A population management system for improving colorectal cancer screening in a primary care setting. Issue 3 (11th August 2015)

• Record Type: Journal Article
• Authors: Wu, Charlotte A.; Mulder, Amara L.; Zai, Adrian H.; Hu, Yuanshan; Costa, Manuela; Tishler, Lori Wiviott; Saltzman, John R.; Ellner, Andrew L.; Bitton, Asaf
• Is Part Of: Journal of evaluation in clinical practice. Volume 22:Issue 3(2016)
• Page Start: 319
• Page End: 328
• Publication Date: 2015-08-11
• Subjects: care redesign -- health information technology -- population management -- preventive colorectal cancer screening -- primary care; Clinical medicine -- Periodicals; 616.005
• DOI: 10.1111/jep.12427
• Languages: English
• ISSNs: 1356-1294

Abstract

Abstract: Rationale: Provision of colorectal cancer (CRC) screening in primary care is suboptimal; failure to observe screening guidelines poses unnecessary risks to patients and doctors. Aims and objectives: Implement a population management system for CRC screening; evaluate impact on compliance with evidence‐based guidelines. Methods: Design: A quasi‐experimental, prospective quality improvement study design using pre‐post‐analyses with concurrent controls. Setting: Six suites within an academic primary care practice. Participants: 5320 adults eligible for CRC screening treated by 70 doctors. Intervention: In three intervention suites, doctors reviewed real‐time rosters of patients due for CRC screening and chose practice delegate outreach or default reminder letter. Delegates tracked overdue patients, made outreach calls, facilitated test ordering, obtained records and documented patient deferral, exclusion or decline. In three control suites, doctors followed usual preventive care practices. Main outcome measures: CRC screening compliance (including documented decline, deferral or exclusion) and CRC screening completion rates over 5 months. Results: At baseline, there was no significant difference in CRC screening compliance (I: 80.4% and C: 79.6%, P = 0.439) and CRC screening completion rates (I: 78.3% and C: 77.3%, P = 0.398) between intervention and control groups. Post‐intervention, compliance rates (I: 88.1% and C: 80.5%, P < 0.01) and completion rates (I: 81.0% and C: 78.1%, P < 0.05) were significantly higher in the intervention group. Conclusions: A population management system using closed‐loop communication may improve CRC screening compliance and completion rates within academic primary care practices. Team‐based care using well‐designed IT systems can enable sharing of patient care responsibilities and improve patient outcomes.