Improving documentation and reporting of breast and colorectal cancer screenings at an ACO family medicine resident clinic

From the 2022 HVPA National Conference

Madilyn Tomaso M.S., M.D. (University of Alabama at Birmingham Family Medicine Residency), Shivani Malhotra MD, Chirag Patel MBA

Preventative care is one of the most important roles of the family physician. Breast and colorectal cancer screenings are a major part of the yearly preventative exam based on USPSTF guidelines. Breast cancer is the second-leading cause of cancer death in U.S. women with an estimated 40,000 deaths per year. However, mammography screening of women aged 50 to 74 significantly reduces rates of advanced and fatal cancers resulting in fewer overall deaths. Colorectal cancer is also a leading cause of cancer deaths in the U.S. for both men and women, but screening of average-risk adults 50 to 75 years of age reduced mortality by up to 30-percent.

To improve screening and documentation as an Accountable Care Organization (ACO), a family medicine resident clinic implemented a new system to document and code screenings directly within the note template in October 2020. Prior to this, screenings were often very difficult to find and thus report. Before implementation from Jan 2019 to September 2020 average colorectal screening reporting was 7-24% and mammogram screening was 0-44%. After the implementation of the new system, both colorectal screening and mammogram screening reporting rate has been up consistently ranging from 25-31% for colorectal and 35-45% for mammograms. To improve reporting of screenings further, a task force will be developed which will focus on reviewing patient charts for up-to-date screenings as well as identifying those who need screening to notify their provider.

What are academic medical centers across the country doing to improve healthcare value?

Value improvement guides: Published reviews in JAMA Internal Medicine coauthored by experienced faculty from multiple leading medical centers, with safety outcomes data and an implementation blue print.

Review article detailing 25 labs to refine for high value quality improvement | July 2020

MAVEN campaign: Free 4 year high value care curriculum online.

Join the Alliance! Membership is free with institutional approval and commitment to improving value in your medical center.

Learn more about HVPA on Health Affairs Blog