Regular reminders for health care providers and patients to schedule preventative health screening tests and procedures resulted in improved provider performance in ordering overdue preventative screening for primary care patients, according to research published in the September special issue "Emerging Models of Care and Payment Delivery" of the Journal for Healthcare Quality, the peer-reviewed publication of the National Association for Healthcare Quality (NAHQ), www.nahq.org.
The purpose of this study, conducted by researchers at Texas Tech University and the University of Texas, was to evaluate the results of a 2011 quality improvement initiative in preventative clinical services adopted for 11 primary care clinics operated by the Austin (Tex.) Regional Clinic, a multicenter primary-care provider. Principle interventions included hiring care coordinators and utilizing a care-gap summary tool. The summary included recommended preventative healthcare services and served as a prompt for clinicians. Also, the care coordinator reminded patients to visit the clinic for needed preventative services, such as diabetic eye exams, mammography and colon cancer screening.
It is estimated that increased use of preventative screening could avert the loss of 2 million life years annually and save $3.7 billion, and health care costs will continue to escalate without commitment to prevention and reduction of long-term chronic illness. In an accountable care environment, preventative-care performance is essential for providing high-quality, low-cost care with consistent positive outcomes.
Results of the study showed that patient and provider reminders are an effective strategy for increasing provider identification of screening needs. Providers responded positively to the interventions and appreciated the roles played by medical assistants and nurses in preparing the documentation needed to identify patient screening needs. One of the most effective process improvements was to charge medical assistants and nurses with responsibility to prepare paperwork for ordering preventative screening tests and procedures and attach the documents to the patient record prior to the office visit and physical examination.
"A main factor in the success of this initiative was support from administration, information technology and the medical staff to work on development and information systems. The medical staff was involved from the start of the initiative and was open to participating in the process improvements and systems changes required to implement the care-gap summary," the authors concluded.
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