scholarly journals Development and Validation of an Electronic Medical Record–Based Algorithm to Identify Patient Milestones in the Hepatitis C Virus Care Cascade

2018 ◽  
Vol 5 (7) ◽  
Author(s):  
Jason Zucker ◽  
Justin G Aaron ◽  
Daniel J Feller ◽  
Jacek Slowikowski ◽  
Henry Evans ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Medical Record ◽  
Electronic Medical Record ◽  
High Accuracy ◽  
Care Cascade ◽  
Using Data ◽  
Specific Care ◽  
Development And Validation ◽  
Disease Specific

Abstract Disease-specific care cascades are important public health and organizational tools to characterize gaps in care and target resources, but they are labor-intensive to maintain. Using data available from the electronic medical record, we developed an algorithm with high accuracy for correctly representing an individual’s status in the hepatitis C virus care cascade.

scholarly journals Electronic medical record‐verified hepatitis C virus screening in a large health system

2019 ◽  
Vol 8 (10) ◽  
pp. 4555-4564 ◽  
Author(s):  
Monica L. Kasting ◽  
Anna R. Giuliano ◽  
Richard R. Reich ◽  
Linh M. Duong ◽  
Julie Rathwell ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Health System ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Virus Screening

scholarly journals Using the electronic medical record to increase testing for HIV and hepatitis C virus in an Appalachian emergency department

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Carmen N. Burrell ◽  
Melinda J. Sharon ◽  
Stephen Davis ◽  
Judith Feinberg ◽  
Elena M. Wojcik ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Best Practice ◽  
Linkage To Care ◽  
Patient Navigators ◽  
Hcv Screening ◽  
Hcv Testing

Abstract Background The ongoing Appalachian opioid epidemic has led to increasing hepatitis C virus (HCV) infections among people who inject drugs (PWID), and Human Immunodeficiency Virus (HIV) outbreaks have been observed. The primary aim of this study was to assess the potential increase in screening for HIV and HCV in an academic central Appalachian emergency department (ED) through the use of Best Practice Alerts (BPAs) in the electronic medical record (EMR). A secondary aim was to assess for an increase in linkage to care using patient navigators. Methods EMR algorithms based on current Centers for Disease Control and Prevention HIV and HCV testing recommendations were created that triggered Best Practice Alerts (BPAs), giving providers a one-click acceptance option to order HIV and/or HCV testing. Placards were placed in care areas, informing patients of the availability of routine screening. Patient navigators facilitated linkage to care for seropositive patients. Results The BPA appeared 58,936 times on 21,098 patients eligible for HIV screening and 24,319 times on 11,989 patients eligible for HCV screening over a one-year period. Of those, 7106 (33.7%) patients were screened for HIV and 3496 (29.2%) patients were screened for HCV, for an overall testing increase of 2269% and 1065% for HIV and HCV, respectively. Linkage to care increased by 15% for HIV to 100, and 14% for HCV to 64%. Conclusion HIV and HCV screening and linkage to care were increased in an academic ED setting in central Appalachia using EMR alerts. This approach could be utilized in multiple ambulatory settings. Increased testing and earlier linkage to care may help combat the current injection drug use-related HCV epidemic and avoid additional HIV outbreaks.

scholarly journals Using the Electronic Medical Record to Increase Testing for HIV and Hepatitis C Virus in An Appalachian Emergency Department

2020 ◽  
Author(s):  
Carmen Burrell ◽  
Melinda J. Sharon ◽  
Stephen Davis ◽  
Judith Feinburg ◽  
Elena M. Wojcik ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Linkage To Care ◽  
Primary Objective ◽  
Patient Navigators ◽  
Hcv Screening ◽  
Hcv Testing

