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.
