Sperring H, Ruiz-Mercado G, Yun BJ, Twitchell D, Shah B, Schechter-Perkins EM. Automated Opt-Out Hepatitis C Testing to Reduce Missed Screening Opportunities in the Emergency Department. Am J Public Health. 2024;114(11):1228-1231. doi:10.2105/AJPH.2024.307783
This study evaluated the impact of implementing automated opt-out hepatitis C (HCV) screening in the emergency department of an urban academic medical center, compared to a previous opt-in model. Over a nine-month period, HCV testing increased by 502%, and the identification of active HCV infections rose by 212%. The increase in testing likely included more patients without traditional risk factors, but overall more cases were detected. The study also found that linking patients to outpatient care improved after the opt-out intervention, from 21.1% to 27.5%. Opt-out screening was effective in reducing missed opportunities for diagnosing HCV, easing clinician workload, and helping patients access necessary treatment. The study suggests that EDs should consider opt-out HCV screening models, but also highlights the importance of ensuring adequate resources for follow-up care, as treatment gaps still exist, especially in Medicaid and commercially insured populations