Improving colonoscopy referral rates through computer-supported, primary care practice redesign.

Area of Science:

• Public Health
• Health Services Research
• Preventive Medicine

Background:

• Colon cancer screening rates are suboptimal in many primary care settings.
• Effective interventions are needed to improve adherence to screening guidelines.

Purpose of the Study:

• To enhance colonoscopy screening referral rates within the Utah Health Research Network.
• To evaluate the impact of clinic workflow modifications and electronic medical record (EMR) integration.

Main Methods:

• A quality improvement project was conducted from October 2004 to June 2007.
• The primary intervention involved clinic workflow changes and computerized screening reminders within the EMR.
• Provider feedback was incorporated to support the intervention.

Main Results:

• The intervention resulted in a sustained improvement in colonoscopy referral rates.
• Two specific network clinics were key drivers of the observed improvement.
• The study highlights the effectiveness of integrated EMR decision prompts and workflow adjustments.

Conclusions:

• A robust EMR system, coupled with workflow modifications and provider feedback, can effectively increase colonoscopy screening referrals.
• This approach demonstrates a sustainable method for improving cancer screening rates in community clinics.
• The findings support the broader adoption of EMR-based decision support for preventive care.