Utility of Accurint® Lexis Nexis in Locating Hard to Reach Patients

BACKGROUND:   The rate of hepatitis C virus (HCV) infection among Florida’s young adults (YA) aged 18 to 30 years has accelerated since 2009.  In 2012, the Florida Department of Health (DOH) began to prospectively collect risk factor information for a sample of HCV infected YA.  The majority of hepatitis cases reported to DOH are reported by receipt of an electronic laboratory result (ELR).  ELRs are often missing case information and YA are highly mobile, relocating often for jobs, family, or school, making them particularly difficult to locate for interview.  In addition, the high rate of illicit drug use (81% in pilot project) in this group results in many cases being incarcerated or in drug treatment programs and thus unavailable for interview.  To contact more cases, DOH purchased Lexis Nexis Accurint, a web-based portal to government data sources including a database of mobile phone numbers. 

METHODS:   Ten counties agreed to participate in the project and 15 investigators were given Lexis Nexis accounts. Staff attempted to contact persons aged 18 to 30 years with HCV infection reported between January 1 and September 30, 2013 and recorded the amount of time spent tracking down case contact information.

RESULTS:   During the pilot phase of the HCV in YA Project, an average of 55 minutes was spent on each case: 35 minutes obtaining contact information and 20 minutes for the interview.  A total of 804 cases were investigated and 373 (46%) were contacted.  With the purchase of Lexis Nexis in 2013, the number of cases investigated more than doubled: 2,177 cases were investigated and 987 (45%) were contacted.  Of the cases investigated, just 31% had contact information available when originally reported to DOH.  The average time spent on each case decreased from 55 to 37 minutes (23 investigating and 14 interviewing).

CONCLUSIONS:  Lexis Nexis was purchased to provide DOH with additional sources needed to locate individuals who are lost to follow-up and possibly unaware of their infection status.  Use of the service saved 12 minutes per case investigation, allowing DOH to more than double the number of cases investigated.  However, the use of Lexis Nexis did not increase the case contact rate.   As in the pilot project, more than half of all cases were not able to be contacted for interviews. While a third of those not contacted were located in a correctional facility or drug treatment center, 37% of all cases investigated could not be located at all.