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334947
Innovation is the best policy: A demonstration project to increase cancer screening rates in New York State FQHCs


Monday, November 2, 2015 : 9:30 a.m. - 9:50 a.m.

Shoshanna Levine, MPH, CPH, Quality and Technology Initiatives, Community Health Care Association of New York State, New York, NY
Kathy Alexis, MPH, CHES, Quality Improvement Program, Community Health Care Association of New York State, New York, NY
Audio (mp3) recording Recorded Presentation (mp4)
The Community Health Care Association of New York State (CHCANYS), in collaboration with the NYSDOH and IPRO, is conducting a five year innovative demonstration project to increase breast, cervical, and colorectal cancer screening rates in New York State (NYS) federally qualified health centers (FQHCs). This two-pronged project focuses on policy and workflow changes in multiple, year-long learning collaboratives, as well as the development and implementation of a data warehouse, the Center for Primary Care Informatics (CPCI), that extracts data from electronic medical records (EMRs) to calculate performance results, display dashboards, and create clinical workflow tools and registries. The first cohort of 12 FHQCs from across NYS raised aggregate cervical, breast, and colorectal cancer screening rates by 3.8, 4.0, and 15.5 percentage points, respectively, from baseline over the project year.

Health center policy changes to evidence-based best practices in several domains increased cancer screening rates in Cohort 1 FQHCs. Our data validation study found many tests captured as unstructured data - not read by CPCI. Policy changes around documentation increased screening rates through better quality data in the warehouse. Additionally, the number of centers that developed policies and workflows to implement pre-visit planning practices and CPCI tools increased from three to nine over the course of the project, catching cancer screening opportunities that may have been missed otherwise. Finally, centers that developed comprehensive policies around Fecal Immunochemical Testing (FIT) kit distribution, tracking, and follow-up for unreturned kits contributed most to the impressive achievements around colorectal cancer screening.

Learning Areas:

Chronic disease management and prevention
Provision of health care to the public
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Describe the innovative demonstration project, including the Center for Primary Care Informatics, undertaken by CHCANYS, the NYSDOH, and IPRO to increase breast, cervical, and colorectal cancer screening rates in New York State FQHCs. Explain the institutional policy and workflow changes leading to elevated breast, cervical, and colorectal cancer screening rates in 12 FQHCs in the first cohort of the project.

Keyword(s): Cancer Prevention and Screening, Quality Improvement

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked on the New York State Cancer Screening Registry Innovative Demonstration Project through development and implementation since its infancy. I led the first cohort of the project through completion and have trained a colleague with limited knowledge in quality improvement and cancer screening to lead the second cohort. In addition, I have led and worked on multiple quality improvement projects on various topics with FQHCs throughout New York State.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3020.0: Influence of State and National Policies on Cancer Prevention, Screening, and Treatment