Issue link: https://beckershealthcare.uberflip.com/i/415620
47 Gastroenterology Healthcare systems should be keen to engage in screening if the effort will reduce the costly impact of CRC treatment by either preventing cancer or detecting it early. GI physicians can play an important role in working with accountable care organizations to ensure that they understand the health benefits of screening. Finally, GI physicians can work with primary providers and healthcare organizations to assure that high-risk patients with a family history of CRC are recognized and triaged appropriately for more intensive screening. The AGA's colorectal cancer clinical service line provides information for healthcare professionals, including guidelines that provide recommenda- tions on the screening of patients for colorectal cancer, as well as clinical care pathways that transform guideline recommendations into clinical steps for screening and surveillance. CS: We need to focus our efforts on disparities in patient groups in lower socio-economic groups and rural areas. We need to address these challenges and work with underinsured and uninsured patients within our local com- munities. In our community, we work with Volunteers in Medicine and the Project Access to create opportunities for these patient populations. ASGE, a member of the NCCRT, is working on these issues as a partner in the new NCCRT program aimed at improving colorectal cancer screening rates and access to specialty care in community health centers. XL: This goal is possible, but it will be a challenge. We need to set attainable, but aggressive goals. The "80 percent by 2018" goal is a great initiative. There are many stakeholders in the roundtable committed to making this happen. It is important that we get more patient organizations involved. The more organizations sitting at the table the better. Q: Do you think gastroenterologists will use a greater number of CRC screening tests to help improve patient compliance? DL: CRC screening includes several options, which begin at the primary care level. Currently, the primary tests are stool-based screening tests, which are non-invasive, and colonoscopy. Patients may prefer one test over another, but every program leads to colonoscopy if the initial test is positive. Gastroenterologists are the experts who perform high-quality colonoscopy, either for primary screening or as a result of a positive stool test or imaging. It is unlikely that GI physicians will be using other pri- mary CRC screening tests until new serum genomic tests are found to be effective. It is quite possible that some form of hybrid testing could emerge in which patients who have a colonoscopy, may have some interim test before their next scheduled colonoscopy. To date, no hybrid program has been studied. XL: We will have to be vigilant and watch for all of the studies coming out that assess the usefulness of new tests, such as the stool DNA test. Over the next several years we will be learning about these alternatives. The more op- tions we have the better. We need to be aware of patient preference. It is im- portant that people get screened. HS: I think more and more of these tests will be utilized. I am not 100 percent sure where there will be maximum utilization yet, but it will most likely be at the primary care level. Once patients come to GI physicians, it will most likely be for a colonoscopy. We are also fighting to establish a continuum of care in the screening process. If there is a positive stool test, then colonoscopy follows. n AnticipAte chAnge. We do. 2013 ® 636.273.6711 | www.nationalASCbilling.com the ASc Revenue cycle. It's all we do. It's all we think about. And it shows. Named one of the world's best outsourcing service providers two years in a row. – Fortune Magazine 2013