Objective: Hepatitis B virus (HBV), a chronic viral infection, is the most common cause of hepatocullular cancer (HCC) worldwide. HCC is the fifth most common cancer in the world and the third leading cause of cancer-related death. Guidelines recommend screening of all patients born in countries with HBV prevalence rates >2%, which is a best practice recommendation for most immigrants in Minnesota. This project will test a point-of-care decision support tool to educate and prompt providers to 1) screen for HBV and 2) order follow-up care.
Methods: Nine clinics with >450 non -English-speaking patients were selected and randomly assigned to active or passive intervention. Point-of-care tools were developed and implemented in EPIC for all primary care providers in the clinics. The point-of-care tool is activated when a patient's language or country of origin indicates a country with HBV prevalence >2%. Data on patient and provider characteristics will be extracted from EPIC. A generalized logistic regression model will provide odds ratios comparing rates of screening and follow-up tests in both interventions.
Results: The point-of-care tool went into production July 19, 2012. We will present preliminary results on screening rates. We anticipate that the active intervention will identify potential HBV carriers and refer them for follow up, resulting in a higher screening rate than the passive intervention.
Conclusion: Results will be disseminated via community meetings. The results could be used to develop other point-of-care interventions for providers in the global village, and the care process could improve care for immigrants statewide.