Background: The American Academy of Pediatrics (AAP) recommends HCV antibody testing for all HCV- exposed infants at age >= 18 months. However, the majority of these infants are not appropriately tested. In 2006, the pediatric infectious disease service (PIDS) at our institution implemented interventions utilizing EMR to improve appropriate HCV testing for HCV-exposed infants.
Methods: Two-part study. During the first period (Jan 1, 1993 - Dec 31, 2005), medical records of all infants born to mothers with HCV were retrospectively reviewed for patient's demographics, and infant's HCV testing. PIDS interventions included contacting the primary care physician (PCP) through EMR requesting HCV testing for children without proper testing. During the second period (Jan 1, 2006 - Dec 31, 2011), interventions utilizing EMR were implemented prospectively; including PIDS consultations during birth hospitalization for all HCV exposed infants, addition of HCV exposure to the EMR problem list, and communication with PCPs via the EMR to assure appropriate HCV testing.
Results: 67,112 infants were born during the study period; 280 had maternal HCV infection and 193 continued to receive medical care at our institution. PIDS interventions utilizing EMR resulted in a significant improvement of appropriate HCV testing among HCV exposed infants from 8% (10/121) to 50% (36/72); p <0.0001. It also resulted in the identification of five new HCV infected children; three of them were born before 2006 and previously undiagnosed.
Conclusions: Interventions utilizing EMR improved the identification and appropriate HCV follow up of infants born to HCV infected mothers.
(C) 2014 by Lippincott Williams & Wilkins, Inc.