{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:28:07Z","timestamp":1760236087120,"version":"build-2065373602"},"reference-count":21,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,10,23]],"date-time":"2021-10-23T00:00:00Z","timestamp":1634947200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Since 2020, the US Preventive Services Taskforce has recommended expanding hepatitis C virus (HCV) screening to include ages 18\u221279, in addition to baby boomers (born 1945\u22121965) and those at-risk for hepatitis C virus. This retrospective cohort analysis compared patients (18 years and above) tested for HCV through usual care versus a coordinator-supported program (HCV pathway) during 2015\u22122018 within Kaiser Permanente Mid-Atlantic States (KPMAS). In total, 131,176 patients were tested through the HCV pathway and 128,311 through usual care (non-standardized testing). Of those tested, 1.6% (HCV pathway) and 0.5% (usual care) had chronic HCV. Of those with chronic HCV, more patients tested within the HCV pathway completed hepatic transient elastography (82.6% HCV pathway vs. 45.6% usual care; p &lt; 0.001) and a gastroenterology visit (72.2% HCV pathway vs. 46.5% usual care; p &lt; 0.001), and had filled prescriptions for treatment (56.5% HCV pathway vs. 40.3% usual care; p &lt; 0.001). The median time to complete each step was shorter for those tested through the HCV pathway (hepatic transient elastography (26 vs. 118 days), gastroenterology visit (63 vs. 131 days), and prescription fill (222 vs. 326 days)). More patients tested through a coordinator-supported, standardized testing pathway completed the necessary testing steps, in less time, compared to usual care. These findings may inform institutions seeking to create effective population-wide testing programs for HCV and other conditions.<\/jats:p>","DOI":"10.3390\/v13112140","type":"journal-article","created":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T21:44:31Z","timestamp":1635198271000},"page":"2140","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A Comprehensive Coordinator Supported Hepatitis C Virus Testing and Linkage to Treatment Program at Kaiser Permanente Mid-Atlantic States"],"prefix":"10.3390","volume":"13","author":[{"given":"Mary Cabell","family":"Jonas","sequence":"first","affiliation":[{"name":"Mid-Atlantic Permanente Research Institute, 2101 E. Jefferson Street, Rockville, MD 20852, USA"},{"name":"Mid-Atlantic Permanente Medical Group, Kaiser Permanente Mid-Atlantic States, 2101 E. Jefferson Street, Rockville, MD 20852, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Rubenstein","sequence":"additional","affiliation":[{"name":"Mid-Atlantic Permanente Research Institute, 2101 E. Jefferson Street, Rockville, MD 20852, USA"},{"name":"Mid-Atlantic Permanente Medical Group, Kaiser Permanente Mid-Atlantic States, 2101 E. Jefferson Street, Rockville, MD 20852, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1917-2748","authenticated-orcid":false,"given":"Eric","family":"Watson","sequence":"additional","affiliation":[{"name":"Mid-Atlantic Permanente Research Institute, 2101 E. Jefferson Street, Rockville, MD 20852, USA"},{"name":"Mid-Atlantic Permanente Medical Group, Kaiser Permanente Mid-Atlantic States, 2101 E. Jefferson Street, Rockville, MD 20852, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0040-9896","authenticated-orcid":false,"given":"Sundeep","family":"Basra","sequence":"additional","affiliation":[{"name":"Mid-Atlantic Permanente Research Institute, 2101 E. Jefferson Street, Rockville, MD 20852, USA"},{"name":"Mid-Atlantic Permanente Medical Group, Kaiser Permanente Mid-Atlantic States, 2101 E. Jefferson Street, Rockville, MD 20852, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Horberg","sequence":"additional","affiliation":[{"name":"Mid-Atlantic Permanente Research Institute, 2101 E. Jefferson Street, Rockville, MD 20852, USA"},{"name":"Mid-Atlantic Permanente Medical Group, Kaiser Permanente Mid-Atlantic States, 2101 E. Jefferson Street, Rockville, MD 20852, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr6902a1","article-title":"CDC Recommendations for Hepatitis C Screening Among Adults\u2014United States, 2020","volume":"69","author":"Schillie","year":"2020","journal-title":"MMWR. Recomm. Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1002\/hep.30297","article-title":"Estimating Prevalence of Hepatitis C Virus Infection in the United States, 2013\u20132016","volume":"69","author":"Hofmeister","year":"2019","journal-title":"Hepatology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"399","DOI":"10.15585\/mmwr.mm6914a2","article-title":"Vital Signs: Newly Reported Acute and Chronic Hepatitis C Cases\u2015United States, 2009\u20132018","volume":"69","author":"Ryerson","year":"2020","journal-title":"Morb. Mortal. Wkly. Rep."},{"key":"ref_4","unstructured":"Centers for Disease Control and Prevention (2021, October 15). Beyond Baby Boomers: Hepatitis C Now Heavily Impacting Multiple Generations, Available online: https:\/\/www.cdc.gov\/nchhstp\/newsroom\/2020\/hepatitis-c-impacting-multiple-generations-press-release.html."