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Medical Screening

Two recent studies show that Electronic Health Record screening programs, which use alert-based systems, have helped boost HCV testing over four times in 3 years, among American Indian/Alaska Native populations. These programs were aimed at helping people born between the years 1945 and 1965, and have also exhibited significant improvement in care integration, according to researchers. These studies were published in the May issue of the Morbidity and Mortality Weekly Report.

HCV is seen to affect people from the AI/AN demographic, according the first report, which was compiled by researchers including Jorge Mera, M.D., of the Office of Clinical and Preventive Services. The Cherokee Nation Health Services and the Indian Health Service have come up with a screening program, which also has automated reminders for EHR systems.

This was devised in light of the 2012 recommendation for single-time HCV testing for baby boomers, from the Centers for Disease Control and Prevention, as well as the widespread option of effective treatments. These agencies also enhanced the awareness of providers about HCV, and CNHS also used the ECHO telehealth system to boost care and treatment capacity access.

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Alert-Based Screening

The reminder sent from CNHS went to primary care clinics in the duration between August 2013 and January 2014, according to Dr. Mera and colleagues. The health record gives a prompt for screening any person born inside the target years, who has made at least one healthcare visit inside the past three years. These patients also had no HCV testing history. On total, there were 92,012 patients, who were eligible for screening.

Among the patients tested, the number went up from 3337 to 16,772 from 2012-2013 to July 2015. Often these, 388 tested positive for HCV, while 223 started treatment. Among both, 201 completed treatment, while 180 showed viro-logic response. According to the authors of the study, implementing ECHO let providers expand HCV care and treatment services from single clinics with single providers, to five clinics with seven HCV care providers. Of the seven, three were physicians, two nurse practitioners, and two pharmacists.

Findings show that primary care providers in the setting can find and treat, as well as cure, HCV infection. The second report, from the National HIV/AIDS Program, Office of Clinical and Preventive Services, IHS, Rockville, Maryland, showed that HCV screening has gone up fourfold among AI/AN persons born between 1945 and 1965 in rural healthcare clinics, according to data from 35 states.

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