Table 2 Additional patient and provider quotes on TAPS/AOQ screening

Perceived clinical benefits

“It’s definitely helpful for me, because I [received] that data before I even saw the patient. So then I can really focus on…the behavior…the treatment plan, and discussing the next steps….”

“I know it's part of them providing holistic care around everything about my health, including HIV, so I'm glad they ask the questions. I hope more doctors do that with their patients 'cause I know that doctors are rushed and they just have to get through things sometimes”

“It’s helped making our practices more consistent, because sometimes patients don’t present as if they have mental health issues or substance use issues. So routinizing the questions and applying them equally to all patients is helpful”

Value of multiple modes of administration

“I think having both modes of collection was helpful, because it captured from different patient populations…as much as it was possible to do things before the visit, I think that was very helpful for workflow”

Patient–provider relationship

“I had a few patients who reacted pretty negatively … it certainly was somewhat of a limitation in a subset of patients who…were put off by the nature of the questions particularly around substance abuse. After I had a conversation with them about it, things were always fine, but…that conversation could’ve maybe happened ahead of time to alert patients that things like this were coming and why”

“[I'm] still an old-school guy. I’m way more apt to speak in person than doing something online, pretty much across the board”

Barriers to completion

“[A patient] raised the concern about documentation of substance use in this way in their chart and it affecting their disability and benefits in a negative way. They were worried that disclosing substance use would cause a private disability insurance to kick them off”

“I had a little bit of hesitancy, which I have almost every time I do one of those [AOQ] questionnaires… Sometimes you feel like if you answer it, they’ll lock you up or there will be some big response to it. So, you think twice about it when you answer it”

“Some of our patients tend to be far more protective of their confidentiality than patients who are HIV-negative or who are not used to the stigma that’s associated with HIV. And so a lot of them are not active on [the patient portal] or are very nervous about their medical information leaking”

“The main reason why privacy is a concern is because everything that you do…it’s bound by HIPAA, but you never know if it could get in the wrong hands or like if the nurse that knows you can access that information or something like that”