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HCV universal EHR prompt successfully increases screening, highlights potential disparities
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 o...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9980726/ https://www.ncbi.nlm.nih.gov/pubmed/36862699 http://dx.doi.org/10.1371/journal.pone.0279972 |
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author | Hack, Benjamin Sanghavi, Kavya Gundapaneni, Sravya Fernandez, Stephen Hughes, Justin Huang, Sean Basch, Peter Fong, Allan Fishbein, Dawn |
author_facet | Hack, Benjamin Sanghavi, Kavya Gundapaneni, Sravya Fernandez, Stephen Hughes, Justin Huang, Sean Basch, Peter Fong, Allan Fishbein, Dawn |
author_sort | Hack, Benjamin |
collection | PubMed |
description | 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. 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 (OR(adj) 1.10, 95% CI: 1.05, 1.15), while those with Medicare were less likely (OR(adj) 0.62, 95% CI: 0.62, 0.65); and Black (OR(adj) 1.59, 95% CI: 1.53, 1.64) race more than White. 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. |
format | Online Article Text |
id | pubmed-9980726 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-99807262023-03-03 HCV universal EHR prompt successfully increases screening, highlights potential disparities Hack, Benjamin Sanghavi, Kavya Gundapaneni, Sravya Fernandez, Stephen Hughes, Justin Huang, Sean Basch, Peter Fong, Allan Fishbein, Dawn PLoS One Research Article 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. 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 (OR(adj) 1.10, 95% CI: 1.05, 1.15), while those with Medicare were less likely (OR(adj) 0.62, 95% CI: 0.62, 0.65); and Black (OR(adj) 1.59, 95% CI: 1.53, 1.64) race more than White. 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. Public Library of Science 2023-03-02 /pmc/articles/PMC9980726/ /pubmed/36862699 http://dx.doi.org/10.1371/journal.pone.0279972 Text en © 2023 Hack et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Hack, Benjamin Sanghavi, Kavya Gundapaneni, Sravya Fernandez, Stephen Hughes, Justin Huang, Sean Basch, Peter Fong, Allan Fishbein, Dawn HCV universal EHR prompt successfully increases screening, highlights potential disparities |
title | HCV universal EHR prompt successfully increases screening, highlights potential disparities |
title_full | HCV universal EHR prompt successfully increases screening, highlights potential disparities |
title_fullStr | HCV universal EHR prompt successfully increases screening, highlights potential disparities |
title_full_unstemmed | HCV universal EHR prompt successfully increases screening, highlights potential disparities |
title_short | HCV universal EHR prompt successfully increases screening, highlights potential disparities |
title_sort | hcv universal ehr prompt successfully increases screening, highlights potential disparities |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9980726/ https://www.ncbi.nlm.nih.gov/pubmed/36862699 http://dx.doi.org/10.1371/journal.pone.0279972 |
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