TY  - BOOK
AU  - Basch, Peter
AU  - Fernandez, Stephen
AU  - Fishbein, Dawn
AU  - Fong, Allan
AU  - Gundapaneni, Sravya
AU  - Huang, Sean
AU  - Hughes, Justin
AU  - Sanghavi, Kavya
TI  - HCV universal EHR prompt successfully increases screening, highlights potential disparities
SN  - 1932-6203
PY  - 2023///
KW  - *COVID-19
KW  - *Hepatitis C
KW  - *Liver Neoplasms
KW  - Aged
KW  - Electronic Health Records
KW  - Hepacivirus
KW  - Hepatitis C/di [Diagnosis]
KW  - Hepatitis C/ep [Epidemiology]
KW  - Humans
KW  - Medicare
KW  - United States/ep [Epidemiology]
KW  - MedStar Health Research Institute
KW  - MedStar Institute for Innovation
KW  - MedStar Washington Hospital Center
KW  - Medicine/Infectious Diseases
KW  - National Center for Human Factors in Healthcare
KW  - Journal Article
N1  - Available online through MWHC library: 2006 - present
N2  - BACKGROUND & OBJECTIVES: Screening for hepatitis C virus is the first critical decision point for preventing morbidity and mortality from HCV cirrhosis and hepatocellular carcinoma and will ultimately contribute to global elimination of a curable disease. This study aims to portray the changes over time in HCV screening rates and the screened population characteristics following the 2020 implementation of an electronic health record (EHR) alert for universal screening in the outpatient setting in a large healthcare system in the US mid-Atlantic region; CONCLUSIONS: Implementation of universal EHR alerts could prove to be a critical next step in HCV elimination. Those with Medicare and Medicaid insurance were not screened proportionately to the national prevalence of HCV in these populations. Our findings support increased screening and re-testing efforts for those at high risk of HCV. Copyright: © 2023 Hack et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited; METHODS: Data was abstracted from the EHR on all outpatients from 1/1/2017 through 10/31/2021, including individual demographics and their HCV antibody (Ab) screening dates. For a limited period centered on the implementation of the HCV alert, mixed effects multivariable regression analyses were performed to compare the timeline and characteristics of those screened and un-screened. The final models included socio-demographic covariates of interest, time period (pre/post) and an interaction term between time period and sex. We also examined a model with time as a monthly variable to look at the potential impact of COVID-19 on screening for HCV; RESULTS: Absolute number of screens and screening rate increased by 103% and 62%, respectively, after adopting the universal EHR alert. Patients with Medicaid were more likely to be screened than private insurance (ORadj 1.10, 95% CI: 1.05, 1.15), while those with Medicare were less likely (ORadj 0.62, 95% CI: 0.62, 0.65); and Black (ORadj 1.59, 95% CI: 1.53, 1.64) race more than White
UR  - https://dx.doi.org/10.1371/journal.pone.0279972
ER  -