A Best Practice Alert for Identifying Hepatitis B-Infected Patients

Area of Science:

• Public Health
• Infectious Diseases
• Health Informatics

Background:

• Hepatitis B virus (HBV) infection screening is crucial for at-risk populations.
• Primary care providers often face challenges adhering to evidence-based screening guidelines.
• Non-U.S.-born individuals from high-prevalence regions require targeted HBV screening.

Purpose of the Study:

• To evaluate the effectiveness of the Global Health Wizard Hepatitis B Best Practice Alert (BPA).
• To assess the BPA's impact on primary care provider adherence to HBV screening guidelines.
• To identify previously unrecognized cases of HBV infection in eligible patient populations.

Main Methods:

• A pilot study was conducted across nine primary care clinics.
• The BPA was implemented to identify eligible patients (≥12 years, high-risk origin, no prior screening).
• Data collection occurred between July 2012 and March 2013, with follow-up through 2019.

Main Results:

• The BPA triggered for over 4,500 patients, identifying six new HBV infections during the pilot.
• The system was expanded, leading to the identification of an additional 29 HBV-infected patients.
• BPA demonstrated effectiveness in identifying HBV infections, but usage declined over time.

Conclusions:

• The Hepatitis B Best Practice Alert is an effective tool for increasing HBV screening in primary care.
• Sustained usage of clinical decision support tools is essential for maximizing public health benefits.
• Strategies to maintain and encourage consistent BPA utilization are needed to improve population-level HBV screening outcomes.