EHR system automation decreases the cost of EBI implementation
Automating a clinic’s EHR system increases the clinic’s capacity to integrate EBIs across multiple cancer screenings by flagging patients due for screening and facilitating data sharing.[[360-362, 414]] The integrated implementation of EBIs also enables clinics to combine multiple funding streams,[[358]] which decreases the cost of EBI implementation and sustainability.[[361, 451]]
Additionally, an automated EHR system enhances a clinic’s capacity to generate patient reminders and perform patient tracking,[[16, 119]] which reduces the amount of staff time required for tracking.[[58]] As a result, the cost of EBIs (e.g., patient and provider reminders) decreases.[[58]]
Cited references for this diagram
During interviews, respondents discussed benefiting from increasing use of automated patient messaging systems while responding to COVID-19 to disseminate CRC screening reminders and establishing or streamlining FIT kit standing orders to reduce burden on heavily strained clinic staff.
Arena L, Soloe C, Schlueter D, Ferriola-Bruckenstein K, DeGroff A, Tangka F, Hoover S, Melillo S, Subramanian S. Modifications in Primary Care Clinics to Continue Colorectal Cancer Screening Promotion During the COVID-19 Pandemic. J Community Health. 2023 Feb;48(1):113-126. doi: 10.1007/s10900-022-01154-9. Epub 2022 Oct 29. PMID: 36308666; PMCID: PMC9617236.
A key lesson learned was the importance of having high-quality electronic systems in place that can support tracking patients in real time to avoid the need for large amounts of staff time to manually track patients for CRC screening programs. In this study, FQHCs with efficient tracking processes were able to implement client reminders that are likely to be highly cost-effective.
Conn ME, Kennedy-Rea S, Subramanian S, Baus A, Hoover S, Cunningham C, Tangka FKL. Cost and Effectiveness of Reminders to Promote Colorectal Cancer Screening Uptake in Rural Federally Qualified Health Centers in West Virginia. Health Promot Pract. 2020 Nov;21(6):891-897. doi: 10.1177/1524839920954164. Epub 2020 Sep 29. PMID: 32990048; PMCID: PMC7894066.
Several grantees also discussed electronic health records as a facilitator for EBIs that involved sending information to clients and for the provider-oriented EBIs.
Hannon PA, Maxwell AE, Escoffery C, Vu T, Kohn MJ, Gressard L, Dillon-Sumner L, Mason C, DeGroff A. Adoption and Implementation of Evidence-Based Colorectal Cancer Screening Interventions Among Cancer Control Program Grantees, 2009-2015. Prev Chronic Dis. 2019 Oct 10;16:E139. doi: 10.5888/pcd16.180682. PMID: 31603404; PMCID: PMC6795067.
Participants discussed programs providing braided funding—a process that involves coordinating separate funding streams from multiple programs, such as CRCCP and NBCCEDP—to pay for common activities such as patient navigation across programs, provider reminders, and patient reminders (e.g., reminders for breast, cervical, and CRC screening).
Soloe C, Arena L, Schlueter D, Melillo S, DeGroff A, Tangka F, Hoover S, Subramanian S. Factors that support readiness to implement integrated evidence-based practice to increase cancer screening. Implement Sci Commun. 2022 Oct 6;3(1):106. doi: 10.1186/s43058-022-00347-6. PMID: 36199117; PMCID: PMC9535984.
The ability to access and share accurate patient information, including EHR data, was identified as another factor supporting readiness for integrated implementation of CRC screening.
Soloe C, Arena L, Schlueter D, Melillo S, DeGroff A, Tangka F, Hoover S, Subramanian S. Factors that support readiness to implement integrated evidence-based practice to increase cancer screening. Implement Sci Commun. 2022 Oct 6;3(1):106. doi: 10.1186/s43058-022-00347-6. PMID: 36199117; PMCID: PMC9535984.
Participants indicated that the clinic staff, particularly patient navigators and care coordinators, rely on the availability of accurate EHR reports to identify patients for screening and/or diagnostics for multiple chronic disease conditions. The clinic staff emphasized that the utility of the EHR data in supporting integrated implementation is contingent on data accuracy.
Soloe C, Arena L, Schlueter D, Melillo S, DeGroff A, Tangka F, Hoover S, Subramanian S. Factors that support readiness to implement integrated evidence-based practice to increase cancer screening. Implement Sci Commun. 2022 Oct 6;3(1):106. doi: 10.1186/s43058-022-00347-6. PMID: 36199117; PMCID: PMC9535984.
Similarly, data sharing among quality improvement (QI) teams promotes a collective understanding of where clinics stand on the delivery of health promotion activities that can foster understanding of opportunities to potentially improve these metrics through integrated implementation.
Soloe C, Arena L, Schlueter D, Melillo S, DeGroff A, Tangka F, Hoover S, Subramanian S. Factors that support readiness to implement integrated evidence-based practice to increase cancer screening. Implement Sci Commun. 2022 Oct 6;3(1):106. doi: 10.1186/s43058-022-00347-6. PMID: 36199117; PMCID: PMC9535984.
Fifth, the capacity and capabilities of the electronic medical records to support cancer screening by quickly identifying patients due for screening, tracking screening completion, and generating provider-level summary screening uptake were seen as critical for successful implementation and maintenance.
Subramanian S, Tangka FKL, Hoover S, DeGroff A. Integrated interventions and supporting activities to increase uptake of multiple cancer screenings: conceptual framework, determinants of implementation success, measurement challenges, and research priorities. Implement Sci Commun. 2022 Oct 5;3(1):105. doi: 10.1186/s43058-022-00353-8. PMID: 36199098; PMCID: PMC9532830.
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