The Kentucky Regional Extension Center was proud to partner with the Kentucky Department for Public Health and other key partners on a five year Center for Disease Control and Prevention grant: Organized Approaches to Improve Colon Cancer Outcomes. As health information technology advisors we worked with grantee practices (seven federally qualified health centers) to use their certified electronic health records to implement evidence based interventions and make significant improvement in their colon cancer screening rates. The Kentucky Cancer Consortium Partner Spotlight from September 16, 2020, provides an overview of the project.

Kentucky Department for Public Health: Organized Approaches to Improve Colon Cancer Outcomes

In 2015, the Kentucky Department for Public Health (KDPH) was selected to participate in a five year grant from the Centers for Disease Control and Prevention (CDC) focused on improving Colorectal Cancer outcomes. In the course of this work, a team of colon cancer and health system experts assisted seven Federally Qualified Health Centers in reviewing baseline screening rate data, assessing current screening practices, and identifying opportunities for improvement in various clinics across the state. The health systems then implemented evidence based interventions, and addressed workflow gaps found during the assessment process.

These Evidence Based Interventions (EBI’s) included:

Provider assessment and feedback – generating reports on provider performance in delivering or offering screening to clients (assessment) and presenting providers with information about their performance in providing screening performance (feedback).

Provider reminders – inform healthcare providers that it is time for a client’s cancer screening test (called “a reminder”) or that the client is overdue for screening (called “a recall”). The reminders can be provided in different ways, such as in client charts or by email.

Client reminders – written (letter, postcard, or email) or telephone messages (including automated messages) advising people that they are due for screening or to complete a scheduled screening

Reducing structural barriers – addressing non-economic burdens or obstacles that make it difficult for people to access cancer screening. Interventions designed to reduce these barriers may facilitate access to cancer screening services.

Patient Navigation – providing coaching to patients on the process for CRC screening and providing support to address barriers such as transportation

From baseline to May 2020, CRC screening rates between all 7 participating health systems improved between 2-29.6% (with an average of 16.1%)! Each health system made different workflow changes to improve their CRC screening workflows to increase their screening rate. The common thread was improving use of stool based testing (FIT or Cologuard) for average risk patients, supported by improving patient education on the process of completing and returning stool based tests, using provider assessment and feedback reports to track progress and making use of patient navigators to support patients in the screening process.

The Kentucky Department for Public Health has received funding for a new five year cycle of funding from CDC and will begin working with 5 new health systems later this year. Key partners in the work include the Kentucky Regional Extension Center, the American Cancer Society, the Kentucky Primary Care Association, the Kentucky Cancer Programs at both UK and UL, and the Kentucky Cancer Consortium.

Contact us at Kentucky REC with your questions about quality improvement. Our team of experts is here to help: 859-323-3090.