Background Chronic hepatitis C virus infection (HCV) is a common infectious disease that affects more than 2.7 million people in the US. Because the emergency department (ED) can present an ideal opportunity to screen patients who may not otherwise get routine screening, we implemented a risk-based screening program for ED patients and established a system to facilitate linkage to care. Methods and findings A risk-based screening algorithm for HCV was programmed to trigger an alert in Epic electronic medical record system. Patients identified between August 2018 and April 2020 in the ED were tested for HCV antibody reflex to HCV RNA. Patients with a positive screening test were contacted for the confirmatory test result and to establish medical care for HCV treatment. Patient characteristics including age, sex, self-awareness of HCV infection, history of previous HCV treatment, history of opioids use, history of tobacco use, and types of insurance were obtained. A total of 4,525 patients underwent a screening test, of whom 131 patients (2.90%) were HCV antibody positive and 43 patients (0.95%) were HCV RNA positive, indicating that only 33% of patients with positive screening test had chronic HCV infection. The rate of chronic infection was higher in males as compared to females (1.34% vs 0.60%, p = 0.01). Patients with history of opioid use or history of tobacco use were found to have a lower rate of spontaneous clearance than patients without each history (opioids: 48.6% vs 72.0%, p = 0.02; tobacco: 56.6% vs 80.5%, p = 0.01). Among 43 patients who were diagnosed with chronic hepatitis C, 26 were linked to a clinical setting that can address chronic HCV infection, with linkage to care rate of 60.5%. The most common barrier to this was inability to contact patients after discharge from the ED. Conclusions A streamlined EMR system for HCV screening and subsequent linkage to care from the ED can be successfully implemented. A retrospective review suggests that male sex is related to chronic HCV infection, and history of opioid use or history of tobacco use is related to lower HCV spontaneous clearance.

Summary Self‐weighing is an evidence‐based weight management strategy, which requires patients to have a home scale. For clinicians to effectively counsel patients on self‐weighing, they should be aware of the costs and features available in typical home scales. Our objective was to describe the cost and features of the top bathroom scales available online. We performed content analysis of top 100 scales listed on a popular online retailer. Two coders independently extracted price and scale features (i.e., digital connectivity, body mass index [BMI] calculation, maximum weight accommodated). We used t‐tests and ANOVA, as appropriate, to examine the relationships between price and features. Among the 97 scales included, mean scale price was $28.99 (SD $21.06; range $7.20–$139.95). Of the advanced features, 20.6% of scales had digital connectivity and 28.9% calculated BMI. Scales with advanced features cost significantly more than scales without (digital connectivity: $49.18 vs. $23.74, P < 0.001; BMI calculation: $42.92 vs. $23.33, P < 0.001). Most scales (76.2%) had a maximum weight of 351–400 lbs, and only 17.5% could accommodate >400 lbs. Price was higher for scales with a higher maximum weight (P = 0.002). No scale with maximum weight > 500 lbs had advanced features. Scales that have digital connectivity for telemedicine or can accommodate higher weights are less commonly available online and their costs may be prohibitive for some patients who need these features. Future research might consider testing whether insurance coverage for scales improves scale access and patient weight management outcomes.

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