AUTHOR=Tandon Saniya , Castaneda Roselyn , Tarasco Nadia , Percival Janie , Nieto Linares Roberto , Geiger Glen , Cooper Curtis L. 

TITLE=Successes and challenges of best practice alerts to identify and engage individuals living with hepatitis C virus

JOURNAL=Frontiers in Public Health

VOLUME=Volume 12 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1281079

DOI=10.3389/fpubh.2024.1281079

ISSN=2296-2565

ABSTRACT=Introduction:Many individuals living with hepatitis C virus (HCV) are unaware of their diagnosis and/or have not been linked to programs providing HCV care.The use of Electronic Medical Record (EMR) systems may assist with HCV infection identification and linkage to care.Methods:In October 2021, we implemented HCV serology focused Best Practice Alerts (BPAs) at The Ottawa Hospital(TOH) via our EMR(EPIC).Our BPAs were programmed to identify previously tested HCV seropositive individuals. Physicians were prompted to order HCVRNA testing and submit consultation requests to the TOH Viral Hepatitis Program. We evaluated data post-BPA implementation to assess the design and related outcomes.Results:From September 1, 2022 to December 15, 2022 a total of 2,029 BPAs triggered for 139 individuals. As a consequence of the BPA prompts, 9 HCV seropositive and 9 HCVRNA positive individuals were linked to care.The proportion of total consults coming from TOH physicians increased post BPA implementation.The BPA messages were frequently declined and physician engagement with our BPAs varied across specialty groups. Programming issues led to unnecessary BPA prompts (e.g., no hard stop to the prompts even though the individual was treated and cured, individuals linked to care without first obtaining HCVRNA testing).A fixed 6-month lookback period for test results limited our ability to capture many individuals.Conclusion:An EMR-based BPA can assist with identification and engagement of HCV infected individuals into care.However, challenges including issues with programming,time commitment towards BPA configuration,productive communication between health-care providers and programming team, and physician responsiveness to the BPAs require attention in order to optimize the impact of BPAs.