Analysis Indicates Need to Raise Awareness

An analysis of medical records provided by Cincinnati area primary care physicians indicates just 58 percent of patients who should be screened for colorectal cancer are actually getting tested.

The Cincinnati area rate of 58 percent is lower than the national average, reported to be as high as 65 percent. It should be noted that the national rate was established using phone surveys, during which patients reported their screening compliance. The Cincinnati rate was established by analyzing medical charts for documentation of the recommended screening.

After reviewing the results, the Hamilton County Colorectal Cancer Task Force of the American Cancer Society endorsed a goal of 65% by 2013.

Colorectal cancer is the second-leading cause of cancer related deaths in the U.S. Early detection can reduce mortality by 15%–33%. The United States Preventive Services Task Force, a division of the U.S. Department of Health and Human Services, recommends colorectal cancer
screening for anyone between the ages of 50-75. Screening may be recommended earlier for patients with a family history or other risk factors.

The Cincinnati rate was established from data analysis conducted by the Health Collaborative. The data was collected in a HIPAA compliant manner from anonymous patient charts provided by nearly 325 physicians. It was published March 12, 2012 to the website, YourHealthMatters.org. Each physician’s practice compliance rate is also reported to the website where it can be compared to other practices and the region’s average.

The report is a product of the Health Collaborative’s transparency and public reporting initiative. This effort is designed to give patient objective data about the quality of medical care provided by area physicians. It also provides physicians with data driven insights about their patient
populations which they can use in their efforts to improve their success in motivating patients to manage their health.

“The bad news is, in Cincinnati, we are not ahead of the curve in persuading our patients to receive the recommended CRC screening,” says Dr. Barbara Tobias, Medical Director for the Health Collaborative. “The good news is that thanks to our primary care physicians voluntarily providing this data, we have a benchmark in place. Now each primary care doctor knows there is work to do to influence patients to get tested.”

In related qualitative research conducted by the Health Collaborative in early 2011, patients interviewed in focus groups indicated they chose to forgo screening because of unanswered questions, fears, and in some cases, misconceptions about the colonoscopy testing procedure. The research suggests primary care physicians could gain better compliance by being more proactive about explaining the test and asking patients to discuss their questions or concerns.

March is Colon Cancer Awareness month. The American Cancer Society has a number of local and national activities planned to raise awareness about the importance of CRC screening. One of those efforts involves arming local primary care physicians with tools to help encourage patients ages 50-75 to get screened. The “Your Day of Rest” campaign is an attempt to tackle some of the discomforts associated with colonoscopy procedures. Given the proper approach, and knowing what to do prior to the procedure, can heighten one’s comfort level of having a colonoscopy.

“Whether it is a fear of having the procedure or just not knowing what goes on during the process, we want to do everything possible to ease a person’s concerns. Of course we hope that everyone that gets screened is OK, but being able to find the problem before the symptoms occur increases survivorship and that is our ultimate goal,” said Dr. Michael Kreines, Colorectal Cancer Mission Chair for the American Cancer Society.

The public reporting initiative and YourHealthMatters are funded in part by Bethesda Inc., and Aligning Forces for Quality, an initiative of the Robert Wood Johnson Foundation.

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The Health Collaborative assembles diverse community stakeholders; hospitals, physicians, insurers, patients, business, education, government and community members, with the goal of generating measurable, sustainable health improvement. The work of the Collaborative has been recognized by the U.S. Department of Health & Human Services, the Agency for Healthcare Research and Quality, and the Robert Wood Johnson Foundation. For more information, visit www.the-collaborative.org.

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