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Cited by 28Electronic Health Records SystemsHepatitis B Virus StudiesInfection Control in Healthcare

Electronic Medical Alerts Increase Screening for Chronic Hepatitis B: A Randomized, Double-Blind, Controlled Trial

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Chak, Eric, Taefi, Amir, Li, Chin-Shang, Chen, Moon S., Harris, Aaron M., MacDonald, Scott, Bowlus, Christopher·2018·Cancer Epidemiology, Biomarkers & Prevention
DOI 10.1158/1055-9965.epi-18-0448PMC PMC6214733
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Abstract

Background: Implementation of screening recommendations for chronic hepatitis B (CHB) among foreign-born persons at risk has been sub-optimal. The use of alerts and reminders in the electronic health record (EHR) has led to increased screening for other common conditions. The aim of our study was to measure the effectiveness of an EHR alert on the implementation of hepatitis B surface antigen (HBsAg) screening of foreign-born Asian and Pacific Islander (API) patients. Methods: We used a novel technique to identify API patients by self-identified ethnicity, surname, country of origin, and language preference, and who had no record of CHB screening with HBsAg within the EHR. Patients with Medicare and/or Medicaid insurance were excluded due to lack of coverage for routine HBsAg screening at the time of this study. At-risk API patients were randomized to alert activation in their EHR or not (control). Results: A total of 2,987 patients met inclusion criteria and were randomized to the alert (n = 1,484) or control group (n = 1,503). In the alert group, 119 patients were tested for HBsAg, compared with 48 in the control group (odds ratio, 2.64; 95% confidence interval, 1.88–3.73; P < 0.001). In the alert group, 4 of 119 (3.4%) tested HBsAg-positive compared with 5 of 48 (10.4%) in the control group (P = 0.12). Conclusions: An EHR alert significantly increased HBsAg testing among foreign-born APIs. Impact: Utilization of EHR alerts has the potential to improve implementation of hepatitis B–screening guidelines. Cancer Epidemiol Biomarkers Prev; 27(11); 1352–7. ©2018 AACR.

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Authors
Chak, E., Taefi, A., Li, C.-S., Chen, M. S., Harris, A. M., MacDonald, S., & Bowlus, C.
Affiliations
  • University of California Davis Medical Center (US)
  • University of California, Davis (US)
  • Centers for Disease Control and Prevention (US)
Corresponding author
Chak, Eric
ORCID
Venue
Cancer Epidemiology, Biomarkers & Prevention
Publisher
American Association for Cancer Research (AACR)
Published
2018-11-01
Volume
27
Issue
11
Pages
1352-1357
ISSN
  • 1055-9965 (ISSN-L)
  • 1538-7755
DOI
10.1158/1055-9965.epi-18-0448
PMC
PMC6214733
OpenAlex
W2885059697
Cited by
28
References
0
Citations by year
2026: 3 · 2025: 3 · 2024: 7 · 2023: 3 · 2022: 4 · 2021: 1 · 2020: 5 · 2019: 1
FWCI
2.21
Type
journal article
Language
en
Open access
Locations
  • Cancer Epidemiology Biomarkers & Prevention (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • Centers for Disease Control and Prevention (1U51PS004633-01)
  • NCATS NIH (UL1TR001860)
Topics
  • Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
  • Health Sciences › Medicine › Epidemiology › Hepatitis B Virus Studies
  • Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
Keywords
chronic hepatitis B, electronic health record alerts, screening reminders, guideline implementation
MeSH terms
Double-Blind Method, Female, Humans, Male, Mass Screening, Hepatitis B, Chronic, Electronic Health Records

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