Journal Article

Using the Electronic Health Record to Characterize the Hepatitis C Virus Care Cascade

Isaacs-Soriano, Kimberly A., Roetzheim, Richard G., Reich, Richard R., Rathwe, Julie A., Giuliano, Anna R., Christy, Shannon M., Vadaparampil, Susan T., Friedman, Mark S.

2022

Overview

Objectives Chronic hepatitis C virus (HCV) infection is one of the main causes of hepatocellular carcinoma. Before initiating a multilevel HCV screening intervention, we sought to (1) describe concordance between the electronic health record (EHR) data warehouse and manual medical record review in recording aspects of HCV testing and treatment and (2) estimate the percentage of patients with chronic HCV infection who initiated and completed HCV treatment using manual medical record review. Methods We examined the medical records for 177 patients (100 randomly selected patients born during 1945-1965 without evidence of HCV testing and 77 adult patients of any birth cohort who had completed HCV testing) with a primary care or relevant specialist visit at an academic health care system in Tampa, Florida, from 2015 through 2018. We used the Cohen κ coefficient to examine the degree of concordance between the searchable data warehouse and the medical record review abstractions. Descriptive statistics characterized referral to and receipt of treatment among patients with chronic HCV infection from medical record review. Results We found generally good concordance between the data warehouse abstraction and medical record review for HCV testing data (κ ranged from 0.66 to 0.87). However, the data warehouse failed to capture data on HCV treatment variables. According to medical record review, 28 patients had chronic HCV infection; 16 patients were prescribed treatment, 14 initiated treatment, and 9 achieved and had a reported posttreatment undetected HCV viral load. Conclusions Using data warehouse data provides generally reliable HCV testing information. However, without the use of natural language processing and purposeful EHR design, manual medical record reviews will likely be required to characterize treatment initiation and completion.

• Publisher: Sage Publications, Inc,SAGE Publications,SAGE PUBLICATIONS, INC
• Subject: Adult / Blood diseases / Cancer / Chronic infection / Clinical outcomes / Continuity of care / Data / Data search / Data warehouses / Electronic Health Records / Electronic medical records / Health / Health care / Health services / Hepacivirus / Hepatitis / Hepatitis C / Hepatitis C - diagnosis / Hepatitis C - drug therapy / Hepatitis C - epidemiology / Hepatitis C, Chronic - diagnosis / Hepatitis C, Chronic - drug therapy / Hepatitis C, Chronic - epidemiology / Hepatocellular carcinoma / Humans / Infections / Intervention / Liver cancer / Mass Screening / Medical records / Medical referrals / Medical screening / Medical treatment / Natural language processing / Patients / Primary care / Public health / Referrals / Statistics / Test validity and reliability / Tests / Viruses