A Targeted Congenital Cytomegalovirus Screening Model Using a Customized Electronic Medical Record Dashboard Report

Targeted congenital Cytomegalovirus (cCMV) screening in newborns has been proposed to identify neonates who could benefit from early diagnosis and intervention. Oftentimes, implementation of targeted screening is variable and left to the discretion of individual institutions. This study investigates the utility of a centralized electronic medical record (EMR) dashboard to improve compliance of targeted screening in the inpatient setting.

Single center prospective feasibility study SETTING: Tertiary medical center METHODS: A targeted cCMV screening dashboard report was generated weekly using an EMR system. The dashboard screened all births in a large multi-site medical center for failed neonatal hearing screens and specific high-risk diagnoses associated with cCMV. Eligible patients requiring further hearing screening or cCMV testing were communicated to inpatient units. Log-binomial regression analyses were utilized to assess provider-led cCMV screening performance after the introduction of weekly reports.

From July 1, 2021, to December 31, 2022, 5,866 newborns were screened by the dashboard. Nine-hundred and eighteen newborns (15.6%) were eligible for testing. Nearly 75% (n = 687) of newborns were tested by inpatient teams prior to report generation. The remaining 25% (n = 231) of eligible newborns were identified by the report but not yet tested by inpatient teams, and subsequently tested. Three of the newborns tested positive for CMV. The rate of eligible newborns appropriately identified by the inpatient teams increased over time (log-binomial regression coefficient 0.0215, P < .01).

An EMR dashboard to guide targeted cCMV screening can improve testing compliance. This model is promising for large-scale cCMV screening.