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Colorectal Cancer Screening and the Electronic Health Record

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Use of clinical reports to identify patients not receiving screenings ... Identify patients meeting screening guidelines. Identify patient overdue for suggested ... – PowerPoint PPT presentation

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Title: Colorectal Cancer Screening and the Electronic Health Record


1
Colorectal Cancer Screening and the Electronic
Health Record
2
Presenter
  • Jerri Hiniker
  • RN, BSN, CPHER
  • Program Manager
  • Stratis Health

3
Stratis Health
  • Stratis Health is a non-profit organization that
    leads collaboration and innovation in health care
    quality and safety, and serves as a trusted
    expert in facility improvement for people and
    communities
  • Under federal contract, Stratis Health serves as
    Minnesotas Medicare Quality Improvement
    Organization (QIO) 
  • Stratis Health is also involved in other state
    and national projects funded through government
    contracts, foundation and corporate grants, and
    health systems
  • www.stratishealth.org

4
Prevention Theme Overview
  • Focus on assisting adult primary care clinics to
    utilize the care management capabilities of
    electronic health records (EHR)
  • Improve cancer screening (colorectal and breast
    cancer) and immunization rates (influenza and
    pneumococcal) for Medicare beneficiaries
  • Care/population management
  • Maximize EHR and office efficiency

5
Prevention Theme Goals
  • Improve rates of colorectal cancer screening by
    15
  • Improve rates of breast cancer screening by 10
  • Improve rates of pneumococcal and influenza
    immunization by 10

6
Participants
  • Sixteen adult primary care clinic sites
  • Rural and urban clinic sites
  • Eight rural
  • Eight urban
  • Small and large clinic sites
  • One to thirty providers per clinic site

7
Expectations of Participants
  • Incorporation of agreed upon care process changes
  • Improvement in care management
  • Submission of data

8
Strengths of an EHR
  • Tracking of preventative care given to a patient
  • Tracking of tests/screenings given
  • Clinical reminders at the point of care
  • Reports of patients not receiving
    tests/screenings
  • Population performance measurement

9
Benefits of an EHR
  • Greater efficiency
  • Improved resource utilization
  • Improved clinical outcomes
  • Greater return on investment

10
Implementing Change
  • Diagnosis of current care practices and
    performance gaps
  • Identification of appropriate interventions to
    reduce performance gaps
  • Monitoring and refinement

11
Interventions
  • Improve data entry related to screening measures
  • Integrate clinical reminders and tracking into
    everyday practice
  • Redesign workflows to improve outcomes
  • Use of clinical reports to identify patients not
    receiving screenings

12
Colorectal Cancer ScreeningData Entry
  • Initiation of fecal occult blood test (FOBT)
    screening
  • Ordering/referral for colonoscopy, flexible
    sigmoidoscopy or double contrast barium enema
  • Document patient refusal of screening
  • Document when screening completed
  • Enter next screening due date

13
Colorectal Cancer ScreeningReminders and Tracking
  • The 4 Rights of Implementing Reminders
  • The right information
  • In the right intervention format
  • To the right person
  • At the right point in the workflow

14
Colorectal Cancer ScreeningWorkflow Redesign
  • Patient care should be organized around
  • Routine screening for disease and/or
    complications of disease
  • Guidelines/parameters for disease management
  • Self-management support activities

15
Colorectal Cancer ScreeningReports
  • Identify patients meeting screening guidelines
  • Identify patient overdue for suggested screenings
  • Prompt communication with patients requiring
    follow-up

16
Results
  • Aggregated baseline results
  • 13 clinics reporting
  • 39.44 colorectal cancer screening performed per
    EHR data
  • Aggregated quarter 5 results
  • 13 clinics reporting
  • 48.64 colorectal cancer screening performed per
    EHR data

17
Next Steps
  • Continued quarterly data submission by clinics
  • Review of clinics progress toward improvement
    thresholds for colorectal cancer screening
  • Assessment of interim interventions
  • Celebrate Successes!

18
Thank You!
  • Contact Information
  • Jerri Hiniker, RN, BSN, CPEHR
  • Email jhiniker_at_stratishealth.org
  • Ph 952-853-8540
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