Electronic medical records improved identification, follow-up of infants with HCV infected mothers

Electronic medical records can help improve identification and follow-up of infants born to mothers with hepatitis C virus infection, according to study findings published in The Pediatric Infectious Disease Journal.

"Perinatal transmission from mother to her baby is the main route of HCV infection in children," Nazha Abughali, MD, of the department of pediatrics at Case Western Reserve University and MetroHealth Medical Center, Cleveland, told Infectious Diseases in Children. "Pediatricians should be vigilant about identifying and testing all infants born to HCV-infected mothers. Older children and adolescents with history of maternal HCV infection should be identified and tested as well."

Nazha Abughali

Abughali and colleagues evaluated 279 infants born to HCV-infected mothers between Jan. 1, 1993, and Dec. 31, 2011, to determine how electronic medical record (EMR) and interventions by the Pediatric Infectious Diseases Service could improve follow-up and appropriate testing of these infants.

Before the intervention, there was a 53% identification rate of patients at risk for HCV; this increased to 71% after the intervention. The rate of appropriate follow-up increased from 8% to 50% following intervention.

Seventy-seven out of 111 patients who had inappropriate follow-up had their primary care physicians notified through EMR of the need for HCV testing. Thirty-six percent of those had HCV antibody testing performed. Three patients were identified as having HCV infection.

Patients considered having appropriate HCV testing had antibody testing after age 18 months. Of those with appropriate follow-up, 6.6% were infected with HCV.

“By utilizing special features of the EMR, such as problem list, electronic messaging, monitoring testing and follow-up visits, we were able to improve the identification and appropriate testing and follow-up of infants born to HCV infected mothers,” the researchers wrote. “Other EMR features that could be used in the future to further enhance the identification and follow-up testing of HCV exposed infants would be implementing best practice alerts that can be programmed into the EMR to remind physicians to test for HCV in patients at risk. Also, we could use the EMR to flag the charts of prenatally HCV exposed infants, thus reminding the [primary care physician] to obtain HCV testing by age 18 months.” — by Amber Cox

Nazha Abughali, MD, can be reached at Department of Pediatrics, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH 44109; email: [email protected]

Disclosure: The researchers report no relevant financial disclosures.