Abstract Background: The ongoing Appalachian opioid epidemic has led to increasing hepatitis C virus (HCV) infections among people who inject drugs (PWID), and Human Immunodeficiency Virus (HIV) outbreaks have been observed. The primary objective of this study was to use the electronic medical record (EMR) to increase HIV and HCV testing in a central Appalachian academic emergency department. A secondary objective was to increase linkage to care using patient navigators. Methods: EMR algorithms based on current Centers for Disease Control and Prevention HIV and HCV testing recommendations were created that triggered Best Practice Alerts (BPAs), giving providers a one-click acceptance option to order HIV and/or HCV testing. Placards were placed in care areas, informing patients of the availability of routine screening. Patient navigators facilitated linkage to care for seropositive patients. Results: The BPA appeared 58,936 times on 21,098 patients eligible for HIV screening and 24,319 times on 11,989 patients eligible for HCV screening over a one-year period. Of those, 7,106 (33.7%) patients were screened for HIV and 3,496 (29.2%) patients were screened for HCV, for an overall testing increase of 2,269% and 1,065% for HIV and HCV, respectively. Linkage to care increased by 15% for HIV to 100%, and 14% for HCV to 64%. Conclusion: HIV and HCV screening and linkage to care were increased in an academic ED setting in central Appalachia using EMR alerts. This approach could be utilized in multiple ambulatory settings. Increased testing and earlier linkage to care may help combat the current injection drug use-related HCV epidemic and avoid additional HIV outbreaks

scholarly journals 1065. Hepatitis C Virus Care Cascade Assessment–One Step Closer to Micro-Elimination

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S561-S562
Author(s):  
Jehan F Chowdhury ◽  
Anna Winston ◽  
Tanya Zeina ◽  
Hong Gi Shim ◽  
Tine Vindenes
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Drug Use ◽  
Sustained Viral Response ◽  
The United States ◽  
World Health ◽  
Viral Response ◽  
Care Cascade ◽  
Care Gaps ◽  
Hcv Antibody

Abstract Background Hepatitis C virus (HCV) is a leading cause of advanced liver disease and death. In the United States about 3.5 million people are living with HCV, but only 50% are aware of the infection, 16% are prescribed treatment, and only 9% achieve sustained viral response. The World Health Organization published an HCV elimination goal for 2030 that strives to achieve a 65% reduction in HCV-related deaths and 90% reduction in transmission. An important step toward this goal is micro-elimination at local hospitals by addressing care gaps in the HCV care cascade. Figure 1 Methods We created a retrospective cohort of patients who tested positive for HCV antibody (HCV Ab+) between 2016 and 2018 at Tufts Medical Center in Boston, Massachusetts. We assessed achievement of care cascade steps including HCV viral load (VL) testing, linkage to care, treatment initiation, and sustained viral response (SVR). We also assessed patient demographics, clinical factors and HCV risk factors. We used STATA/IC 14.1 to conduct bivariate analysis to identify factors associated with loss to follow-up across each care cascade step. Results A total of 24,308 HCV antibody tests were done during this timeframe, of which 5% (n=1,222) were HCV Ab+. After excluding duplicate tests, 1,041 unique patients with HCV Ab+ were included. This cohort had a mean age of 47 years and were 61% male, 66% white, 72% on public insurance, 12% HIV-positive, 13% HCV treatment-experienced. The most frequent HCV risk factor was injection drug use, occurring in 64% of patients. Of patients with HCV Ab+, 76% (n=791) were tested for an HCV VL, of which 50% (n=393) had detectable VL and 50% (n=398) had undetectable VL. Of the patients with a detectable VL, 58% (n=226) were linked with care. Following care linkage, 69% (n=155) initiated treatment, of which 90% (n=139) completed treatment, of which 97% (n=135) achieved SVR (Figure 1). Factors that were significantly associated with getting a VL test and linking to care included private insurance, HIV co-infection, absence of intravenous drug use and cirrhosis; however, these factors were not significantly associated with achieving subsequent steps. Conclusion Assessment of the HCV care cascade at our hospital allowed us to identify clear care gaps and areas needing improvement towards a local micro-elimination. Disclosures All Authors: No reported disclosures

Sign in / Sign up

Export Citation Format

Share Document