S3384 The Impact of Epic EMR on Hepatitis C Screening Rates in Internal Medicine Residency Clinic

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Introduction: There are an estimated 2.7-3.9 million Americans living with Hepatitis C Virus (HCV) infection.1 In 2018, our internal medicine (IM) residency clinic switched from Smart Office electronic medical record (EMR) to Epic, where healthcare maintenance status, including HCV screening, can more easily be tracked. The aim of this study was to determine if switching to Epic EMR in our IM residency clinic in 2018 led to improved HCV screening rates as compared with 2017. Methods: A retrospective chart review was performed of visits from the 2017 calendar year (pre-Epic) and 2018 calendar year (post-Epic) to determine the ordering rate for HCV screening for all patients born between 1945 and 1965 as indicated by the CDC and USPSTF during the study period. Screening rates were then compared between groups. Results: With the switch to Epic would found a statistically significant increase in HCV screenings ordered in 2018 compared with 2017 (P-value = 0.032). There was an increase from 38% of eligible patients being ordered HCV screening to 44%. Specifically, the 2018 group was 14% more likely to receive an HCV antibody order (RR 1.14, 95% CI 0.96-1.36, 1-sided P-value = 0.065) than the 2017 group. Conclusion: Our study demonstrated that with the initiation of Epic EMR, our residency clinic HCV screening rates significantly increased. The increase is likely due to Epic’s Health Maintenance tab which allows easy documentation and tracking as well as a reminder feature. However, screening rates remained low overall. Future directions involve assessing how to provide further EMR reminders in Epic to encourage screening, especially in the setting of the expanded screening pool.

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