Challenges remain for ED-based screening program adept at identifying hepatitis C.

In a six-month study, investigators evaluating an ED-based screening program for hepatitis C have found that when they target screening toward groups deemed most at risk for the infectious disease, more than 10% of those who accept testing do, in fact, test positive for hepatitis C. However, nurses offering the screening have concerns about protecting patient privacy as well as slowing down the triage process. Further, there are multiple barriers involved with ushering patients through the required testing algorithm and linking those who test positive for the disease to care. Groups targeted for screening during triage include baby boomers, IV drug users, and patients with an unspecified liver disease. Investigators say adding the hepatitis C screening questions at triage adds 30 seconds to one minute to the process. While improvements in testing have enabled EDs to integrate hepatitis C testing into the normal lab workflow process, many patients are discharged before test results return, creating barriers for disclosure and linkage to confirmatory testing. With limited appointments available for specialty hepatitis C care, patients must typically wait several months before seeing a specialist.