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Effectiveness of a Provider Reminder on Fecal Occult Blood Test Follow-up
Authors:Meaghan F. Larson   Cynthia W. Ko  Jason A. Dominitz
Affiliation:(1) VA Puget Sound Health Care System, Seattle, WA, USA;(2) Division of Gastroenterology, Department of Medicine, University of Washington School of Medicine, 1660 S. Columbian Way, Seattle, WA 98108, USA;(3) Northwest Center for Outcomes Research in Older Adults, VA Puget Sound Health Care System, Seattle, WA, USA
Abstract:Purpose To determine the impact of an electronic reminder upon the timeliness and proportion of patients referred for evaluation of a positive fecal occult blood test and receipt of colonoscopy. Methods Outpatients (468) with a positive occult blood test were prospectively identified and had a note entered into their electronic medical record prompting their provider to act upon this result. The results were compared to 634 control patients from the prior year. Results The intervention was associated with a 20.3% absolute increase in gastroenterology consultation within 14 days (P < 0.001) and significantly prompter consultation. The median time to colonoscopy decreased by 38 days during the intervention (P = <0.0001). A multivariable model found that the intervention was significantly associated with shorter time to consultation and colonoscopy. Conclusion A simple electronic reminder is associated with a significant improvement in the proportion of patients referred for, and timeliness of, evaluation of a positive FOBT. The views and opinions of the authors expressed herein do not necessarily state or reflect those of the United States Government or the Department of Veterans Affairs. This study was approved by the University of Washington Institutional Review Board on September 26, 2006.
Keywords:Occult blood  Mass screening  Quality of health care  Delivery of health care  Health personnel  Veterans  Colorectal neoplasm
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