EHR tied to improved screening rates: study

On-time colon cancer screening rates at Group Health Cooperative, Seattle, doubled when the system implemented a centralized electronic registry to identify patients and provide them with reminders and additional support.

Researchers from the Group Health Research Institute configured the health system's electronic health record to flag patients who weren't current on their colon and rectum screenings. Those patients received a reminder letter plus detailed information about the pros and cons of different screening options, according to a newly released study about the intervention, in the Annals of Internal Medicine.

Patients who failed to schedule a colonoscopy after receiving the letter and pamphlet were automatically sent a fecal occult blood testing kit in the mail, complete with “illustrated instructions and a postage-paid return envelope,” Group Health said in a news release. If they failed to send in the kit, they received another reminder letter three weeks later.

The number of Group Health patients who were current for colorectal screening jumped 51% during the two-year study period among patients who received the automated intervention, the researchers found.

In addition, overall healthcare costs fell because a greater number of patients in the automated group chose fecal occult blood testing, which is less expensive than sigmoidoscopy or colonoscopy.

"Traditionally, the onus has been on each primary-care doctor to encourage their patients to get health screening tests on schedule," Dr. Beverly Green, a family physician at Group Health Cooperative, an affiliate investigator at the Group Health Research Institute and the study's lead author, said in the release. “Group Health pioneered using a centralized registry to remind women to be screened regularly for breast cancer. We borrowed that approach and applied it to colorectal cancer. We empowered patients to do testing on time, by giving them options, or sending them a FOBT kit by default if no choice was made."

The percentage of patients who were current for screenings rose even higher, to 51%, when patients were contacted by a medical assistant, and to 65% when they received an additional follow-up call and assistance from a nurse.