San Francisco’s Jail Health Services (JHS) provides HIV, HCV, and STI testing upon request to all people who are incarcerated in either of the City’s county jails. HIV and STI treatment are offered to all people who test positive and is paid for by the City’s general funds, as health insurance is suspended while people are in jail. However, only very limited funding is available for HCV treatment (as of 2022, the City had allocated enough funds to treat 12 people per year). JHS reached out to Facente Consulting to help better understand how to use available medical record data to maximize HCV testing and treatment efforts, given this constraint.
Facente Consulting is helping JHS build the infrastructure to create an HCV care cascade for JHS patients using their Epic medical record system – including the number of people who are incarcerated who’ve been tested for HCV antibodies, the number of people with anti-HCV antibodies who have had a viral load test to confirm active infection, the number of people with confirmed HCV infection who have received treatment, the number of people treated who achieve sustained virologic response (cure), and the number of people diagnosed with HCV who receive screening for hepatocellular carcinoma (liver cancer). After creating the data infrastructure within Epic to regularly review the HCV care cascade in the jails, Facente Consulting will provide capacity-building assistance to JHS staff to allow sustained, ongoing use of this information for continuous quality improvement after the project is complete.