Colorectal Cancer Screening and Risk Assessment Workflow and Documentation Guide for Health Center NextGen Users

This Guide provides focused documentation to assist users of NextGen software to improve the process of assessing, documenting, tracking, and following up on colorectal cancer screening. The Guide gives particular attention to assessment of personal and family risk and the tracking and follow-up of screening results that are not addressed in the standard NextGen guidance documents.

The Guide was initially developed by Harbor Health Services in collaboration with the Massachusetts League of Community Health Centers and NACHC, with support from the American Cancer Society. 

Colorectal Cancer Screening Best Practices: A Handbook for Hospitals and Health Systems

The purpose of the Colorectal Cancer Screening Best Practices: A Handbook for Hospitals and Health Systems is to provide advice on the design and delivery of a variety of effective CRC screening interventions to help all hospitals and health systems strengthen their colorectal cancer screening efforts.  With their expertise in both improving health and in serving as leaders in their communities, hospitals and health systems are uniquely positioned to play a pivotal role in increasing colorectal cancer screening for those they serve.  The handbook is divided into four sections:  Critical Steps, Case Studies, Implementation, and Tools & Resources. It is intended to provide you with needed information drawn from real life examples about how to ultimately improve CRC screening rates within the hospital and health system setting.

A corresponding webinar was held in July 2018 announcing the release of the handbook and included presentations from two health systems featured in the guide. View the Colorectal Cancer Screening Best Practices for Hospitals and Health Systems webinar.

Many thanks to the hospitals and health systems featured in the guide for sharing their time and their tremendous expertise, as well as to handbook’s expert advisory group, which was chaired by Drs. Michael Potter and Dorothy Lane, Co-Chairs of the NCCRT Professional Education and Practice Implementation Task Group.

This handbook is dedicated to the memory of Marie LaFargue.

Risk Assessment And Screening Toolkit To Detect Familial, Hereditary And Early Onset Colorectal Cancer

Limited or inaccurate family history collection and risk assessment is a major barrier to successful cancer screening. Individuals who have a first-degree relative with colorectal cancer (CRC) are at least two times more likely to develop CRC, with the risk increasing with earlier ages of diagnosis and the number of relatives diagnosed with CRC. Therefore, screening and prevention efforts must focus on those with familial or hereditary risk, which requires collecting the necessary family history information for risk assessment. Primary care clinicians play a pivotal role in identifying people at increased CRC risk and facilitating recommended screening.

This new NCCRT toolkit aims to improve the ability of primary care clinicians to systematically collect, document, and act on a family history of CRC and adenomas polyps, while also educating clinicians on the need for more timely diagnostic testing for young adults who present with alarm signs or symptoms of CRC and ensuring that those patients receive a proper diagnostic work up. This toolkit serves as a comprehensive, step-by-step guide to improve operations within practices and suggests many useful resources and tools to aid these changes. 

Companion Quick Start Guide

Accompanying the full toolkit is a short, quick start guide with recommendations on how to ease into the transition process, while still making the critical improvements necessary for successful system-wide implementation. 

Thank you to the outstanding work and guidance provided from the NCCRT Family History and Early Age Onset Colorectal Cancer Task Group and the smaller project advisory group. Also, thank you to the excellent work from our project developers at The Jackson Laboratory. 

 

best practices handbook for health plans

“Thank you! This is exactly the type of information health plans need to pass to one another to improve partnership/collaboration, as the consumer will benefit at the end.”

“I really enjoyed that each of the health plans featured in the toolkit highlights a different intervention or opportunity. That gives our partners many approaches to choose from.”

Colorectal Cancer Screening Best Practices Handbook for Health Plans

Health plans have an essential role to play in the effort to screen more Americans for colorectal cancer, particularly given that seven out of 10 people who are unscreened are covered by insurance.

Colorectal Cancer Screening Best Practices Handbook for Health Plans, provides a first-of-its-kind compilation of best practices, case studies, templates and tools, that will kick start or infuse health plans’ efforts to save more lives and prevent more cancers.

To develop the handbook, the NCCRT convened an advisory group of health plan experts and interviewed high-performing health plans to understand what works and what doesn’t when it comes to increasing screening among members. Thank you to the many individuals and organizations who contributed their time and expertise to developing this much requested resource.

In the future, we hope to update this handbook with more case studies from high-performing health plans. If you have a story to share about how your health plan has worked to raise colorectal cancer screening rates, please email nccrt@cancer.org.

NCCRT’s issue brief, The Importance of Waiving Cost-sharing for Follow-up Colonoscopies, provides additional information on the colonoscopy copay issue.

View the March 28, 2017 webinar introducing the Handbook for a guided tour of the best practices, case studies, and templates and tools found within the handbook, and hear from one of the profiled health plans.

Colorectal Cancer Screening Best Practices Handbook For Health Plans

Colorectal Cancer Screening Best Practices Handbook for Health Plans – March 28, 2017

This webinar introduced the new NCCRT Colorectal Cancer Screening Best Practices Handbook for Health Plans. The purpose of this handbook is to provide health plans with advice on the design and delivery of effective colorectal cancer screening programs. The webinar provided participants with a guided tour of the best practices, case studies, and templates and tools found within the handbook, including a deeper dive into the exemplary practices for one of the profiled health plans.

