Effectiveness of a Provider Reminder on Fecal Occult Blood Test Follow-up
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.
KeywordsOccult blood Mass screening Quality of health care Delivery of health care Health personnel Veterans Colorectal neoplasm
We are grateful to Paul Nichol M.D., Toan D. Nguyen M.D., Molly Aldassy R.N., and Mauri Miner for their participation in the quality improvement program that prompted this study and to David Weinberg, M.D., MSc, for his thoughtful review and comments. Jason Dominitz is supported by an American Society for Gastrointestinal Endoscopy Endoscopic Career Development Award. This material is the result of work supported by resources from the VA Puget Sound Health Care System, Seattle, Washington.
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