EHR use doubles colon cancer screening rates

Electronic health records can be used to help identify patients in need of colon cancer screening and help encourage them to obtain the screening, according to a new study published in the Annals of Internal Medicine.

The researchers, from Group Health Research Institute, used EHRs to identify 4,675 Group Health patients ages 50 to 73 who were not up to date for colorectal cancer screening. They were randomly assigned to one of four groups of increasingly interventionist care. The lowest level of intervention was "usual care" whereby patients received physician and clinic reminders to obtain the screening. The other three levels of care involved automated reminder letters and the mailing of fecal occult blood testing (FOBT) kits if they hadn't scheduled an appointment for a colonoscopy or sigmoidoscopy. The highest level of care included additional "navigated" assistance.    

The researchers found that only 26 percent of patients in the "usual care" level obtained the screening, compared to more than 50 percent of the patients in the levels that received automated reminders and the FOBT. The patients in the highest level of intervention had the highest percentage of subsequent screening, with 65 percent.

As an added bonus, the costs of the screening for patients in the three highest levels was lower than for those in the "usual care" level, since more of them were using the FOBTs that they received in the mail rather than the more expensive invasive procedures.

The researchers credited the centralized, automated approach that the EHRs afforded them in improving the screening rates.

"Traditionally, the onus has been on each primary-care doctor to encourage their patients to get health screening tests on schedule," said Beverly Green, MD, MPH, the study's lead author. "We borrowed [a centralized registry approach used for breast cancer screening] and applied it to colorectal cancer," she added.

Other studies have also found that EHRs help improve patient care and outcomes.

To learn more:
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