Wojcik EM, et al. - In an Appalachian emergency department (ED), researchers examined the characteristics of hepatitis C virus (HCV) antibody-positive (Ab+) and ribonucleic acid (RNA)-confirmed-positive patients identified via two screening models. They retrospectively studied 444 patients (median age: 39 years) who screened HCV Ab+ in the ED from January 1 to October 31, 2018. They obtained data and performed comparative analyses between the risk-based and the universal screening models. They identified this work being the first to present characteristics of HCV Ab+ and RNA-confirmed-positive patients identified during the transition to a universal screening model in an Appalachian ED. The risk factor model led to the identification of 126 HCV Ab+ patients out of 3,014 screened (4%) from January to May 2018, whereas the universal model identified 318 HCV Ab+ patients out of 5,407 screened (6%) from June to October 2018. Regardless of the screening model, most diagnoses were new. However, under the universal model, more patients screened HCV Ab+, and a similar proportion was RNA-confirmed-positive. Given a modest adoption of universal screening, and the continuation of similar risk factors, future research should investigate the path to implement a universal screening model more effectively on a wider scale to recognize early infections.