Integrating Routine HCV Testing in Primary Care: Lessons Learned from Five Federally Qualified Health Centers in...

Area of Science:

• Hepatology and Infectious Diseases
• Public Health and Epidemiology
• Primary Care Medicine

Background:

• Hepatitis C virus (HCV) is a prevalent blood-borne infection in the US, yet routine testing remains uncommon.
• An estimated 2.7-3.9 million Americans are infected with HCV, highlighting a significant public health concern.
• Addressing this gap is crucial for early detection and management of HCV.

Purpose of the Study:

• To evaluate the impact of integrating routine HCV testing into primary care settings.
• To measure the effectiveness of an opt-out HCV testing and linkage-to-care model.
• To identify successes and barriers in implementing HCV testing in federally qualified health centers.

Main Methods:

• Implementation of a routine opt-out HCV testing and linkage-to-care model in five federally qualified health centers.
• Inclusion of medical assistant-initiated testing and reflex laboratory-based HCV tests.
• Utilized electronic health record modifications to prompt, track, and facilitate reimbursement for uninsured patients.

Main Results:

• 4,207 unique patients were tested for anti-HCV, with an 11.6% positivity rate.
• Of those positive, 7.4% were diagnosed with current HCV infection after confirmatory testing.
• Linkage to care was achieved in 38.7% of patients diagnosed with current infection.

Conclusions:

• The integrated model successfully incorporated HCV testing and linkage to care into routine primary care.
• The study identified key successes and potential barriers for other health centers integrating HCV testing.
• This approach demonstrates a viable strategy for improving HCV case finding and care coordination.