Greater Cincinnati Primary Care Practices Improved Colon Cancer Screenings

GREATER CINCINNATI PRIMARY CARE PRACTICES IMPROVED COLON CANCER SCREENINGS 

Report finds 6% increase in overall rate for colon cancer screening in region

CINCINNATI – More patients in Greater Cincinnati are getting screened for colon cancer, according to a new report. The overall rate for colon cancer screening in Greater Cincinnati increased to 64 percent in 2013, an increase of 6 percentage points over the 2011 baseline data which measured a screening rate of 58 percent.

The ratings, voluntarily reported by primary care practices to YourHealthMatters, show how well doctors and their patients in the Greater Cincinnati region did in completing the recommended screening for colon cancer.

YourHealthMatters.org is the community’s trusted, neutral source for health care quality ratings. Created by The Health Collaborative, the website allows Greater Cincinnati health care consumers to rate primary care practices in their area based on voluntarily reported patient satisfaction survey results, cardiovascular health, diabetes care, and colon cancer screening rates.

The goal for doctors and their patients is that all patients between the ages of 50 and75 should be screened for colon cancer via one of the professionally recognized tests for colon cancer screening, as established by the United States Preventive Services Task Force (USPSTF).

Patients were considered up-to-date in their screening for colon cancer if they had one of three USPSTF recommended screening tests: A colonoscopy procedure, performed between Jan. 1, 2004 – Dec. 31, 2013 (recommended every 10 years); a flexible sigmoidoscopy procedure, performed between Jan. 1, 2009 – Dec. 31, 2013 (recommended every five years); or an annual stool testing in the form of either a Guaiac Fecal occult blood test (gFOBT) between Jan. 1-Dec. 31, 2013 or a Fecal immunochemical test (FIT) between Jan. 1 – Dec. 31, 2013.

In order for a practice to get a point toward their score, a patient between the ages of 50 and 75 must have received one of the approved screening tests within the prescribed time period. Additionally, the screening must have been documented in the patient’s medical chart with their primary care physician.

UC Health Primary Care – West Chester improved the screening rate of its eligible patients from 31% in 2011 to 62% in 2013, utilizing a series of new approaches to electronic health record (EHR) optimization and referral processes.

“The combined approach of EHR tracking of colon cancer screenings, along with follow-up from our team at the time a screening is referred, has really had an impact on the results we’re seeing,” said Manoj Singh, MD, FAAFP, UC Health Primary Care, West Chester. “We’re very excited about the improvements we’ve been able to make to these critically important preventative tests,” she said.

To identify patients between the ages of 50-75 that were not up-to-date on their colon cancer screening, UC Health ran a report using EPIC, an EHR software program. The doctors at UC Health- West Chester then reached out to those patients via MyChart, the online portal for accessing personal health records, prescription refills, and scheduling appointments, to remind them to schedule a wellness visit to receive their screening. For patients who did not have MyChart set-up, the Physicians at UC Health sent a letter to encourage them to schedule appointments.

Dr. Singh also attributes changes to the referral process for screenings as an important variable in the improved screening rates. If after two weeks following a referral to a UC gastroenterologist the patient has not scheduled an appointment, the gastroenterologist then reached out to the patient to set-up an appointment.

Dr. Singh noted that one of the challenges to getting patients the necessary screenings is the need to educate patients about their importance as preventative measures. “If patients wait until symptoms present to get the required screening, we’re no longer talking about screening,” he said, “we’re talking about cancer.”

The improvements the practice has seen have inspired new ways to educate patients on prevention – They’ve just rolled out a new strategy this month to provide patients with an EPIC “snapshot,” a brief summary of their demographic and health information, at the time a patient presents at the practice. If the snapshot indicates that the patient is missing a recommended screening or preventive treatment, it allows the practice to confirm with the patient at that time and follow-up with any necessary tests.

Dr. Barbara Tobias, Medical Director at the Health Collaborative, says that prevention and screening is a major component to advancing the Triple Aim. “Improving patients’ access to preventive care and colon cancer screening, supports our goals for better care, better health, and lower overall health cost in our Greater Cincinnati community.”

The Health Collaborative is a partner organization with the American Cancer Society in the “80% by 2018” initiative, developed by the National Colorectal Cancer Roundtable to achieve the goal of 80% of adults aged 50 and older being regularly screened for colorectal cancer by 2018. Toward this goal, the American Cancer Society provides information on helpful consumer resources on colon cancer screening to the Health Collaborative, which is regularly engaged in promoting information to increase awareness about preventive screening for colon cancer via YourHealthMatters.org.

The YourHealthMatters report measured 197,919 eligible patients between the ages of 50 and 75 attributed to 483 providers, across 128 primary care practices in Greater Cincinnati. The measurement period included patients with dates of service at their primary care physician between Jan. 1, 2013 and Dec. 31, 2013. It excluded patients who had not been seen by their primary care physician once per year for the past two years, in order to capture those patients that were established with their provider.

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