not an ideal candidate as determined by a computer program, the government (or a health insurance company) could use the conclusion as a reason not to cover the Rx. And that, friends, is bad.