Three Ohio health centers are wrapping up their work on a pilot program to designed and implement interventions that will 1) educate providers and communities to reduce health disparities; 2) increase the number of Ohioans living with Hepatitis C Virus (HCV) who are aware of their infection; and 3) facilitate linkages of newly diagnosed individuals to appropriate care and treatment. All three participating health centers have seen an increase in the number of patients receiving HCV testing since the beginning of the project (11/1/2018). To date, the health centers collectively have diagnosed 29% (337/1168) of individuals screened to be HCV positive. Of the HCV positive patients, 65% were unaware, and 35% were previously aware of their infection. A total of 89% of patients who screened positive for HCV also had a current or historical substance abuse disorder.The participating health centers recognized a need to care for these HCV positive patients with primary care services, and all three are now working to begin treating HCV within their practices. Medicaid has changed the ruling on HCV treatment in Ohio, allowing FQHCs to bill for treatment services in consultation with a specialty care provider (i.e. hepatologist, infectious disease provider, or a gastroenterologist). Compass Community Health has set up a Hepatitis C clinic, which began in April 2019 to test and treat patients within their FQHC. Compass is linking identified patients with internal referrals to a provider and care coordinator for treatment. Hopewell Health Centers has also identified a treatment partnership with an outside specialist, and have trained one of their providers to begin to treat HCV infected patients. Valley View Health Centers is currently working on training providers to begin to treat patients for HCV as well.
Some of the challenges faced during this project were related to the ability of health centers to pull specific data points from their electronic medical record (EMR), and to track patients undergoing treatment of Hepatitis C. Since HCV testing and treatment has not been traditionally offered within the primary care setting, there are not a lot of out of the box EMR solutions.
For health centers considering providing Hepatitis C Treatment to their patients, some lessons learned from this pilot project are as follows:
- Providing appropriate training to staff on screening and testing patients
- Decide if universal screening for adults or targeted screening based on risk factors is more effective for your health center
- Develop a process for initiating treatment with a partner agency or in consultation with a specialist (as mentioned above)
- Designate a dedicated staff member for Hepatitis C management and prevention in order to link patients to care and oversee patient engagement in their treatment
