Hepatitis C is the most common blood-borne infection, but roughly 75% of people infected don’t have symptoms and might not realize they have the virus. In the United States, worse health outcomes associated with hepatitis C are higher for American Indian/Alaska Native people, Black people, and Hispanic people than for white people according to the Centers for Disease Control and Prevention. Early detection of hepatitis C can help minimize these disparities by linking patients to treatment sooner, preventing serious complications like severe liver disease and stopping the spread of infection to others.
STUDY OBJECTIVE
Researchers at BMC want to remove barriers to screening patients in the emergency department for hepatitis C.
DETAILS
The emergency department at BMC transitioned from an opt-in testing system to an automatic electronic order of testing (opt-out) upon any other phlebotomy order placed. This update triggers hepatitis C laboratory orders to be added automatically when providers are ordering other blood tests for patients meeting hepatitis C screening criteria. The new system also automatically excludes patients who had a hepatitis C test completed in the last six months.
FINDINGS
The team saw a significant increase in the number of hepatitis C tests and the number of active infections identified following the update. Identifying active hepatitis C infections enables emergency room staff to link more patients with outpatient care, and this early intervention and treatment can improve long-term health outcomes across all patients.
IMPACT
“BMC’s new screening program for hepatitis C virus is unique - we are proactively screening and linking to care patients who have hepatitis C, which carries significant long-term morbidity risk but is incredibly treatable when diagnosed early. We hope that by expanding access to early detection of hepatitis C virus, BMC can bridge gaps in health equity and ensure that all individuals can achieve better health outcomes and lead healthier lives.” says Elissa Schechter-Perkins MD, MPH, DTMH, senior author on the paper, director of emergency medicine infectious disease management at BMC, and associate professor of emergency medicine at Boston University Chobanian & Avedisian School of Medicine.
Source: Sperring, H; Ruiz-Mercado, G; Yun, B.J.; Twitchell, D; Shah, B; Schechter-Perkins., E.M. (2024) “Automated Opt-Out Hepatitis C Testing to Reduce Missed Screening Opportunities in the Emergency Department.” American Journal of Public Health.