Researchers have developed decision support tools to match findings with follow-up recommendations. Surveillance intervals will continue to be monitored, particularly as reimbursement becomes increasingly tied to quality measures. Appropriate colonoscopy surveillance intervals are included in the Centers for Medicare and Medicaid Services 2014 Physician Quality Reporting System measures and the American Gastroenterological Association’s Choosing Wisely campaign. 8 Overuse is problematic because of safety risks (potential bleeding, perforation), costs of the procedure, lost work days 9 and cause of potential delays among patients for whom the procedure would provide greater value.Ī major focus of healthcare reform is appropriate use of medical procedures, including reduction of unneeded procedures. Many gastroenterologists lack knowledge about or ignore recommendations for surveillance colonoscopy intervals. 7 found >30% of patients had repeat colonoscopy ≤5 years of a normal baseline although guidelines recommend 10 years. 5, 6 Using Medicare claims data, Goodwin et al. 5 There is evidence of both under and over-use (e.g., repeat colonoscopy sooner than recommended among those with low-risk findings, such as nonadenomatous polyps). 3, 4 Effectiveness of this process is limited by suboptimal rates of surveillance among patients with precancerous polyps those with advanced adenomas often fail to receive follow-up colonoscopy within 5 years. 1 Colonoscopy begins a process 2 whereby adenomatous polyps can be identified early and removed to reduce incidence and mortality. Via a survey, colonoscopists agreed/strongly agreed it is easy to use (83%), provides guideline-based recommendations (89%), improves quality of Spanish letters (94%), they would recommend it for other institutions (78%), and it made their work easier (61%), and led to improved practice (56%).ĭiscussion CoRS’ widespread adoption and acceptance likely resulted from stakeholder engagement throughout the development and implementation process.Ĭonclusion CoRS is well-accepted by clinicians and provides guideline-based recommendations and results communications to patients and providers.Ĭolorectal cancer is the second leading cause of cancer death worldwide. Results In its first year, CoRS was used in 98.6% of indicated cases. Materials and Methods The authors developed and implemented the first electronic medical record–based colonoscopy reporting system (CoRS) that matches endoscopic findings with guideline-consistent surveillance recommendations and generates tailored results and recommendation letters for patients and providers. Appropriate use of surveillance colonoscopy, post polypectomy, is a focus of healthcare reform. Objective Through colonoscopy, polyps can be identified and removed to reduce colorectal cancer incidence and mortality.
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