Improving Hepatitis C Identification: Technology Alone Is Not the Answer

Bruce Nitsche, Sara C. Miller, Margaret Giorgio, Carolyn A. Berry, Andrew Muir

Research output: Contribution to journalArticlepeer-review


An estimated 3 to 5 million Americans are chronically infected with hepatitis C virus (HCV), and approximately 75% of those persons were born between 1945 and 1965 (the so-called baby boomer generation). Because of the largely asymptomatic nature of HCV, up to 50% of those infected are unaware of their disease. Risk-based testing has been largely ineffective. Based on prevalence data, the Centers for Disease Control and Prevention and other organizations recommend a onetime HCV antibody test for all baby boomers. However, uptake of this recommendation requires significant changes in clinical practice for already busy primary care clinicians. We studied the effectiveness of a quality improvement initiative based on continuous audit and feedback combined with education for improving testing in alignment with guidelines; the control group was a cohort of clinicians whose only reminder was an institution-wide electronic health record prompt. Our data show improved testing rates among all clinician groups, but more significant improvement occurred among providers who received continuous feedback about their clinical performance coupled with education.

Original languageEnglish (US)
Pages (from-to)506-512
Number of pages7
JournalHealth promotion practice
Issue number4
StatePublished - Jul 1 2018


  • Internet/electronic interventions
  • continuing education
  • environmental and systems change
  • health research
  • process evaluation
  • quality assurance/quality improvement

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Nursing (miscellaneous)


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