Population-Level Hepatitis C Testing Using A Personal Electronic Health Portal System Significantly Improves Screening Rates in Baby Boomers

BACKGROUND: Hepatitis C virus (HCV) infection is a major public health burden. The USPSTF and CDC have both released guidelines which recommend screening the baby boomer population (individuals born between 1945 and 1965) given the overrepresentation of HCV infection in this cohort. However, screening rates remain low despite prior attempts at improvement. OBJECTIVE: To improve HCV testing rate in the birth cohort in compliance with national guidelines without increasing primary care provider workload or alert fatigue. METHODS: We developed a population health initiative that employed EHR-based tools involving direct patient messaging and bulk lab test ordering via a personal electronic health portal system. This was completed independent of a face-to-face interaction between the patient and provider. RESULTS: We collected data on 1,024 patients total (514 in the intervention group and 510 in the control group) over a 12-week period. We found a statistically significant higher test completion rate within the intervention group vs. the control group after this initiative was launched: 33.7% in the intervention group (173/514) vs. 19.0% in the control group (97/510) (p-value <0.0002, OR 2.16, 95% CI 1.62–2.88). Bulk lab ordering appeared to have a large impact while bulk messaging appeared to have a less significant role. CONCLUSION: To our knowledge, this is the first EHR-based population health initiative to involve obtaining blood work without a direct face-to-face encounter between the provider and patient. This methodology has a broad range of applications including any recommended screening or disease-specific testing, and it will be essential for health systems to adopt similar protocols as we progress toward a pay-for-performance reimbursement model. DISCLOSURES: All authors: No reported disclosures.