The Use of the Whole Primary-Care Team, Including Community Health Workers, to Achieve Success in Increasing Colon Cancer Screening Rate

The National Colorectal Cancer Roundtable, an organization cofounded by the American Cancer Society and the Centers for Disease Control and Prevention, has set an aggressive goal to achieve an 80% colon cancer screening rate by the year 2018 to reduce the burden of colon cancer in the United States. This goal is in alignment with the primary care movement to focus on prevention and population health. However, colon cancer screening has been proven as an especially challenging preventive measure to get traction on with patients. Oakland Family Medicine, a medium primary care practice in Maine, has engaged in a quality improvement project to increase the colon cancer screening rates from 28%, when the project started, to 80.3%. To achieve these results, it required a redesign of the primary care team, including the use of team extenders like community health workers. In addition, it requires understanding the data and its flaws, knowing the workflow and working to simplify it, and finally, to be clear what problem you are trying to solve. The Oakland Family Medicine project shows that closing the gaps in care for colon cancer screening is not only possible but that the new national goal is attainable also.