TY - JOUR
T1 - Research article electronic medical alerts increase screening for chronic hepatitis B
T2 - A randomized, double-blind, controlled trial
AU - Chak, Eric W
AU - Taefi, Amir
AU - Li, Chin-Shang
AU - Chen, Moon S
AU - Harris, Aaron M.
AU - MacDonald, Scott
AU - Bowlus, Christopher
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Background: Implementation of screening recommendations for chronic hepatitis B (CHB) among foreign-born persons at risk has been sub-optimal. The use of alerts and reminders in the electronic health record (EHR) has led to increased screening for other common conditions. The aim of our study was to measure the effectiveness of an EHR alert on the implementation of hepatitis B surface antigen (HBsAg) screening of foreign-born Asian and Pacific Islander (API) patients. Methods: We used a novel technique to identify API patients by self-identified ethnicity, surname, country of origin, and language preference, and who had no record of CHB screening with HBsAg within the EHR. Patients with Medicare and/or Medicaid insurance were excluded due to lack of coverage for routine HBsAg screening at the time of this study. At-risk API patients were randomized to alert activation in their EHR or not (control). Results: A total of 2,987 patients met inclusion criteria and were randomized to the alert (n = 1,484) or control group (n = 1,503). In the alert group, 119 patients were tested for HBsAg, compared with 48 in the control group (odds ratio, 2.64; 95% confidence interval, 1.88-3.73; P < 0.001). In the alert group, 4 of 119 (3.4%) tested HBsAgpositive compared with 5 of 48 (10.4%) in the control group (P = 0.12). Conclusions: An EHR alert significantly increased HBsAg testing among foreign-born APIs. Impact: Utilization of EHR alerts has the potential to improve implementation of hepatitis B-screening guidelines.
AB - Background: Implementation of screening recommendations for chronic hepatitis B (CHB) among foreign-born persons at risk has been sub-optimal. The use of alerts and reminders in the electronic health record (EHR) has led to increased screening for other common conditions. The aim of our study was to measure the effectiveness of an EHR alert on the implementation of hepatitis B surface antigen (HBsAg) screening of foreign-born Asian and Pacific Islander (API) patients. Methods: We used a novel technique to identify API patients by self-identified ethnicity, surname, country of origin, and language preference, and who had no record of CHB screening with HBsAg within the EHR. Patients with Medicare and/or Medicaid insurance were excluded due to lack of coverage for routine HBsAg screening at the time of this study. At-risk API patients were randomized to alert activation in their EHR or not (control). Results: A total of 2,987 patients met inclusion criteria and were randomized to the alert (n = 1,484) or control group (n = 1,503). In the alert group, 119 patients were tested for HBsAg, compared with 48 in the control group (odds ratio, 2.64; 95% confidence interval, 1.88-3.73; P < 0.001). In the alert group, 4 of 119 (3.4%) tested HBsAgpositive compared with 5 of 48 (10.4%) in the control group (P = 0.12). Conclusions: An EHR alert significantly increased HBsAg testing among foreign-born APIs. Impact: Utilization of EHR alerts has the potential to improve implementation of hepatitis B-screening guidelines.
UR - http://www.scopus.com/inward/record.url?scp=85055909592&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85055909592&partnerID=8YFLogxK
U2 - 10.1158/1055-9965.EPI-18-0448
DO - 10.1158/1055-9965.EPI-18-0448
M3 - Article
C2 - 30089680
AN - SCOPUS:85055909592
VL - 27
SP - 1352
EP - 1357
JO - Cancer Epidemiology Biomarkers and Prevention
JF - Cancer Epidemiology Biomarkers and Prevention
SN - 1055-9965
IS - 11
ER -