Advanced Electronic Population Health and Personal Health Record Tools to Improve Once Lifetime Hepatitis C Screening

Not Applicable

Completed

• Conditions: Hepatitis C
• Interventions: Other: Routine alerting; Other: Bulk ordering and bulk messaging

• Registration Number: NCT03654365
• Lead Sponsor: MetroHealth Medical Center

Brief Summary

This study involves randomizing patients due for once in a lifetime Hepatitis C screening based on Center for Disease Control and Prevention and United States Preventative Services Task Force guidelines in one of three primary care clinics within the MetroHealth System to bulk messaging and bulk ordering for HCV antibody vs usual care (routine alerting).

Detailed Description

All patients had to have an active personal health record account at the time of being randomized.

Patients had to have been seen by their primary care provider in the last 6 months to be eligible and therefore had a "missed opportunity" for Hepatitis C screening.

Control group received "usual care" which in our system included alert (health maintenance reminder) to the primary care provider at the time of the visit and passive alert in their personal health record (i.e. an alert if they log into their personal health record and look for reminders for preventative care that it due/overdue).

Intervention group received same care as control group plus automatic ordering of the hepatitis C screening test and active electronic letter their personal health record that they were due for hepatitis C screening, what hepatitis C is, what the testing and if positive, treatment could involve, and instruction to go to one of the laboratories in the healthcare system to have their blood drawn if they were interested in the testing.

Study Timeline

• Study Start: 2016-11-17
• Primary Completion: 2017-03-25
• Study Completion: 2017-03-25
• Study First Submitted: 2018-06-26
• Status Verified: 2018-08
• Study First Submitted QC: 2018-08-29
• Last Update Submitted: 2018-08-29
• Study First Posted: 2018-08-31
• Last Update Posted: 2018-08-31

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 1024

Inclusion Criteria

• seen recently in one of the three primary care study sites and have an active person health record at the time of randomization; and meet Centers for Disease Control and Prevention/United States Preventative Services Task Force guidelines for once in a lifetime hepatitis C screening

Exclusion Criteria

• already had once in a lifetime screen for hepatitis C or positive for hepatitis C (by lab test or International Classification of Disease code)

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Control	Routine alerting	Pts in the control arm receive usual care. Usual care includes a EHR based reminder of single HCV testing for patients who are in the birth cohort. (routine alerting)
Intervention	Bulk ordering and bulk messaging	Pts in the intervention arm receive bulk messaging and bulk ordering of the HCV ab test.
Intervention	Routine alerting	Pts in the intervention arm receive bulk messaging and bulk ordering of the HCV ab test.

Primary Outcome Measures

Name	Time	Method
Impact on hepatitis C antibody testing rates at 12 weeks post direct patient messaging	12 weeks post-intervention	Number of patients who remain untested for HCV at 12 weeks post direct patient messaging

Secondary Outcome Measures

Name	Time	Method
Impact of bulk ordering vs bulk messaging and bulk ordering on HCV antibody testing rates	12 weeks post-intervention	Assessment of if the patient in the intervention group seemed have the hepatitis screening done just because they were having other blood work done versus specifically wanting to be screened for hepatitis C.