{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T11:19:20Z","timestamp":1781176760437,"version":"3.54.1"},"reference-count":17,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T00:00:00Z","timestamp":1721952000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Services Research"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To develop, deploy, and evaluate a national, electronic health record (EHR)\u2010based dashboard to support safe prescribing of biologic and targeted synthetic disease\u2010modifying agents (b\/tsDMARDs) in the United States Veterans Affairs Healthcare System (VA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources and Study Setting<\/jats:title><jats:p>We extracted and displayed hepatitis B (HBV), hepatitis C (HCV), and tuberculosis (TB) screening data from the EHR for users of b\/tsDMARDs using PowerBI (Microsoft) and deployed the dashboard to VA facilities across the United States in 2022; we observed facilities for 44\u2009weeks post\u2010deployment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>We examined the association between dashboard engagement by healthcare personnel and the percentage of patients with all screenings complete (HBV, HCV, and TB) at the facility level using an interrupted time series. Based on frequency of sessions, facilities were grouped into high\u2010 and low\/none\u2010engagement categories. We modeled changes in complete screening pre\u2010 and post\u2010deployment of the dashboard.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Collection Methods<\/jats:title><jats:p>All VA facilities were eligible for inclusion; excluded facilities participated in design of the dashboard or had &lt;20 patients receiving b\/tsDMARDs. Session counts from facility personnel were captured using PowerBI audit log data. Outcomes were assessed weekly based on EHR data extracted via the dashboard itself.<\/jats:p><\/jats:sec><jats:sec><jats:title>Principal Findings<\/jats:title><jats:p>Totally 117 facilities (serving a total of 41,224 Veterans prescribed b\/tsDMARDs) were included. Before dashboard deployment, across all facilities, 61.5% of patients had all screenings complete, which improved to 66.3% over the course of the study period. The largest improvement (15 percentage points, 60.3%\u201375.3%) occurred among facilities with high engagement (post\u2010intervention difference in outcome between high and low\/none\u2010engagement groups was 0.17 percentage points (pp) per week, 95% confidence interval (0.04\u2009pp, 0.30\u2009pp); <jats:italic>p<\/jats:italic>\u2009=\u20090.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We observed significant improvements in screening for latent infections among facilities with high engagement with the dashboard, compared with those with fewer sessions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1475-6773.14363","type":"journal-article","created":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T10:45:14Z","timestamp":1721990714000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["National rollout of a medication safety dashboard to improve testing for latent infections among biologic and targeted synthetic disease\u2010modifying agent users within the Veterans Health Administration"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2687-5043","authenticated-orcid":false,"given":"Gabriela","family":"Schmajuk","sequence":"first","affiliation":[{"name":"Department of Medicine University of California San Francisco  San Francisco California USA"},{"name":"Department of Medicine San Francisco VA Medical Center  San Francisco California USA"},{"name":"Institute for Health Policy University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3333-7833","authenticated-orcid":false,"given":"Anna","family":"Ware","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California San Francisco  San Francisco California USA"},{"name":"Department of Medicine San Francisco VA Medical Center  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3298-2112","authenticated-orcid":false,"given":"Jing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California San Francisco  San Francisco California USA"},{"name":"Department of Medicine San Francisco VA Medical Center  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9093-6299","authenticated-orcid":false,"given":"Gary","family":"Tarasovsky","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California San Francisco  San Francisco California USA"},{"name":"Department of Medicine San Francisco VA Medical Center  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9257-2609","authenticated-orcid":false,"given":"Stephen","family":"Shiboski","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6771-3465","authenticated-orcid":false,"given":"Jennifer L.","family":"Barton","sequence":"additional","affiliation":[{"name":"Department of Medicine VA Portland Health Care System  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9247-8957","authenticated-orcid":false,"given":"Karla L.","family":"Miller","sequence":"additional","affiliation":[{"name":"Primary Care Service VA Salt Lake City Health Care System  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7549-7700","authenticated-orcid":false,"given":"Holly A.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Medicine Ralph H Johnson VA Medical Center  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1181-3978","authenticated-orcid":false,"given":"Jo","family":"Dana","sequence":"additional","affiliation":[{"name":"Department of Medicine San Francisco VA Medical Center  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8807-4095","authenticated-orcid":false,"given":"Kimberly","family":"Reiter","sequence":"additional","affiliation":[{"name":"Medical Service Raymond G. Murphy VA Medical Center  Albuquerque New Mexico USA"},{"name":"Department of Medicine University of New Mexico School of Medicine  Albuquerque New Mexico USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4249-9492","authenticated-orcid":false,"given":"Elizabeth","family":"Wahl","sequence":"additional","affiliation":[{"name":"Department of Medicine VA Puget Sound Healthcare System  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4056-0737","authenticated-orcid":false,"given":"Karine","family":"Rozenberg\u2010Ben\u2010Dror","sequence":"additional","affiliation":[{"name":"Department of Medicine Great Lakes Region VA Health Care System, VISN 12 PBM  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7361-7162","authenticated-orcid":false,"given":"Ronald G.","family":"Hauser","sequence":"additional","affiliation":[{"name":"Clinical Chemistry Veterans Affairs Connecticut Healthcare System  West Haven Connecticut USA"},{"name":"Department of Laboratory Medicine Yale University School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5943-0078","authenticated-orcid":false,"given":"Mary A.","family":"Whooley","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California San Francisco  San Francisco California USA"},{"name":"Department of Medicine San Francisco VA Medical Center  San Francisco California USA"},{"name":"Institute for Health Policy University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.39480"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/PTS.0000000000001079"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2020.03.003"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.210257"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.122.009256"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.2196\/44455"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.14697"},{"key":"e_1_2_9_9_1","unstructured":"Microsoft Docs.Data sources in PowerBI Desktop \u2013 PowerBI. 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