Sustained and cumulative impact of an electronic medical record-based alert on a hepatitis C birth cohort screening...

Area of Science:

• Public Health
• Health Informatics
• Infectious Disease Screening

Background:

• Hepatitis C Virus (HCV) screening in primary care is crucial for early detection and treatment.
• Physician testing patterns for HCV often exhibit a power-law distribution, with a few physicians conducting most tests.
• Implementing targeted interventions is necessary to improve population-wide screening rates.

Purpose of the Study:

• To evaluate the impact of an electronic medical record-embedded best practice alert (BPA) on HCV age cohort screening.
• To assess changes in HCV testing behavior among primary care physicians following BPA implementation.
• To determine the effectiveness of a BPA in achieving comprehensive HCV screening within a defined population.

Main Methods:

• A quasi-experimental study design was employed, monitoring HCV testing before and after BPA implementation.
• Data were collected over four 9-month intervals, including a pre-BPA baseline and three post-BPA periods.
• Physician-level HCV test order data were analyzed for distribution patterns and changes in screening rates.

Main Results:

• HCV testing order patterns followed a power-law distribution, indicating physician-specific screening behaviors.
• The introduction of the BPA led to a significant increase in HCV testing rates.
• Screening of 56.8% of the target age cohort was achieved within three years post-BPA implementation.

Conclusions:

• Physician-driven HCV screening in primary care is characterized by a power-law distribution.
• A simple BPA integrated into electronic medical records is an effective tool for enhancing HCV screening.
• The BPA facilitated rapid and widespread HCV age cohort screening, demonstrating its public health utility.