Table 2 Themes and Select Primary Care Provider Quotations

Innovation: Evaluating Cues to HCV Testing

 • “I test everybody for hep C…you can’t tell who has hep C, you know? You can’t tell so it’s kind of like universal precautions. It’s like you have to assume everybody could have it.”

 • “They don’t know what’s out there so they just put the reminder up there and we just have to do it. No one asks our opinion how it should be, you know?”

 • “You get more reminders and more alerts and more steps and more barriers to everything you want to do and yet no diminution in the number of patients you’re expected to see and the more stuff you get the nurses to do, the more alerts you get, and you don’t have any time for that. So, you know, it’s just, I like taking care of patients, but the whole, the totality of the crap just gets more onerous all the time. “

Recipients: Framing HCV Testing Decisions

 • “Frankly I was a little surprised to be contacted about this because it seems, at least with the public health/preventive medicine background, this seems like a no-brainer that we should just do this, but I do not.”

 • “If the patient has no risk factor and if…they’re still offered then the testing and if they say ‘No, I’m all set’ I don’t push them but if someone has the risk factors definitely then, you know, I put it in a different way so that it’s okay for them to have the test done…we go with the patient, whether yes or no.”

 • “I want time set aside to deal with things, so I try if at all possible to get their labs before they come in for their visit so that it’s taken care of at that time...so if they’ve already had their labs and the reminder pops up after the fact, and it doesn’t always occur to me, check what reminders are due at the time that I’m ordering labs.”

Context: HCV Testing and Linkage to Care in the New Treatment Era

 • “I would say for me I think screening is screening and regardless of whether a patient can tolerate or pursue treatment I think it’s important to know and beyond myself personally I can’t really say one way or the other. I don’t know if people are not screening because they know patients aren’t going to be fit for treatment or if that’s changed based on the new treatments.”

 • “In terms of treatment for hep C I was very impressed when I came to the VA. We got a lot more people through treatment in the VA system than I ever got done outside the system.”

 • “I feel like it comes and it finds us rather than we go looking for it so it’s more like I’m not looking for it and that’s why I don’t test for it very often, like routinely, and because I don’t treat it, it makes it even less in my brain to look for it.”