An Electronic Health Record–based Intervention to Promote Hepatitis C Virus Testing Among Adults Born Between 1945 and 1965

Details

• Alternative Title:
  Med Care
• Personal Author:
  Federman, Alex D. ; Kil, Natalie ; Kannry, Joseph ; Andreopolous, Evie ; Toribio, Wilma ; Lyons, Joanne ; Singer, Mark ; Yartel, Anthony ; Smith, Bryce D. ; Rein, David B. ; Krauskopf, Katherine
• Description:
  Background
  
  The Centers for Disease Control and Prevention (CDC) recommends one-time hepatitis C virus (HCV) antibody testing for “Birth Cohort” adults born during 1945–1965.
  
  Objective
  
  To examine the impact of an electronic health record (EHR)-embedded best practice alert (BPA) for HCV testing among Birth Cohort adults.
  
  Design
  
  Cluster-randomized trial was conducted from April 29, 2013 to March 29, 2014.
  
  Subjects and Setting
  
  Ten community and hospital-based primary care practices. Participants were attending physicians and medical residents during 25,620 study-eligible visits.
  
  Intervention
  
  Physicians in all practices received a brief introduction to the CDC testing recommendations. At visits for eligible patients at intervention sites, physicians received a BPA through the EHR to order HCV testing or medical assistants were prompted to post a testing order for the physician. Physicians in control sites did not receive the BPA.
  
  Main Outcomes
  
  HCV testing; the incidence of HCV antibody positive tests was a secondary outcome.
  
  Results
  
  Testing rates were greater among Birth Cohort patients in intervention sites (20.2% vs. 1.8%, P < 0.0001) and the odds of testing were greater in intervention sites after controlling for imbalances of patient and visit characteristics between comparison groups [odds ratio (OR), 9.0; 95% confidence interval, 7.6–10.7). The adjusted OR of identifying HCV antibody positive patients was also greater in intervention sites (OR, 2.1; 95% confidence interval, 1.3–11.2).
  
  Conclusions
  
  An EHR-embedded BPA markedly increased HCV testing among Birth Cohort patients, but the majority of eligible patients did not receive testing indicating a need for more effective methods to promote uptake.
  
  
• Subjects:
  Aged Cluster Analysis Databases, Factual Electronic Health Records Female Health Promotion Hepacivirus Hepatitis C, Chronic Humans Male Mass Screening Middle Aged

  More +
• Source:
  Med Care. 55(6):590-597.
• Pubmed ID:
  28288075
• Pubmed Central ID:
  PMC5759753
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States
• Place as Subject:
  New York City, NY
• Volume:
  55
• Issue:
  6
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:ba0af395bc31efb1f9eaee550dfe9102df678126dab0267ef19111c691ef675d
• Download URL:
  https://stacks.cdc.gov/view/cdc/50775/cdc_50775_DS1.pdf
• File Type:
  [PDF - 251.16 KB ]