1HealthPartners Institute, Minneapolis, Minnesota.
2HealthPartners Travel and Tropical Medicine Department St. Paul, Minnesota.
Am J Trop Med Hyg. 2020 Aug;103(2):884-886. doi: 10.4269/ajtmh.20-0041. Epub 2020 May 14.
We developed and evaluated the Global Health Wizard Hepatitis B Best Practice Alert (BPA) to increase primary care provider adherence to evidence-based guidelines for hepatitis B virus (HBV) infection screening in non-U.S.-born patients. We conducted a pilot study using nine clinics to test BPA effectiveness. Eligible patients were aged ≥ 12 years, from a country of origin with ≥ 2% HBV prevalence, had no electronic health record documentation of HBV screening, and were seen for primary care during July 2012-March 2013. The BPA triggered for > 4,500 patients and identified six previously unrecognized HBV-infected patients. The pilot project demonstrated BPA effectiveness and continued to be used at pilot clinics until 2018 and was expanded to additional clinics in 2019; 29 additional HBV-infected patients were identified. Although successful, BPA usage steadily decreased over time. Poor BPA usage limits the power to achieve the goal of improved population-based HBV screening.
我们开发并评估了全球健康向导乙型肝炎最佳实践警报（BPA），以提高初级保健提供者对乙型肝炎病毒（HBV）感染筛查的循证指南的依从性，对象是非美国出生的患者。我们使用 9 家诊所进行了一项试点研究，以测试 BPA 的有效性。合格患者的年龄≥12 岁，原籍国 HBV 流行率≥2%，没有 HBV 筛查的电子健康记录文件，并且在 2012 年 7 月至 2013 年 3 月期间接受初级保健治疗。BPA 触发了超过 4500 名患者，并发现了 6 名以前未被识别的 HBV 感染患者。试点项目证明了 BPA 的有效性，并继续在试点诊所使用，直到 2018 年，并在 2019 年扩展到其他诊所；又发现了 29 名 HBV 感染患者。尽管取得了成功，但 BPA 的使用率随着时间的推移而稳步下降。BPA 使用率低限制了实现改善基于人群的 HBV 筛查目标的能力。
