1035 Hepatitis C Virus Screening Practices by Medical Residents in a Federally-Qualified Health Center

Abstract

INTRODUCTION: Hepatitis C virus (HCV) is the most common chronic blood-borne pathogen in the United States. Treatment for HCV infection is currently available, curative, and with few associated side effects, increasing the importance of identifying HCV-infected individuals. HCV screening guidelines recommend a 1-time screening for baby boomers (individuals born between 1945 and 1965). Baby boomers have a higher risk for HCV-related morbidity and mortality. As of 2015, less than 13% of this population has undergone screening for HCV infection. This study aims at quantifying the baseline screening rates amongst baby boomers in a medical residents’ community clinic and evaluating the impact of resident-targeted interventions on HCV screening rates. METHODS: A retrospective chart review of baby boomers seen by medical residents between 7/1/17 and 12/31/18 was performed. Patients had to be seen at least once for a physical exam by the medical resident during the study period, and not screened for HCV infection previously. Baseline screening rates were recorded. Interventions were implemented for a period of 4 months. These included an updated electronic medical record (EMR) reminder for screening based on birth year, an EMR HCV risk assessment tool to identify patients need testing before visit, a link to HCV screening indications and guidelines, and small group teaching sessions about testing and linking patients to appropriate posttest care. A second phase of data collection included a chart review of baby boomers seen between 2/1/19 and 5/31/19 and meeting same criteria. A paired comparison t-test is used to analyze results. RESULTS: This investigation includes 502 patients in the first phase and 164 patients in the second phase of data collection. Pre-intervention screening rate was 89/502 (17.7%) compared with 72/164 (43.9%) post-intervention (P value < 0.0001). CONCLUSION: This investigation shows the suboptimal baseline HCV screening rate in baby boomers in a residents’ community clinic. Our post-intervention findings highlight the impact of focused resident-targeted education and the effectiveness of integrating appropriate tools into clinic infrastructure to help improve the rate of screening. Subsequently, this can help identify individuals who are in need for medical attention, potentially reducing complications of HCV infection and providing good value for our health care dollar overall.