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1652","DOI":"10.1002\/hep.25556","article-title":"Awareness of infection, knowledge of hepatitis C, and medical follow-up among individuals testing positive for hepatitis C: National Health and Nutrition Examination Survey 2001\u20132008","volume":"55","author":"Denniston","year":"2012","journal-title":"Hepatology"},{"key":"ref_6","first-page":"1","article-title":"Recommendations for the identification of chronic hepatitis C virus infection among persons born during 1945\u20131965","volume":"61","author":"Smith","year":"2012","journal-title":"Morb. Mortal. Wkly. Rep. Recomm. Rep."},{"key":"ref_7","unstructured":"US Preventive Services Task Force (2021, October 15). Final Recommendation Statement\u2014Hepatitis C Virus Infection in Adolescents and Adults: Screening, Available online: https:\/\/www.uspreventiveservicestaskforce.org\/uspstf\/recommendation\/hepatitis-c-screening."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"175","DOI":"10.2105\/AJPH.2017.304132","article-title":"Increases in Acute Hepatitis C Virus Infection Related to a Growing Opioid Epidemic and Associated Injection Drug Use, United States, 2004 to 2014","volume":"108","author":"Zibbell","year":"2018","journal-title":"Am. J. Public Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"25","DOI":"10.14218\/JCTH.2019.00059","article-title":"Assessing the Effectiveness of Strategies in US Birth Cohort Screening for Hepatitis C Infection","volume":"8","author":"Tsay","year":"2020","journal-title":"J. Clin. Transl. Hepatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1002\/hep.29362","article-title":"Impact of an electronic health record alert in primary care on increasing hepatitis c screening and curative treatment for baby boomers","volume":"66","author":"Konerman","year":"2017","journal-title":"Hepatology"},{"key":"ref_11","unstructured":"Centers for Disease Control and Prevention (2021, October 15). Know More Hepatitis, Available online: https:\/\/www.cdc.gov\/knowmorehepatitis\/index.htm."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Linas, B.P., Barter, D.M., Leff, J.A., Assoumou, S.A., Salomon, J.A., Weinstein, M.C., Kim, A.Y., and Schackman, B.R. (2014). The Hepatitis C Cascade of Care: Identifying Priorities to Improve Clinical Outcomes. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0097317"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"ofaa322","DOI":"10.1093\/ofid\/ofaa322","article-title":"Persistent Challenges in the Hepatitis C Virus Care Continuum for Patients in a Central Texas Public Health System","volume":"7","author":"Reader","year":"2020","journal-title":"Open Forum Infect. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"226","DOI":"10.14218\/JCTH.2018.00063","article-title":"Hepatitis C Screening: Barriers to Linkage to Care","volume":"7","author":"Saab","year":"2019","journal-title":"J. Clin. Transl. Hepatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/j.cgh.2019.12.038","article-title":"Hepatitis C Care Pathway Associated With Increased Screening, Confirmation, and Diagnosis Communication to Patients","volume":"19","author":"Rubenstein","year":"2021","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1093\/cid\/ciw086","article-title":"Streamlining Screening to Treatment: The Hepatitis C Cascade of Care at Kaiser Permanente Mid-Atlantic States","volume":"62","author":"Jonas","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1089\/apc.2015.0139","article-title":"The HIV Care Cascade Measured Over Time and by Age, Sex, and Race in a Large National Integrated Care System","volume":"29","author":"Horberg","year":"2015","journal-title":"AIDS Patient Care STDs"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1089\/apc.2020.0145","article-title":"Beyond the HIV Care Continuum and Viral Suppression: Broadening the Scope of Quality Metrics for Total HIV Patient Care","volume":"34","author":"Horberg","year":"2020","journal-title":"AIDS Patient Care STDs"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1080\/01621459.1989.10478874","article-title":"The robust inference for the Cox proportional hazards model","volume":"84","author":"Lin","year":"1989","journal-title":"J. Am. Stat. Assoc."},{"key":"ref_20","unstructured":"Therneau, T. (2020, September 01). A Package for Survival Analysis in R, Available online: https:\/\/CRAN.R-project.org\/package=survival."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1038\/s41591-019-0706-x","article-title":"Global elimination of hepatitis C virus by 2030: Why not?","volume":"26","author":"Dore","year":"2020","journal-title":"Nat. Med."}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/13\/11\/2140\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:21:53Z","timestamp":1760167313000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/13\/11\/2140"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,23]]},"references-count":21,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["v13112140"],"URL":"https:\/\/doi.org\/10.3390\/v13112140","relation":{},"ISSN":["1999-4915"],"issn-type":[{"type":"electronic","value":"1999-4915"}],"subject":[],"published":{"date-parts":[[2021,10,23]]}}}