The summaries are free for public
use. The Chronic Liver Disease
Foundation will continue to add and
archive summaries of articles deemed
relevant to CLDF by the Board of
Trustees and its Advisors.
Abstract Details
Sustained and cumulative impact of an electronic medical record-based alert on a hepatitis C birth cohort screening program
1Division of Gastroenterology and Hepatology, NorthShore University Health System, Evanston, IL, USA.
2Division of Gastroenterology and Hepatology, Oregon Health & Science University and Portland VA Medical Center, Portland, OR, USA.
Abstract
The study aimed to assess the effect of an electronic medical record-embedded Best Practice Alert (BPA) on HCV age cohort screening in primary care clinics. HCV testing by primary care physicians was monitored prior and subsequent to the implantation of the BPA. Four intervals of nine months duration were analyzed in detail, including a pre-BPA baseline analysis and three annual post-BPA assessments. Pre- and post-BPA orders consistently followed a power law distribution, characterized by small groups of physicians placing the majority of test orders. Significant correlations were present between the numbers of tests orders by each physician, suggesting that "high" and "low" screening performances tended to be physician-specific. Testing rates increased markedly in response to the BPA, resulting in completion of screening in 56.8% (50,468 of 88,914%) of the entire age cohort within less than three years. In conclusion, HCV age cohort testing by primary care physicians follows a power-law distribution, with high-performing physicians contributing disproportionately to the overall effort. A simple BPA resulted in a sufficient increase in testing to allow testing of the entire target population within a reasonable time frame.