Hepatitis C is the most common blood-borne infection, but roughly [75% of people infected don’t have symptoms](https://www.cdc.gov/hepatitis-c/hcp/diagnosis-testing/index.html#:~:text=Nearly%20half%20of%20people%20with,vaccine%20to%20prevent%20hepatitis%20C.) and might not realize they have the virus. In the United States, worse health outcomes associated with hepatitis C are higher for American Indian/Alaska Native people, Black people, and Hispanic people than for white people according to the [Centers for Disease Control and Prevention](https://www.cdc.gov/hepatitis/statistics/2022surveillance/hepatitis-c/table-3.8.htm). Early detection of hepatitis C can help minimize these disparities by linking patients to treatment sooner, preventing serious complications like severe liver disease and stopping the spread of infection to others.

**STUDY OBJECTIVE**

Researchers at BMC want to remove barriers to screening patients in the emergency department for hepatitis C.

**DETAILS**

The emergency department at BMC transitioned from an opt-in testing system to an automatic electronic order of testing (opt-out) upon any other phlebotomy order placed. This update triggers hepatitis C laboratory orders to be added automatically when providers are ordering other blood tests for patients meeting hepatitis C screening criteria. The new system also automatically excludes patients who had a hepatitis C test completed in the last six months.

**FINDINGS**

The team saw a significant increase in the number of hepatitis C tests and the number of active infections identified following the update. Identifying active hepatitis C infections enables emergency room staff to link more patients with outpatient care, and this early intervention and treatment can improve long-term health outcomes across all patients.

**IMPACT**

“BMC’s new screening program for hepatitis C virus is unique - we are proactively screening and linking to care patients who have hepatitis C, which carries significant long-term morbidity risk but is incredibly treatable when diagnosed early. We hope that by expanding access to early detection of hepatitis C virus, BMC can bridge gaps in health equity and ensure that all individuals can achieve better health outcomes and lead healthier lives.” says Elissa Schechter-Perkins MD, MPH, DTMH, senior author on the paper, director of emergency medicine infectious disease management at BMC, and associate professor of emergency medicine at Boston University Chobanian & Avedisian School of Medicine.

**Source**: Sperring, H; Ruiz-Mercado, G; Yun, B.J.; Twitchell, D; Shah, B; Schechter-Perkins., E.M. (2024) “Automated Opt-Out Hepatitis C Testing to Reduce Missed Screening Opportunities in the Emergency Department.” [*American Journal of Public Health*. ](https://ajph.aphapublications.org/doi/epdf/10.2105/AJPH.2024.307783)



#### Media Contact:

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