Start Date
5-15-2025 9:30 AM
End Date
5-15-2025 11:30 AM
Description
Background and Problem
Viral hepatitis disproportionately affects historically marginalized populations, with less than one-third of high-risk patients receiving appropriate screening. Racial and ethnic minoritized groups, rural residents, and PWID face significant disparities in both testing and treatment.
Paradoxically, while underserved populations remain undertested, providers frequently order inappropriate hepatitis tests, particularly acute- phase markers like HAV IgM and HBV core IgM, in clinical situations where guidelines do not indicate their use. This pattern of inappropriate testing is partly driven by provider uncertainty regarding the selection of appropriate serologic tests from a complex array of options. Clinical decision support (CDS) within computerized ordering systems improves laboratory test appropriateness.
The local problem addressed by this initiative was the observed high frequency of inappropriate viral hepatitis test ordering within the institution, representing both inefficient resource utilization and a potential distraction from targeted screening efforts.
Specific Aim: Improve the appropriateness of viral hepatitis testing and reduce wasteful ordering through implementation of a clinical scenario based electronic health record (EHR) order set.
Keywords
quality improvement, clinical decision support, viral hepatitis
Included in
Improving Viral Hepatitis Testing with a Clinical Scenario Based Order Set: The Viral Hepatitis Hub
Background and Problem
Viral hepatitis disproportionately affects historically marginalized populations, with less than one-third of high-risk patients receiving appropriate screening. Racial and ethnic minoritized groups, rural residents, and PWID face significant disparities in both testing and treatment.
Paradoxically, while underserved populations remain undertested, providers frequently order inappropriate hepatitis tests, particularly acute- phase markers like HAV IgM and HBV core IgM, in clinical situations where guidelines do not indicate their use. This pattern of inappropriate testing is partly driven by provider uncertainty regarding the selection of appropriate serologic tests from a complex array of options. Clinical decision support (CDS) within computerized ordering systems improves laboratory test appropriateness.
The local problem addressed by this initiative was the observed high frequency of inappropriate viral hepatitis test ordering within the institution, representing both inefficient resource utilization and a potential distraction from targeted screening efforts.
Specific Aim: Improve the appropriateness of viral hepatitis testing and reduce wasteful ordering through implementation of a clinical scenario based electronic health record (EHR) order set.
Comments
Presented at the 2025 Jefferson Health Equity and Quality Improvement (HEQI) Summit.