Improving inpatient hepatitis C screening by using EHR default settings

Opportunity

The hepatitis C virus (HCV) is the leading cause of liver transplant and hepatocellular carcinoma in the United States, but direct-acting antiviral medications are now available and can cure the disease in over 95% of those that are treated. The Centers for Disease Control and Prevention (CDC) estimate that 75% of all chronic HCV infections in the United States are among adults born between 1945 and 1965. In 2016, the Commonwealth of Pennsylvania signed into law a requirement that all hospitalized patients born during this time period be offered HCV screening.  Prior intervention has included an EHR alert to prompt screening but it was poorly utilized with less than 20% of eligible patients screened. 

Approach

This study will aim to improve inpatient Hepatitis C screening by defaulting screening in an admission order set within the electronic order set. Clinicians will have the option to opt-out and not order the screening test. This intervention will be tested through a stepped wedge cluster randomized trial to assess its effect.

Impact

This study is currently in progress.

Collaborators

Penn Medicine Division of Infectious Disease

Funding

Penn Medicine

nudgeunit@uphs.upenn.edu

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