Objective: To improve HCV testing rate in the birth cohort in compliance with national guidelines without increasing primary care provider workload or alert fatigue.
Methods: We developed a population health initiative that employed EHR-based tools involving direct patient messaging and bulk lab test ordering via a personal electronic health portal system. This was completed independent of a face-to-face interaction between the patient and provider.
Results: We collected data on 1,024 patients total (514 in the intervention group and 510 in the control group) over a 12-week period. We found a statistically significant higher test completion rate within the intervention group versus the control group after this initiative was launched: 33.7% in the intervention group (173/514) versus 19.0% in the control group (97/510) (p-value <0.0002, OR 2.16, 95% CI 1.62-2.88). Bulk lab ordering appeared to have a large impact while bulk messaging appeared to have a less significant role.
Conclusion: To our knowledge, this is the first EHR-based population health initiative to involve obtaining blood work without a direct face-to-face encounter between the provider and patient. This methodology has a broad range of applications including any recommended screening or disease-specific testing, and it will be essential for health systems to adopt similar protocols as we progress toward a pay-for-performance reimbursement model.
A. Avery, None