Establishment of intrahospital referral collaboration system for hepatitis-virus-positive patients to hepatology specialists

Abstract

The purpose of this study was to evaluate the effectiveness of the intrahospital referral collaboration system for hepatitis-virus-positive patients to hepatology specialists. The following intrahospital collaboration (laboratory department alert system) was conducted from November 2017 to June 2020. (1) Medical technologists: When a blood test reveals positivity for the HB antigen (HBsAg) or HCV antibodies (HCVAbs), medical technologists indicate an alert in the electronic medical record recommending intrahospital referral to the gastroenterology department. (2) Physicians: After confirming the alert, the physician in charge explains the result to the patient and refer the patient to gastroenterology. In July 2020, we conducted an automatic alert system that allows physicians to recognize a recommendation for referral to gastroenterology when the electronic medical record of an HBsAg- or HCVAb-positive patient is opened. The intrahospital referral rates before collaboration, after the implementation of the laboratory department alert system, and after that of the automatic alert system were 6.0%, 28.8%, and 39.5% for HBsAg-positive patients and 8.6%, 30.7%, and 28.6% for HCVAb-positive patients, respectively. The number of intrahospital referrals increased after collaboration compared with before collaboration. The intrahospital referral rates and the number of referrals increased through the intrahospital referral collaboration, and the hepatitis-virus-positive patients were efficiently referred to gastroenterology.