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Using REDCap to Address Gaps in Electronic Health Record Data for Strengthening Colorectal Cancer Screening and

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A REDCap system improved colorectal cancer (CRC) screening by aiding patient navigation, especially for those with barriers. This initiative enhanced CRC early detection and patient outcomes in underserved areas.

Keywords:
AppalachiaColorectal CancerElectronic Health RecordHealth DisparitiesPatient ScreeningQuality ImprovementRural

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Area of Science:

  • Public Health
  • Health Informatics
  • Cancer Screening

Background:

  • Colorectal cancer (CRC) screening rates remain low despite widespread electronic health record (EHR) adoption, particularly in underserved regions.
  • The West Virginia Program to Increase Colorectal Cancer Screening (WVPICCS) initiative sought to address these suboptimal screening rates.

Purpose of the Study:

  • To evaluate the impact of a secure, HIPAA-compliant REDCap system on patient navigation.
  • To assess the effect of this system on CRC screening outcomes within the WVPICCS initiative.

Main Methods:

  • A REDCap database was developed to supplement existing EHRs, capturing patient data, CRC screening history, and navigation activities.
  • Custom EHR reports and queries integrated REDCap and EHR data to identify at-risk patients and address barriers like insurance and transportation.
  • Descriptive statistics and contingency analyses were used to evaluate screening completion rates and the association between navigation and screening uptake.

Main Results:

  • Of 4,654 identified patients, 47.7% were screened for CRC. Navigation was provided to 12.2% (109 of 893) of a tracked patient subset.
  • Patients receiving navigation showed a higher likelihood of completing CRC screening (39.5% vs. 31.0%), though not statistically significant (p > 0.05).
  • In subgroup analyses, navigated patients with documented barriers achieved higher screening rates (38.1%) compared to non-navigated patients (31.0%).

Conclusions:

  • A REDCap-based patient navigation system facilitated the identification, tracking, and support of at-risk patients, leading to modest improvements in CRC screening.
  • Refining and expanding such data systems is crucial for overcoming challenges in CRC early detection and improving patient health outcomes.