Electronic health records improve colon cancer screening rates ...

Centralized record-keeping systems may help improve rates of colon cancer screening, according to a new study.

Researchers at the Group Health Cooperative, a non-profit health care and insurance system in Washington state, used electronic health records to identify and monitor almost 5,000 patients who were due for a?colon cancer screening but hadn't gotten it.

One group of patients received "normal care" - reminders from their doctor during appointments. A second group received a letter in the mail encouraging them to get screened; a third group got a call from a medical assistant on top of all of that, and a fourth group got a "patient navigator" to manage the screening process.

Each additional step increased the percentage of people who got screened, from 26% in the "normal" group to 65% in the patient navigator group.

"With a simple centralized program, we leveraged our electronic health records to identify those who needed screening," said Dr. Beverly Green, the lead study author and a practicing family physician at GHC. "We doubled the colon cancer screening rates."

Traditionally, Green says, colon cancer screening rates are much lower than with other cancers - namely breast and cervical cancers - largely because of one major factor: Convenience.

"You have to take off a day of work, maybe two. The prep is uncomfortable. You have to have somebody to drive you," said Green. "People don't like the idea of (colonoscopies); they're fearful of it."

But she said, colonoscopy wasn't the only screening option offered.

"While [patients are] mustering up their strength to have a colonoscopy, 5 years have passed, and in that period of time, they could be doing a stool card."

A stool card - also known as a Fecal Occult Blood Test (FOBT) - involves putting a small stool sample on a card and mailing it into a lab, where technicians look for trace amounts of blood.

Current U.S. Preventative Services Task Force recommendations say patients should do either a stool card each year, beginning at age 50; a flexible sigmoidoscopy every 5 years along with stool testing, or a colonoscopy every 10 years.

One major criticism of the study is that, although researchers were able to double screening rates, the number of colonoscopies - considered the most sensitive screening tool - actually went down.

"A lot more people did get screened," Green says, "but a few people, because we sent them a stool card, did that in place of a colonoscopy."

And she says while a stool card isn't as effective as a colonoscopy - it'll catch 75% of colon cancers, but very few, if any, pre-cancerous lesions - some testing is better than no testing.

"The best test for colorectal [cancer] screening is the test the patient will do, and one they'll keep doing on time."

Source: http://thechart.blogs.cnn.com/2013/03/04/electronic-health-records-improve-colon-cancer-screening-rates/

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