About Screen for Life WI

Funded through the Centers for Disease Control and Prevention’s (CDC) Colorectal Cancer Control Program (CRCCP), Screen for Life WI is a multi-year project aimed at increasing colorectal cancer (CRC) screening rates. Screen for Life WI has partnered with seven Milwaukee area Community Health Centers (CHCs) and Federally Qualified Health Centers (FQHCs) to improve screening rates for their patient’s ages 50-75.

The National Colorectal Cancer Roundtable (NCCRT) has established a national screening goal to reach an 80% screening rate for adults ages 50-75 by 2018. To support this national goal, Screen for Life WI is supporting the work of several partner health systems to increase their individual colorectal cancer screening rates to help Wisconsin and the country reach 80% by 2018.

For more information on screening rates, please check out the ACS Cancer Statistics Center.

To increase colorectal cancer screening rates, the CDC’s Colorectal Cancer Control Program (CRCCP) has prioritized funds to be used to impact systems level changes through the adoption and implementation of evidence-based interventions (EBIs) and supportive strategies. To learn more about the evidence-based interventions check out The Community Guide.

EBI/Supportive Strategy Definition Examples:
Provider Assessment & Feedback Provider assessment and feedback interventions both evaluate provider performance in delivering or offering screening to clients (assessment) and present providers with information about their performance in providing screening (feedback).

 

  • Within a clinic, assessing individual provider performance for appropriately recommending CRC screening and notifying providers how they compare to one another
  • Among clinics, assessing CRC screening rates adherent to current guidelines and publishing results compared to a target rate
  • Creating incentives through fostering competition by periodically publishing screening rates of “competing” providers and/ or clinics
Provider Reminder and Recall System Reminders inform health care providers that it is time for a client’s cancer screening test (reminder) or that the client is overdue for screening (recall).

 

  • Activating/utilizing the provider reminder function in an EMR to remind providers that the patient is due or overdue for screening. Reminders could include information about USPSTF recommendations for CRC screening
  • Creating a system where clearly visible reminders are placed on paper charts prior to the office visit (tickler)

 

Patient Reminders Client reminders are written (letter, postcard, email) or telephone messages (including automated messages) advising patients that they are due for screening.

 

  • Utilizing EMR data to identify the population eligible for screening and those due for screening and calling and/or mailing a postcard or letter informing the client that they are due for screening. This would also require a process to monitor responses to the reminder

 

Reducing Structural Barriers Structural barriers are non-economic burdens or obstacles that make it difficult for people to access cancer screening. Interventions designed to reduce these barriers may facilitate access to cancer screening services by:

·       Modifying hours of service to meet client needs

·       Offering services in alternative or non-clinical settings (e.g. mobile mammography vans are worksites or residential communities)

·       Eliminating or simplifying administrative procedures and other obstacles (e.g. scheduling assistance, patient navigators, transportation, dependent care, translation services, limiting the number of clinic visits)

  • Reducing time or distance between service delivery settings and target populations
  • Direct referral to colonoscopy
  • Offering screening conjunction with other preventive service visits (e.g. visits for flu vaccines)
  • Assessing clinic workflow to streamline processes for patient identification, test provision or referral, tracking and follow up

 

Small Media Small media materials can be used to inform and motivate people to be screened for cancer. They can provide information tailored to specific individuals or targeted to general audiences.
  • Videos
  • Social media
  • Printed materials (letters, posters, brochures, newsletters)

 

Health Information Technology (HIT) HIT, particularly the EMR is a critical tool in the identification and management of health system populations that are due or overdue for CRC screening.

 

  1. Conducting ongoing validation of CRC screening rates derived from EMRs (manual audits)
  2. Ensuring that CRC screening test information is recorded in the EMR consistently and in searchable fields
  3. Identifying eligible populations that are due or overdue for screening in the EMR and sending client reminders
  4. Supporting provider reminder interventions
  5. Creating provider feedback reports based on EMR data
  6. Creating a cancer screening registry
  7. Assessing the quality of the CRC screening process, including screening rates, return rates for FOBT/FIT, adherence rates for colonoscopy, time to follow up for those with positive screening tests, and other quality metrics.

 

Community Clinical Linkages Linking community programs to clinical services. Helps to ensure that people with or at high risk of chronic diseases have access to community resources and support to prevent, delay or manage chronic conditions.
Patient Navigation (PN) Patient navigation is an approach to identify and reduce barriers to access and use of cancer screening services. CDC requires the following activities to be conducted:

  1. Written assessment of individual client barriers to cancer screening, diagnostic services, and initiation of cancer treatment
  2. Client education and support
  3. Resolution of client barriers (e.g. transportation, translation services)
  4. Client tracking and follow up to monitor client progress in completing screening, diagnostic testing, and initiating cancer treatment
  5. Reminder calls/contacts to return FOBT/FIT kits and/or bowel prep and endoscopy appointments
  6. Patient navigation must include a minimum of two, but preferably more, contacts with the client
  7. Collection of data to evaluate the short term and intermediate outcomes of patient navigation—number of clients navigated and screening completion rates, FOBT/FIT return rate, colonoscopy completion rate, number of screenings with cancers detected and with adenomas detected