Seeking New Benefits within an EHR

It is known that screening for colon polyps with colonoscopy can decrease the rate of colon cancer, the second leading cause of cancer death in both men and women. And yet, many people are never appropriately screened. This was highlighted by the recent “Love your Butt” campaign designed to encourage people to be screened.  While putting “Love your Patooty” signs in the metro is one attempt to increase screening rates, a recent article published in the Annals of Internal Medicine described a more focused approach using EHR’s to identify candidates for focused interventions. The study observed 4 methods for tracking this approach, each adding one additional element to the care provided. These included a “usual care” control group, an EHR-based addition that automated reminders and selected the patients that needed mailings sent, a further group that received mailings plus “assisted” telephone calls from an MA to follow up and schedule screenings, and a final group that received “navigated” assistance from an RN to help them with more complicated decision making.

The results of this study were interesting. On top of the “usual care” group, patients in the EHR-automated group were twice as likely to be current for CRC screenings within 2 years. The more advanced groups received notable steps up from there, but not as impressive as the automated group. This can be very useful. It shows that a system set up to fully automate the process, with the EHR handling everything except requiring staff to put messages out with regular mail. If the office wants to go further, it can, through phone calls and expert advice.

EHR’s have been criticized for being expensive and time consuming, but in this study, the ability to use structured data to identify patients who were eligible for, but had not yet received, colonoscopy allowed the investigators to target just these people for more aggressive, and ultimately often successful, interventions. The fact that the vast majority of the task could be done without provider oversight is more interesting. This same type of structured data and related processes could also be used to identify other groups of patients such as those who need vaccines or other tests. A good system can be set up to allow providers to easily check both the dates and results of screening but also prompt users if screening is overdue. Structured data can also be used to identify patients who have received prescriptions which might have had warnings issued, such as the recent one regarding Ambien in women. These types of uses for an EHR are just beginning to be investigated and utilized and everyone should look forward to seeing more such investigations.

Further Readings:

“’Love Your Butt’ Ads Try To Conquer Colonoscopy Fears”

Study Abstract

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