Shared Decision-Making for Colorectal Cancer Screening

Colorectal cancer (CRC) is the second-leading cause of cancer deaths in the U.S. for men and women. Screening and early treatment of CRC is a pillar of the Southwestern Health Resources (SWHR) approach to lowering the total cost of care across populations. SWHR exceeded contractual quality measure requirements through its innovative CRC screening program.

The problem

CRC is highly curable if caught early — yet just one in three eligible adults are screened for it. Because patients rarely bring up CRC screening with their primary care providers, the onus is on physicians to draw their attention to it. SWHR needed to design an intervention that addressed the patient's need for CRC education and patient-physician communication.

The opportunity

SWHR estimated that a 25% gap closure could be achieved by using data analytics (to target patients in need of CRC screening) and creating a simple shared decision-making tool for providers. And with early diagnosis and treatment of colorectal cancers in the populations they serve, SWHR would lower the total cost of care for payors and employers.

The solution

SWHR created a three-step process to close CRC screening gaps. First, practices were sent lists of patients ages 50 to 75 years old who both needed screenings and were scheduled for appointments. Second, SWHR designed and distributed the shared decision-making tool for use by physicians to inform patients about screening options and the importance of getting tested. Talking points were also provided to guide productive and comfortable conversations between patients and providers. Third, a tracking process enabled clinic staff to follow up with patients who had not been screened.

The results

During the three-month pilot project, clinics achieved a gap closure rate of 32% — exceeding the original goal of 25% — representing screenings for nearly 500 patients who may not have been screened otherwise.