Speakers:

  • Tamara O’Shaughnessy, QNA Group
  • Anshul Dixit, MD, MPH, MBA, Wellmark Blue Cross and Blue Shield

“This was one of the best colorectal cancer presentations, and it also provided information we can readily utilize with our current health plans in support of the 80% by 2018 initiative.”

New Hampshire Colorectal Cancer Screening Program Patient Navigation Model Replication Manual

The New Hampshire Colorectal Cancer Screening Program (NHCRCSP) patient navigation model has been highly effective in increasing the completion and quality of colonoscopy screening and surveillance among statewide underserved groups. Patients in this program, all of whom were navigated, were 11 times more likely to complete colonoscopy than non-navigated patients in a comparison group. Given this success, the Centers for Disease Control and Prevention (CDC) and the NHCRCSP worked together to develop a manual to help others replicate the model. The manual includes step-by-step instructions for implementing a screening navigation program, including a detailed navigation protocol, guidance on data collection, navigator training, and sample templates and tools.

Intended Audiences: Any organization that conducts colorectal cancer screening or administers a colonoscopy program may benefit from implementing this intervention. Organizations could include health systems, endoscopy centers, primary care practices (including Federally Qualified Health Centers), universities, state or local health departments, and grantee programs. This manual also may be useful for health care providers, pharmacy staff, and other community partners to clarify their roles in the intervention and how it benefits their patients.

Congratulations to former NCCRT Steering Committee member Dr. Lynn Butterly and to all the others who helped create this resource.

Evaluation: A rigorous evaluation was conducted, including a comparison of NHCRCSP-navigated patients to a similar group of non-navigated patients. Learn more on page 8 and in Appendix D. Evaluation results were also published in the journal Cancer.

Permissions: Made publicly available online through the Centers for Disease Control and Prevention.

Publication date: October 2016

Post date: September 18, 2017

Contact: Send comments, questions, and suggestions to NHPNManual@cdc.gov or NHCRCSP@hitchcock.org.

EClinicalWorks Best Practices Guide

eClinicalWorks Best Practices Guide – May 5, 2016

This webinar provided an in-depth look at our eClinicalWorks Best Practices Workflow and Documentation Guide to support colorectal cancer screening for eClinicalWorks. This webinar is best suited for those who work directly with EHRs and eClinicalWorks in particular. This is not an introductory webinar.

Speakers:

  • Sandy Carfachio, Health Center Network of New York
  • Michelle Tropper, MPH, Health Center Network of New York
  • Carla Henke, MD, Community of Hope

Waiving Colonoscopy Co-Pays

Waiving Colonoscopy Co-pays – April 12, 2016

This webinar explained what’s covered with respect to colorectal cancer screening, what’s not covered and how to code for it; provided an update on federal and state efforts to remove cost sharing for colorectal cancer screening; and described a case study in which Gateway Health of Pennsylvania plan removed copays for colonoscopies following positive FIT tests. Learn more about the cost-sharing issue in the brief: The Importance of Waiving Cost-sharing for Follow-up Colonoscopies: Action Steps for Health Plans.

Speakers:

  • Joel Brill, MD, American Gastroenterological Association
  • Caroline Powers, American Cancer Society Cancer Action Network, Inc.
  • Marnie Schilken, MPH, Gateway Health

EHR Best Practice Workflow and Documentation Guide to Support Colorectal Cancer Screening Improvement with eClinicalWorks

The NCCRT commissioned the Health Center Network of New York (HCNNY) to develop EHR Best Practice Workflow and Documentation Guide to Support Colorectal Cancer Screening Improvement with eClinicalWorks. Please note that this tool is an advanced tool designed to inform those who work directly with electronic health records (EHRs). The overall goal of the project was to identify and document specific best practice workflows that support appropriate CRC screening and follow up and proper utilization of family history data within the eClinicalWorks EHR system (eCW). The guide is also intended to further enable FQHCs to employ existing CRC screening improvement tools to ultimately yield improved patient health outcomes. HCNNY will continue to enhance the guide as further information and/or product capabilities related to CRC screening become known. HCNNY and its participating FQHCs learned a great deal throughout this project and while the challenges of ensuring timely CRC screening for all patients are far from resolved, the detailed recommendations developed provide a roadmap for documentation that will assist health centers in building the necessary foundation for more reliable, actionable information to support their efforts to improve CRC screening rates. We are thankful for the support and collaboration from the National Association of Community Health Centers (NACHC), the American Cancer Society (ACS) and the National Association of Chronic Disease Directors (NACDD) in developing this tool.

Watch the May 5, 2016 webinar introducing this new resource to learn more.

Steps For Increasing Colorectal Cancer Screening Rates: A Manual For Community Health Centers

Steps for Increasing Colorectal Cancer Screening Rates: A Manual for Community Health Centers – September 11, 2014

This webinar introduced the new resource, Steps for Increasing Colorectal Cancer Screening Rates: A Manual for Community Health Centers.

Speakers:

  • Richard Wender, MD, American Cancer Society
  • Mary Doroshenk, MA, NCCRT
  • Maria Syl D. del la Cruz, MD, Thomas Jefferson University