MDNews - San Antonio

Let us help you spend less time manag ing your medical practice so you can spend more time with your family. Consulting Coding Billing 613 N.W. Loop 410, Suite 3 45 San A ntonio, Texas 78216 W: w w w.concordispm.com P: (210) 70 4 -1014 A 2012 INITIATIVE THAT CHEROKEE NATION HE ALTH SERVICES £CNHS¤ IN OKL AHOMA L AUNCHED TO ENHANCE HEPATITIS C MANAGEMENT HA S YIELDED SIGNIFICANT, POSITIVE RESULTS AMONG THE AMERICAN INDIAN POPUL ATION. BOOSTS HEPATITIS C SCREENING BY K ATY MENAŽBERKLEY Novel Strategy among American Indians WHEN JORGE MERA, MD, was hired as an infectious-disease physician by CNHS in 2012, he was tasked with establishing a clinic specializing in the management of chronic hepatitis C virus infection. That was a major undertaking. According to a 2015 report from the CDC, American Indians and Alaska Natives are 50 percent more likely than whites to be infected and almost three times as likely to die from hepatitis C. After studying the high rate of infection in t he A merica n India n popu lation, Dr. Mera was determined to find ways to e x pa nd s cr e en i n g a nd , u lt i m a t e ly, improve patient outcomes. "When I started, I ran into a backlog of 262 patients with [hepatitis C]," he says. "And that was the start. After the first year of evaluating all these patients and also estimating what would be the actual amount of patients in the area who had hepatitis C, the numbers grew pretty big. We thought we better do something a little bit more structural and organized to tackle this problem." Col laborating w ith India n Hea lth Ser vice, CNHS bega n by launching a screening progra m that involved the implementation of EHR reminders. The reminders encouraged healthcare provid- ers to target individuals born between 1945 and 1965 for hepatitis C screening, which is in line with expanded screening recommended by the CDC and the U.S. Preventive Services Task Force in 2012 and 2013, respectively. "Medica l providers a re required to screen for a bunch of things ... and they have 15 or 20 minutes to see a patient," Dr. Mera says. " We just implemented a tool so the provider wouldn't have to worry about remembering [to screen for hepatitis C]." That ef for t, a long with educationa l progra ms for hea lthca re providers a nd patients coordinated with the Oklahoma State Depa r tment of Hea lth a nd col- laborations w ith the CDC, Ok la homa Universit y a nd the Universit y of New Mexico, proved to be a power ful com- b i n a t i o n . A c c o r d i n g t o t h e C D C , f irst-time hepatitis C testing increased f ivefold a mong patients using CN HS services between 2012 and 2015. During a 33-month period, a mong 92,012 indi- v i du a l s w ho h a v e h a d a t le a s t one encounter with CNHS, the number of people screened for HCV for the f irst time climbed from 3,337 to 16,772. TARGETED TREATMENT O n c e p a t i e n t s w e r e d i a g n o s e d , Dr. Mera's g roup launched intensive treatment pla ns, administering a nti- v ira l medications — options that a re better tolerated tha n interferon thera- pies previously used to treat hepatitis C. A s pa r t of the CNHS pilot prog ra m, 58 percent of patients with active HCV infection were treated with an antivira l, a n d 9 0 p e r c e n t o f t h o s e t r e a t e d were cured. " W hat we have now a re mu lt iple, different, equa lly eff icacious regimens wh ic h a r e a l l or a l a nd wh ic h h ave m i n i ma l side ef fect s ...," says Dav id Bernstein, MD, Vice Cha ir of Medicine for Cl i n ica l Tr ia ls a nd P rofessor of Medicine at Hofstra Nor thwell School of Medicine in New York, who was not involved in the CNHS study. " You ca n rea lly just treat a nd cure." Dr. Mera looks for wa rd to the imple- mentation of simila r progra ms in other hea lt h systems, bot h to identif y a nd treat hepatitis C a nd to eliminate the stig ma surrounding the disease. ■ 2 2

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