U sing patient navigators to help patients overcome barriers and understand the medical system helps patients in Kentucky and Florida get the screening and follow-up care they need.
In the stories below, you’ll learn how some Colorectal Cancer Control Program awardees increased colorectal cancer screening rates in their communities through patient navigation.
Little Flower Clinic is a federally qualified health center in Kentucky. Most of its patients are homeless. It offered colorectal cancer screening with colonoscopy, but had a low screening uptake. Many patients had trouble preparing for a colonoscopy, especially accessing a bathroom and getting the clear liquids needed.
The clinic decided to try stool tests instead of colonoscopies. They worked with the Kentucky Colorectal Cancer Control Program to hire a part-time patient navigator to explain how the test kit works and make reminder calls. Little Flower Clinic also located outside funding to provide a $10 gift card to patients who completed and returned the kits.
As a result, the average number of patients who are screened and receive results increased from 48 to 95 each month, and the clinic doubled its overall colorectal cancer screening from 33% in 2016 to 66% in 2018. Little Flower Clinic is on track to reach 72% by the end of 2019.
The University of Florida College of Medicine had low colorectal cancer screening use for several reasons. The clinic didn’t track screening for the clinic overall or for each doctor. Its doctors offered colonoscopy as the main, and sometimes only, screening test; and patients often had to wait a long time for a colonoscopy appointment. Additionally, its electronic health records system did not identify patients who needed to be screened.
The university worked with the Florida Department of Health and the American Cancer Society to improve its screening in several ways. A clinic navigator was hired and the clinic’s electronic health record system was upgraded so it could generate monthly reports on colorectal cancer screening for the clinic and each doctor. The system was also set up to identify patients who were due for screening. The partners educated clinic staff on colorectal cancer screening recommendations and tests; and the clinic began offering stool test kits regularly. They also made colonoscopy appointments available on Saturdays, which reduced screening delays and helped patients who couldn’t get screened on weekdays.
The clinic’s colorectal cancer screening improved from 55% in 2014, to more than 70% by 2019. After seeing success in this first clinic, the university made the same changes in a second clinic, which has shown an increase from about 50% to more than 65% from 2018 to mid-2019.