
Overview
Hepatitis C (HCV) is not only a significant health concern but also a preventable one. Each year, over 300 Australians lose their lives to hepatitis C-related complications. As a blood-borne virus, HCV can lead to severe liver damage, liver cancer, and death if left untreated.
Early detection through enhanced screening programs and increased public awareness is crucial. By identifying and treating HCV early, we can prevent its spread and reduce its prevalence and impact significantly. Modern treatments, particularly Direct Acting Antivirals (DAAs), have shown remarkable efficacy, achieving cure rates of 93 to 94 per cent between 2019 and 2022.
Despite these advancements, there remains a critical gap between HCV diagnosis and the uptake of DAA treatment. General practice is uniquely positioned to bridge this gap, playing a vital role in early detection, patient education, and the management of HCV. By focusing on the elimination of HCV, general practices have an extraordinary opportunity to save lives, reduce healthcare costs, and transform hepatitis C from a widespread health challenge to a preventable and curable condition.
Addressing HCV in general practice not only improves individual patient outcomes but also enhances overall public health, leading to a healthier, more informed community.
In this toolkit, you can find quality improvement activity ideas, resources, and information that can assist your practice in focusing on HCV in primary health care.
Foundation of Quality Improvement
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Foundation of Quality ImprovementViewHide
The foundation of quality improvement outlines what quality improvement (QI) is, why undertake QI and what are the key components of QI.
Foundations of quality improvement
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Model for Improvement (MFI) TemplateViewHide
This MFI template has been adapted from the institute of healthcare innovation to develop, test, and implement changes in general practices participating in South Western Sydney PHN’s QIPC program.
Quality improvement in primary care program (QIPC)
Quality Improvement Activities
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Data CleansingViewHide
Data cleansing involves identifying and correcting errors, inconsistencies, or missing information in a data record. It ensures high-quality data that will enable a clinician to provide optimal care. Ethnicity (country of origin) and indigenous status are considered risk factors for hepatitis C (HCV). Heavy alcohol consumption is linked to liver disease and an increased likelihood of complications from HCV. Accurate coding and up-to-date patient medical records enable a clinician to identify patients for HCV screening who are at higher risk of contracting HCV and provide optimal care for those diagnosed with HCV. The following QI activities can assist you in updating and improving your patient’s medical records.
Hepatitis C – Ethnicity recording
Clinical guide for Best Practice software – How and where to document – Data cleansing
Clinical guide for Medical Director software – How and where to document – Data cleansing
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ScreeningViewHide
Identifying and treating hepatitis C (HCV) early can reduce its prevalence and impact on the patient and society. Early detection through enhanced screening programs can prevent the spread of HCV. The following QI activities can assist you in identifying patients who may benefit from HCV testing. For example, having an abnormal ALT result is a clinical indicator for HCV testing.
Hepatitis C – Hep C patient- abnormal ALT
Clinical guide for Best Practice software – How and where to document – Pathology
Clinical guide for Medical Director software – How and where to document – Pathology
Hepatitis C – Potentially undiagnosed hep C patients with HCV ab positive
Clinical guide for Best Practice software – How and where to document – Coding
Clinical guide for Medical Director software – How and where to document – Coding
Hepatitis C – Potentially undiagnosed hep C patients on DAA treatment
Clinical guide for Best Practice software – How and where to document – Coding
Clinical guide for Medical Director software – How and where to document – Coding
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ManagementViewHide
Hepatitis C (HCV) is a treatable condition, and Direct-Acting Antivirals (DAAs) offer a highly effective treatment option, with success rates around 95 per cent. By screening patients with an active HCV diagnosis who lack an APRI score or are not yet on DAA therapy, healthcare providers can assess the level of care required and prioritise treatment. Identifying and treating these patients is crucial for maximising the benefits of DAAs. Following up 12 weeks after DAA treatment not only confirms the cure but also helps identify barriers and areas for improvement, ultimately supporting the goal of HCV elimination.
Hepatitis C – Hep C patient- not on DAA (no treatment)
Clinical guide for Best Practice software – How and where to document – Coding
Clinical guide for Medical Director software – How and where to document – Coding
Hepatitis C – Hep C no APRI risk
Hepatitis C – Hep C elimination
Clinical guide for Best Practice software – How and where to document – Coding
Clinical guide for Medical Director software – How and where to document – Coding
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MBSViewHide
Hepatitis C (HCV) remains one of the most prevalent diseases in Australia. By utilising these walkthroughs to identify hepatitis C patients potentially eligible for MBS items, practices can better monitor their patient population while also increasing revenue for their practice by billing the associated item numbers. This supports practice sustainability, high-quality care and long-term practice growth.
Hepatitis C – Hep C patient – indigenous health assessment
Clinical guide for Best Practice software – How and where to document – Health Assessments
Clinical guide for Medical Director software – How and where to document – Health Assessments
Hepatitis C – Hep C patient eligible for heart health check
Clinical guide for Best Practice software – How and where to document – Heart health check
Clinical guide for Medical Director software – How and where to document – Heart health check
Hepatitis C – Hep C patient eligible for home medication review
Clinical guide for Best Practice software – How and where to document – Home medication review
Clinical guide for Medical Director software – How and where to document – Home medication review
Tips and Tricks
Private bookmark
It is not always easy to remember what filters have been applied to obtain the required patient cohort, especially when using multiple filters.
The Private Bookmark function is available on all POLAR reports. By creating your bookmark, a single click from the bookmark list will allow you to retrieve all previously applied filters needed for the patient cohort.
To learn how to set up a private bookmark Click here
Correct documentation
For POLAR to extract the most accurate data, it is important each item is correctly documented in the patient’s file. Data mapping of each tab is available in the help menu, to guide clinicians in documenting care items in the correct place in their clinic’s medical software.
Helpful Resources
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Clinical Support ResourcesViewHide
Australian injecting and illicit drug users league (AIVL) | Hepatitis C resources
University of Liverpool | Hepatitis drug interactions calculator
HCV Guidelines | Hepatitis C management
STI Guidelines Australia | Hepatitis C guidelines
The power of words | Anti-stigma guide
AIVL’s National NSP Directory | NSPs in NSW
Haemophilia Foundation Australia | Hepatitis C resources
ASHM | National HCV Testing Policy
Pharmaceutical Benefits Scheme (PBS) | New Hepatitis C treatments listed on the PBS
ASHM | Decision making in hepatitis C
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Patient Support ResourcesViewHide
Hepatitis NSW | Hepatitis resources
Liver Foundation | Hepatitis C
Hepatitis Australia | National hepatitis infoline
Hepatitis Australia | Non-English-speaking resources
Hepatitis Australia | Patient guide for testing and treatment
University of Sydney | Motivate C project
MHAHS | Hepatitis C: What you need to know
Information and Support
Please email enquiries to CQIsupport@swsphn.com.au for further information or support with the toolkit.