Background: There is an estimated 160,000 individuals that have been diagnosed with Hepatitis C Virus (HCV) in New Jersey. HCV is a well-known and widespread challenge to personal, societal, and governmental resources and ultimately, human life. Current guidelines from the USPSTF recommend offering a 1-time screening for HCV infection to adults born between 1945 and 1965. Early detection allows for early treatment, cure, and slowing the spread of disease. We posit that expanding routine testing outside the baby boomers would aid in early identification, management, containment, and, ideally, cure of this often-dreaded and still-fatal disease.
Purpose: Jersey City Medical Center (JCMC) implemented EHR screening prompts to encourage providers routinely to screen all patients equal to or greater than 18 years of age for HCV. JCMC’s IT and Laboratory departments collected data continuously from January 1, 2016 to September 30, 2017.
Description: Testing volume increased 20% compared to baseline before intervention. Routine testing of eligible patients admitted at our hospital revealed the profound impact of early identification: 3.85 % of patients tested were positive for HCV. Our screening of eligible patients tested 7,867 patients (3,335 baby boomers and 4,532 non-baby boomers) for HCV. Of those tested, 181 baby boomers (5.4%) and 122 non-baby boomers (2.7%) tested positive for HCV RNA, indicating they have a current infection. Of those that tested positive, 46% were able to be connected with ongoing outpatient care.
Conclusions: Given our baby boomer population, population of high risk non-baby boomers and results thus far, we feel it is imperative to maximize the routine screening for HCV. We plan to maximize testing of inpatients by linking testing order to admission order and are reviewing the plausibility of offering rapid HCV testing to high risk populations such as those who frequent methadone clinics and needle exchange programs.