Electronic Medical Alerts Increase Screening for Chronic Hepatitis B: A Randomized, Double-Blind, Controlled Trial

Details

• Alternative Title:
  Cancer Epidemiol Biomarkers Prev
• Personal Author:
  Chak, Eric ; Taefi, Amir ; Li, Chin-Shang ; Chen, Moon S. ; Harris, Aaron M. ; MacDonald, Scott ; Bowlus, Christopher
• Description:
  Background:
  
  Implementation of screening recommendations for chronic hepatitis B (CHB) among foreign-born persons at risk has been sub-optimal. The use of alerts and reminders in the electronic health record (EHR) has led to increased screening for other common conditions. The aim of our study was to measure the effectiveness of an EHR alert on the implementation of hepatitis B surface antigen (HBsAg) screening of foreign-born Asian and Pacific Islander (API) patients.
  
  Methods:
  
  We used a novel technique to identify API patients by self-identified ethnicity, surname, country of origin, and language preference, and who had no record of CHB screening with HBsAg within the EHR. Patients with Medicare and/or Medicaid insurance were excluded due to lack of coverage for routine HBsAg screening at the time of this study. At-risk API patients were randomized to alert activation in their EHR or not (control).
  
  Results:
  
  A total of 2,987 patients met inclusion criteria and were randomized to the alert (n = 1,484) or control group (n = 1,503). In the alert group, 119 patients were tested for HBsAg, compared to 48 in the control group (odds ratio [OR] = 2.64 [95% CI = 1.88–3.73]; P< .001). In the alert group, 4 of 119 (3.4%) tested HBsAg-positive compared to 5 of 48 (10.4%) in the control group (P = .12).
  
  Conclusions:
  
  An EHR alert significantly increased HBsAg testing among foreign-born APIs.
  
  Impact:
  
  Utilization of EHR alerts has the potential to improve implementation of hepatitis B screening guidelines.
  
  
• Subjects:
  Asian Double-Blind Method Electronic Health Record Electronic Health Records Female Hepatitis B Hepatitis B, Chronic Humans Male Mass Screening Preventative Care

  More +
• Source:
  Cancer Epidemiol Biomarkers Prev. 27(11):1352-1357
• Pubmed ID:
  30089680
• Pubmed Central ID:
  PMC6214733
• Document Type:
  Journal Article
• Funding:
  U51 PS004633/PS/NCHHSTP CDC HHS/United States ; UL1 TR001860/TR/NCATS NIH HHS/United States
• Volume:
  27
• Issue:
  11
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:ec0c48083cf0e6a8e693659c89f5ccff4645e5beef439e4de9ba7c4f35cf427e
• Download URL:
  https://stacks.cdc.gov/view/cdc/60319/cdc_60319_DS1.pdf
• File Type:
  [PDF - 193.74 KB ]