Use of Computer Generated Alerts in the Detection and Treatment of HCV in the Underserved Baby Boomer Population of New York: 879

Introduction: Hepatitis C virus (HCV) is a RNA virus causing acute and chronic hepatitis affecting people worldwide. The infected population is at an elevated risk for developing liver cirrhosis and hepatocellular carcinoma. The prevalence in the US of chronic HCV infection is 2.7 million. Over 70% of HCV infections are found in the baby boomer population born between 1945-1965. The prevalence of anti-HCV antibody in the US is 1.3% in non-institutionalized population as per the National Health and Nutrition Examination Survey data. On 01/01/2014 New York State Department of Health passed a law mandating HCV screening to be offered to baby boomer population with follow up testing and management. We designed a prospective study with two phases. Phase I is discussed here and was executed to determine the prevalence of anti-HCV antibodies in baby boomers at our institution; Nassau University Medical Center (NUMC). In Phase II, NUMC will act as a model for elimination of HCV in underserved populations to meet the WHO elimination goal by 2030. Methods: NUMC created a hard stop computer alert to offer HCV antibody screening via ELISA technique to patients born between 1945-1965 at outpatient or inpatient visits. A database search was conducted from 01/2014 to 02/2018. A report was generated based on an algorithm to track the population with positive test results and obtain the required data (Fig 1). Phone calls for appointments and certified mail were used to inform the patients of positive results and clinic follow ups were made for confirmatory testing with HCV PCR and genotyping in order to offer a treatment regimen according to AASLD guidelines.879 Figure 1 No Caption available.Results: The search yielded 25,337 pop-ups that were generated in patients born between 1945-1965. 14,002 patients out of 25,337 were offered HCV screening and 1,551 patients underwent testing. 101 out of the 1,551 tested positive for HCV antibody. Conclusion: The prevalence of anti-HCV antibody in this population at NUMC was found to be 6.5%. Phase II will focus on elimination of HCV in patients that were selected in phase I. Based on the data from the World Hepatitis Summit in November 2017 the diagnostic rate would have to triple to meet the elimination goal by 2030. Emphasis needs to shift towards preventative, educational outreach programs since most countries have low HCV diagnostic rates with low projections. Our novel screening tool will help serve as a model to significantly increase HCV diagnostic rate in the underserved populations.