Issue link: https://beckershealthcare.uberflip.com/i/1424600
70 Executive Briefing Health systems are turning to creative, tech- based solutions to remind eligible patients about CRC screenings Patient engagement related to CRC screenings begins even before individuals visit the physician's office and continues both during and after office visits. Prisma Health Medical Group and Yale New Haven Health's Northeast Medical Group use a variety of outreach techniques at different points in the patient experience: • Branded text messaging and patient portals. Prisma Health Medical Group uses these techniques to communicate with patients about the need for CRC screening. Since around three-quarters of the organization's patient population uses the portal between visits, many patients find out about screening tests through this tool before they even have a doctor's appointment. • After-visit summaries, customized to each patient's orders. Prisma Health Medical Group utilizes this approach to inform patients about different options for CRC screening. "If a patient is due for their colonoscopy, they will receive information about the procedure in their summary," Ms. Lawrence said. "If they're disinclined to have a full colonoscopy and have no risk factors, they can use Exact Sciences mt-sDNA. Because we use mt-sDNA in all our markets, we've seen a huge uptick in our ability to meet colorectal cancer screening requirements. It's a lot less prep and it's easier to do in the comfort of the home. Our after-visit summaries include a link to a how-to video from Exact Sciences. It's nice for patients to review that and see what to expect when the box arrives at their door." • Phone calls and motivational interviewing. Between visits, the PHCs at Yale New Haven Health's Northeast Medical Group often reach out to patients via phone. "All of our PHCs are trained in motivational interviewing," Ms. May noted. "Instead of just telling patients that they're overdue for screenings, they can discuss the best option based on risk factors, personal preferences and other determinants. Once patients truly understand the issues, they can move forward." • Automated phone outreach with transfers to scheduling. Yale New Haven Health also utilizes automated telephonic outreach. When patients pick up the phone, an automated voice indicates that they are overdue for colorectal cancer screening and then patients can transfer to their primary care office to schedule a visit with their PCP to discuss screening options. Provider visibility into CRC screening rates and patient choice of screening procedures are powerful ways to close care gaps Prisma Health Medical Group works collaboratively with the lead physicians and administration at practices to ensure they understand screening metrics and their performance. "We do transparent comparisons of data across the organization which show how each practice stacks up. People know exactly where they and their peers stand. That has motivated people to see how they're doing," Ms. Lawrence said. The provider scorecard pulls data from across the organization. "This is helpful for closing CRC screening gaps when the compliance piece of the measure has been done at an independent GI facility," Ms. Nichols noted. "Providers log into their scorecards once a month and they can pull gap lists from the scorecard. At any time, they can generate a comprehensive list and target individuals." Prisma Health's provider scorecards are also helpful for the quality improvement team. As Ms. Nichols explained, "When we go into a practice, we look at the performance across all providers on a particular measure. If there is a wide amount of variance, that's usually due to workflow issues, so we analyze those first. If the providers' performance is within 5 percent to 10 percent of each other and they're underperforming, we need to understand what's not working across the practice." Industry-level data can also be compelling for providers. "We work closely with Exact Sciences, and they've been great at sharing data to create change in our organization," Ms. May said. "They have data showing CRC screening compliance rates increase when patients are offered a choice, rather than simply being told that they must get a colonoscopy. Using data embedded in our EHR and shared data from Exact Sciences, we can show the difference in compliance rates to clinicians and staff within our primary care sites." Targeted tech, magnified effect: CRC screening rates are rising thanks to technology optimization and innovative provider practices Over the last 18 months, Prisma Health Medical Group has improved its overall colorectal cancer screening score by 5 percent. "That's a pretty big swing, given that we are less than a percent away from meeting the top decile national benchmark, not to mention the COVID-19 pandemic. We've tried to make progress by using many different levers, while simultaneously supporting providers and practices," Ms. Nichols said. "We're happy to see these outcomes." Yale New Haven Health's Northeast Medical Group has found small changes and optimizations can lead to big shifts in terms of empowering patients and changing the culture from a clinician perspective. "When it comes to colorectal cancer, early detection really makes a difference in the diagnosis, quality of life and the patient's overall health state. By optimizing our EHR and our human resources, we are empowering patients to speak up on their own behalf and take care of their health. Although we believe the primary reference standard for CRC screening is the colonoscopy, clinicians understand that the best screening option is the one that gets done," Ms. Shalagan said. "We have to meet patients halfway and that's definitely made a difference." n A leading provider of cancer screening and diagnostic tests, Exact Sciences relentlessly pursues smarter solutions providing the clarity to take life-changing action, earlier. Building on the success of Cologuard ® and Oncotype DX ®, Exact Sciences is investing in its product pipeline to take on some of the deadliest cancers and improve patient care. Exact Sciences unites visionary collaborators to help advance the fight against cancer. For more information, please visit the company's website at www.exactsciences.com, follow Exact Sciences on Twitter @ExactSciences, or find Exact Sciences on Facebook.