Diagnoses Original Tests Proposed buy MAPK Inhibitor Library and Retained Additional Tests Proposed and Retained Tests Proposed

and Eliminated Abnormal Liver Enzymes Cholestatic ANA, AMA, RUQ U/S GGT Hepatitic AST/ALT<5x UしN HBsAg, HCVAb, RUQ U/S, Ceruloplasmin, ASMA, ANA Stop potential medications, a1 antitrypsin, Iron studies SPEP Hepatitic AST/ALT>5x ULN IgM Anti-HAV, HBsAg, IgM Anti-HBc, HCV Ab, ASMA Hepatitis B HBeAg, Anti HBeAg, HBV DNA HIV, RUQ U/S, HCVAb Hepatitis C Genotype, HBsAg, AFP and RUQ U/S if cirrhosis HCV RNA, HIV Iron Studies Fatty Liver Disease HBsAg, HBsAb, Lipids, HgbAlc, >1 imaging study last 12 months Liver Mass HBsAg, HCVAb, AFP, >1 imaging study last 3 months Cirrhosis HBsAg, HCVAb, AFP, Iron Studies. ANA, a1 Antitrypsin AMA, Ceruloplasmin ANA: AntinuclearAb, AMA: Anti-mitochondrialAb; HM781-36B ASMA: Anti-smooth muscle Ab: RUQ U/S: Right Upper Quadrant Ultrasound SPEP: Serum protein electrophoresis; ULN: Upper Limit of Normal Disclosures: Norah Terrault – Advisory Committees or Review

Panels: Eisai, Biotest; Consulting: BMS; Grant/Research Support: Eisai, Biotest, Vertex, Gilead, AbbVie, Novartis The following people have nothing to disclose: Chanda Ho, Christy Boscardin, Nathaniel Gleason, Ralph Gonzales Purpose To improve provision of specialty hepatology care for Veterans living at a distance, the Minneapolis VA Health Care System implemented a Cirrhosis Care Collaborative consisting of a liver video-telehealth learn more (Vtel) clinic and monthly education for primary

care providers (PCPs). Methods To establish a personal relationship with providers and introduce the project, site visits to outpatient clinics and medical centers were conducted. Based on a need assessment that showed lack of basic knowledge in cirrhosis care of PCPs, an educational curriculum was developed. Monthly 45 minute video-education sessions covering basic liver and hepatitis topics were provided. GME credit was available. Sessions were evaluated using online feedback. Case discussions were added at provider’s request. Liver Vtel clinic visits were conducted by one hepatologist. A nurse provided patient education via Vtel. The clinic was evaluated using administrative records and a patient satisfaction survey. After screening consults request for appropriateness for Vtel initially a specialized Vtel consult was developed. Preliminary results are reported. Results From Nov. 2011 to May 2013, 75 Vtel visits were conducted. Most patients had hepatitis G or cirrhosis diagnoses. The no show rate was similar for Vtel (10%) and in-person clinic appointments (7%). 40 patients completed satisfaction surveys with a mean score of 4. 5 (out of 5). By using Vtel, patients saved on average 260 miles in travel per visit and the VA saved $108 in travel reimbursement per visit. /5 clinicians attended education sessions.