Increasing cancer screening and preventative care bonuses

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Keeping patients up-to-date with screening tests is an important part of my job as a family physician. The most common evidence-based screening interventions in primary care, from mammograms and pap tests to colonoscopies, are effective for lowering cancer mortality. As a result, provincial governments incentivize us to increase our population screening rates for these individual interventions through preventive care bonuses. For example, in Ontario, we receive a large bonus payment if we can demonstrate that 80% of our eligible women have had paps.

Despite this incentive and the good intentions of physicians, screening rates are suboptimal. Some patients are eager and proactively come in for testing, but others are more hesitant to have screening done, they aren’t aware they should, or they simply forget.

Consequently we spend a lot of time and office resources attempting to contact patients (phoning, emailing, snail mailing, and so on) so that we can explain and book these tests. In the end, this work can seem overwhelming to busy clinics. Procrastination turns into neglect, and everyone loses.

Is there an easier way? I think I’ve found it.

Automating Screening Invitations with Ocean

Using Ocean, I built a series of patient-centric reminder questionnaires for the most common screening initiatives:

Each questionnaire introduces the test, discusses the guidelines, asks the patient if and when their last test was done, and asks then how they would like to proceed.

Before each visit, based on my EMR’s reminder cues, my clinic sends the relevant questionnaires for each test that the patient is due for via a secure email link. It’s very easy to cue them up, so I can ask them about their mammogram, pap, tetanus shot, and so on, all in one simple link.

Best of all, it’s easy to send these as batch questionnaires, so I can work through my reminder reports of patients and send them out in one sitting. No phone tag required.

If patients don’t have email, they are given the Ocean tablet in the waiting room to complete them when they arrive. Either way, the note is streamed into my EMR automatically, providing both the plan of action highlighted and a formatted note that can be used with my automated EMR reminders.

By automating this process, my screening rates have increased, and my patients are ultimately receiving better care, without additional time and effort for clinic staff.


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