Becker's Hospital Review

69 Executive Briefing SPONSORED BY T o better understand how healthcare organizations are using technology to increase colorectal cancer (CRC) screening rates, Becker's Hospital Review recently spoke with two healthcare leaders from Yale New Haven Health's Northeast Medical Group in New Haven, CT — Maggie Shalagan, Population Health Manager, and Kaitlin May, Population Health Supervisor — and two leaders from Prisma Health Medical Group in Greenville, S.C. — Katie Lawrence, Executive Director, Ambulatory Optimization and Integration, and Molly Nichols, Manager, Performance Improvement. To boost CRC screening rates, health information technology (HIT) optimization can play an essential role When it comes to closing CRC screening gaps, health systems recognize electronic health record (EHR) systems have a central role to play. To find and activate patients for CRC screening, providers at Prisma Health Medical Group rely on data in patient medical records. "We have a health maintenance tab in our EHR with all the care gaps that are coming due for a patient or that are overdue," Ms. Lawrence said. "Within primary care, the required documentation tab draws attention to things that will be due very soon. For colorectal cancer, physicians can see not only that patients are due for a screening, but the cadence of follow- up screenings that they need, based on clinical outcomes." Yale New Haven Health's Northeast Medical Group also uses data analytics, population health dashboards and quality improvement dashboards in the EHR to track certain metrics. "Patients [aged] 45 to 75 are added to our colorectal cancer screening metric denominator," Ms. Shalagan said. "This populates the screening topic in the health maintenance section of the patient's medical chart." HIT optimization also has a human element. Prisma Health Medical Group, for example, has created an Information Services Advisory Group designed to reduce EHR tasks for primary care physicians. "We realized we needed to use the medical record to the best of its ability," Ms. Lawrence said. "The last thing we wanted was to add four clicks to every visit for every provider. The Information Services Advisory Group meets monthly and is co-led by a physician champion and a physician assistant champion. The team analyzes how to simplify care gaps and workflows by pre-populating forms and pre-launching screenings." During office visits, care gaps are displayed to Prisma Health providers in a different color font and the associated orders are pre-checked. This saves a tremendous number of clicks for clinicians. "After we implemented changes like this in the EHR system, providers started coming up with other ideas and fed them to the committee," Ms. Lawrence noted. Yale New Haven Health's Northeast Medical Group has also paired human resources with its EHR data to improve CRC screening rates. Preventive health coordinators, (PHCs), are embedded on-site in about half of the primary care practices. "The PHCs work with clinicians and support staff in the office to review risk factors like personal and family history of colorectal cancer and other gastrointestinal (GI)-related issues that require a colonoscopy," Ms. Shalagan said. "Once they review that information, they engage in shared decision-making with patients and offer alternative screening methods like mt-sDNA tests, Fecal Immunochemical Tests, sigmoidoscopies and computed tomography (CT) scans of the colon." Through their work in the EHR system, the PHCs have identified additional opportunities for system optimization. "A big problem that we had in our EHR was that colon cancer screening was automatically set at 10 years, but some patients need to be screened again sooner than that," Ms. May said. "Before we had the PHC role, there was no standardized process to change patient charts to reflect the correct recall. The PHCs began to enter the information into patient charts manually, but it was time-consuming and error prone. Now we are automatically changing screening recalls based on GI recommendations written in Epic®. This has improved the accuracy of patient reminders and it has streamlined work for the PHCs." Health information technology (HIT) optimization and the fight against colorectal cancer — Insights from Yale New Haven Health and Prisma Health 4 Action Steps to Increase CRC Screening Rates • Use EHR tools like the patient portal and messaging, high-visibility physician alerts and pre-population of screening topics and forms. • Designate preventive health coordinators to follow up on screening gaps and educate patients about different screening methods. • Engage with patients before, during and after office visits using email, texts, phone calls and more. • Share provider scorecard data across the organization to increase screening rates.

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