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CDC-led Pilot Prompts ONC, AMA to Create CDS Mechanisms for Hepatitis C

June 19, 2014
by Gabriel Perna
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The Centers for Disease Control and Prevention (CDC) is teaming with the Office of the National Coordinator for Health IT (ONC) and the American Medical Association (AMA) to create clinical quality measures (CQMs) and clinical decision support (CDS) tools that will aim to overcome the hepatitis C virus (HCV) infection.

The CDS mechanisms are specifically needed for rural areas, where there is a shortage of HCV specialists, ONC wrote in a blog post. The initiative was promoted by a CDC-led pilot program that saw telemedicine used to fight HCV and develop new treatment tools in rural areas. At two programs, in areas of Arizona and Utah where there are a shortage of HCV specialists, primary care clinicians received training on HCV treatment and thus far, 46 percent of all patients presented received antiviral treatment.

The CDS tools developed will be in the Health Level 7 (HL7) Clinical Decision Support Knowledge Artifact Implementations Draft Standard for Trial Use (DSTU), ONC says.  This will enable broad dissemination of the most current guideline-based CDS interventions. There are requirements around linking the CDS tools with public health and clinical care data systems to track the implementation of these intervention.

"With the health IT infrastructure linking the activities of coalition partners, the goals of the projects are to test and cure 10,000 persons with hepatitis C," ONC writes.

According to ONC, the HCV infection is a growing problem in the United States with three million patients living with it. Costs for those patients, ONC writes, are five times higher than the average patient. ONC and CDC also not there are gaps in HCV treatment at every stage of the disease.

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A very thoughtful article, Gabriel.

Hepatitis C is a major problem because it is asymptomatic and the diagnosis is hard. However, what I find somewhat suspicious is that there is some interest in increasing HCV staff right now when a new treatment for Hepatitis C was discovered.

Sovaldi, new Hepatitis C treatment by Gilead Sciences, hit the market in December 2013 like no other, with almost more than $10 billion in sales it's first year. The citation says that 'Costs for Hepatitis C patients are five times as much as for an average patient'. I find that hard to believe since the new drug Harvoni cost is $94,500 in the US (it's lower in Europe and India).

I hope this call for HCV staff is in regards to the needs of the patients and not there only because pharma companies have to sell the drugs they discovered.


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