241 A Care Model for Optimization of Colorectal Cancer Screening in Western Pennsylvania

Abstract

INTRODUCTION: Our Health Network and insurance provider collaborated to focus on a Care Model for colorectal cancer (CRC) screening to address barriers to screening. This Care Model corresponds to a manner in which healthcare services are delivered while outlining best practices and services to patients as they progress through stages of colon cancer (Figure 1). Well-known barriers to CRC screening include lack of transportation, lack of primary care physician (PCP) involvement and education, apprehension about the prep and/or complications, and certain ethnicities. METHODS: Our Health Network and insurance provider worked together on the GI Care Model to address underutilization of CRC. The team interviewed PCP practices in the region to identify their processes for screening. The team performed a geographical analysis identifying screening rates for Western PA and the city of Pittsburgh by zip code and socioeconomic status. Transportation status, PCP status, age, and ethnicity as well as socioeconomic status were evaluated. The team then used this information to implement initiatives targeted at reducing and eliminating these barriers. RESULTS: PCPs expressed lack of updated knowledge regarding the latest colon cancer guidelines and challenges in scheduling a procedure. 122 healthcare professionals attended the webinar series in the first quarter. Feedback was overwhelmingly positive with requests for further education on a quarterly basis. Screening rates were higher if a patient had a PCP vs no PCP (Table 1). A Best Practices Alert was generated and sent by massmail to all healthcare practitioners across the region which outlined the latest recommendations with respect to screening. Difficulties in scheduling were optimized by providing flow diagrams of the scheduling process. We found that the strongest correlation to a lack of screening was lack of a vehicle (Table 2). The PALS (People Able to Lend Support) volunteer program was implemented for patients who had no vehicle. A patient education program (Doc Talks) was also offered to patients in the community at selective health insurance retail stores. Opportunity to answer questions and address fears of procedure were discussed. CONCLUSION: The GI Care Model has made significant progress in increasing awareness, education, access, and identification of common barriers which contribute to underutilization of CRC screening in our region. We will be addressing the barriers by ethnicity in future months as part of our Care Model.