Despite effective treatment for chronic hepatitis C, deficiencies in diagnosis and access to care preclude disease elimination. Screening of baby boomers remains low.
Dr Monica Konerman and colleagues from Michigan, USA assessed the impact of an electronic health record–based prompt on hepatitis C virus (HCV) screening rates in baby boomers in primary care and access to specialty care and treatment among those newly diagnosed.
The research team implemented an electronic health record–based “best practice advisory” that prompted primary care providers to perform HCV screening for patients seen in primary care clinic born between 1945 and 1965, who lacked a prior diagnosis of HCV infection, and who lacked prior documented anti-HCV testing.
The best practice advisory had associated educational materials, order set, and streamlined access to specialty care for newly diagnosed patients.
|HCV screening increased from 7% for patients with a primary care provider visit |
Pre-best practice advisory and post-best practice advisory screening rates were compared, and care of newly diagnosed patients was analyzed.
In the 3 years prior to best practice advisory implementation, 52,660 baby boomers were seen in primary care clinics and 28% were screened.
The researchers found that HCV screening increased from 7% for patients with a primary care provider visit in the 6 months prior to best practice advisory to 72% over the 1 year post-best practice advisory.
Of 53 newly diagnosed patients, all were referred for specialty care, 11 had advanced fibrosis or cirrhosis, 20 started treatment, and 9 achieved sustained virologic response thus far.
Dr Konerman's team concludes, "Implementation of an electronic health record–based prompt increased HCV screening rates among baby boomers in primary care by 5-fold due to efficiency in determining needs for HCV screening and workflow design."
"Streamlined access to specialty care enabled patients with previously undiagnosed advanced disease to be cured."
"This intervention can be easily integrated into electronic health record systems to increase HCV diagnosis and linkage to care."