IMPACT OF HEALTHCARE PROVIDER OUTREACH ON COLOGUARD TEST COMPLETION RATES IN PRIMARY CARE

Document Type

Conference Proceeding

Publication Date

7-17-2025

Publication Title

J Gen Intern Med

Keywords

adult, aged, cohort analysis, colonoscopy, colorectal cancer, colorectal cancer detection kit, conference abstract, controlled study, electronic medical record, female, health care personnel, human, major clinical study, male, medical student, primary medical care, voice mail

Abstract

BACKGROUND: Colorectal cancer (CRC) screening is a critical component of preventive healthcare, and stool-based tests such as Cologuard have provided patients at average-risk of colorectal cancer with a non-invasive option for screening. However, the completion rates for Cologuard testing remain suboptimal. Healthcare provider outreach, including phone calls and Electronic Medical Record (EMR) portal messaging, has been proposed as a strategy to improve test completion rates, yet its effectiveness for tests already ordered but not completed in the primary care setting is not well known. This study aims to evaluate whether healthcare provider outreach increases the completion rates of Cologuard tests in patients who had previously been ordered the test but had not completed it. METHODS: This is a prospective cohort study conducted within a large academic internal medicine practice in an urban medical center with insured patients. The study included patients who were ordered a Cologuard test between 1/1/2023 and 12/31/2023 but had not completed it. Information on the type of healthcare provider outreach and whether the patient was reached by phone, EMR portal message, or a voicemail was left, was manually recorded into a dataset spreadsheet stored securely on the cloud. The primary outcome was Cologuard test completion, defined as the successful submission of a completed test to the laboratory. RESULTS: A total of 263 patients met study criteria. Of those, 5 were excluded as they completed a colonoscopy. Of the 258 remaining patients included, 112 (43%) were reviewed and/or contacted by residents and 146 (57%) by medical students. By the time contact with patients was made, 27 (10.5%) had already completed their Cologuard test, and thus did not require outreach and were not included in the final analysis. Of the remaining 231 patients, 124 (54%) were sent a MyChart portal message or left a voicemail. Of the 107 (46%) patients reached via phone, 91 (86%) expressed interest in completing the Cologuard and the remaining 16 (14%) did not. Of the 91 who expressed interest in completing, 1 1 (12%) completed the Cologuard. Of the 16 who did not express interest, 3 (19%) ended up completing the Cologuard. Out of the 231 patients identified, 10 (4%) needed new kits ordered due to prior kit expiring. A total of 29 (12.5%) completed the Cologuard kit after outreach was made. Of the 29 patients who completed their Cologuard, 14 of them were reached on the phone. The other 15 had contact through a MyChart message or voicemail. CONCLUSIONS: Healthcare provider outreach to patients who were overdue for Cologuard test completion led to a small increase in completion of Cologuard. Interestingly, patients expressing desire to complete Cologuard was not associated with an increased completion rate compared to those who did not express desire to complete Cologuard.

Volume

40

First Page

S818

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