The Ohio Association of
Community Health Centers (OACHC) has partnered with the Ohio Department of
Health (ODH) to improve screening and testing for hepatitis c in targeted
counties in Ohio. Two
Federally Qualified Health Centers (FQHCs) have been selected to 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.
Cincinnati Health Network
(CHN) and Five Rivers Health Centers began working on this pilot in November of
2020. Both health centers had been doing hepatitis c screening for their
populations but did not have standard workflows in place to ensure that every
patient eligible for a lifetime hepatitis c screening was receiving it.
CHN has a long history of
providing doing hepatitis c screening to patients and have been referring those
in need of treatment to the University of Cincinnati Medical Center. For this
pilot project they have worked to create and approve a new policy for screening
and linkage to care including revamping their clinical workflow and patient
education. Their new policy ensures that providers are ordering the HCV test
which includes an automatic reflex, and that providers are sharing patient education
documents through the After Visit Summary (AVS) function in Athena, their EMR.
Additionally the health center has been using Azara DRVS Patient Visit Planning
tool to identify patients who are in need of a hepatitis c test.
Five Rivers Health Center
has been screening patients for hepatitis c with an antibody test and referring
patients to treatment at their Medical Surgical Health Center. For this pilot
the health center is working on a Medical Resident- led initiative to increase screening
and testing of patients. Residents are working on pulling in a patient
education document that will be included in the AVS in Epic, which is helping
with patient awareness and education.
They will be training
providers on ordering the reflex testing in the future as well, to be sure that
every patient is getting the RNA confirmatory testing necessary for diagnosis.
Five Rivers is also
planning to use the provider specific scorecard in Azara DRVS to be able to
review which providers are offering hepatitis c testing, and to what extent. They
are also currently using the Patient Visit Planning Report to identify patients
without a lifetime screening for hepatitis c as well.
OACHC has
offered a clinical training, and an Azara DRVS training for this project. Both
health centers are working with the Azara team to map three additional
hepatitis C specific measures as part of this pilot as well. OACHC felt that
these measures would make reporting to ODH easier at the conclusion of the
project, and also help the health centers inform their clinical care decisions
for patients. Both health centers have had their initial mapping meetings for the
following measures; HCV Diagnosis, HCV Linkage to Care, and HIV screening for
HCV patient and will be wrapping up their work this month.
To date, there is some data available in Azara DRVS for the Hepatitis
C Lifetime Screening measure in Azara DRVS. A preliminary look at this data
over the course of the pilot has shown that Five Rivers has been screening 46%
of patients eligible for a hepatitis c test (TY 2021 March), and trending
upwards since December 2020, and that CHN has been screening 44% of patients (TY
2021 March) and their percentage has been remaining steady since December 2020.
In comparison, the average performance for this measure of all 22 health
centers that have implemented Azara DRVS are performing at an average of 19%.
The two pilot health centers are currently two of the three top performers in
the state, behind only one health center who previously participated in this
same pilot in 2019. The health center’s respective screening progress is
expected to improve by the pilot end.
