Joanna Ready, MD

Gastroenterology, Santa Clara

Hepatitis B Screening Program

“At Kaiser Permanente, we work to keep people healthy, not just take care of them when they’re sick,” says Dr. Ready. “So rather than wait for patients with HBV to come to us, why not bring the care to them?”

Though nearly 70 million people in the United States have been vaccinated against hepatitis B (HBV), approximately 850,000 already are infected. HBV can become a chronic infection, putting people at high risk of death from cirrhosis and liver cancer. But with early treatment, those who develop complications stand a much greater chance of surviving. And if they are KP Northern California members, their chances are even better, thanks to Joanna Ready, MD.

Dr. Ready designed a systematic hepatitis B screening program in 2014 that involves reaching out to the 10,000 KP members who are chronically infected and inviting them to undergo laboratory tests and ultrasound every 6 months to monitor the progression of their disease and regularly screen them for liver cancer.

“By doing systematic screening and providing treatment to patients when they need it,” says Dr. Ready, “we can reduce the risk of cirrhosis and hopefully identify hepatocellular carcinoma earlier, when it can be treated surgically via resection rather than a liver transplant.”

The program required coordinating many resources, using information technology, and building multispecialty teams across medical centers to set up systems for providing outreach and follow-up. Today 7,100 patients with chronic HBV are enrolled in the program, making it one of the largest of its kind in the United States. And more than 80 percent of these participants are up to date on their screenings, compared to less than 20 percent in 2011.

“The Hepatitis B Screening Program is an excellent example of the way Kaiser Permanente approaches health care—by combining prevention with acute care,” says Philip Madvig, MD, Associate Executive Director of The Permanente Medical Group. “Dr. Ready’s commitment to serving this population of patients, her clinical expertise, and her tenacity and clarity of purpose make her a role model for other physicians to follow.”