Tracking Abnormal Cervical Cancer Screening: Evaluation of an EMR-Based Intervention
| Autor: | Jerome E. Sobieraj, Elizabeth A. Dupuis, Hilary F. White, Karen M. Freund, Manjusha Gokhale, Daniel Newman |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Urban Population Reminder Systems Uterine Cervical Neoplasms Cervical cancer screening Young Adult Intervention (counseling) Internal Medicine medicine Carcinoma System level Electronic Health Records Humans Young adult Early Detection of Cancer Vaginal Smears Cervical cancer Gynecology Obstetrics business.industry Cancer Continuity of Patient Care Uterine Cervical Dysplasia medicine.disease Clinical trial Carcinoma Squamous Cell Female Original Article business Delivery of Health Care |
| Zdroj: | Journal of General Internal Medicine. 25:575-580 |
| ISSN: | 1525-1497 0884-8734 |
| DOI: | 10.1007/s11606-010-1287-z |
| Popis: | System level barriers have been associated with inadequate follow-up of abnormal cervical cytology.The aim of this study was to develop and evaluate an electronic tracking system to improve follow-up of abnormal Pap tests.We implemented an electronic medical record (EMR)-based Pap test tracking system at two clinical practices at an inner-city academic health center. The system generated a provider-specific monthly report of all abnormal Pap results, and provided a patient-specific Pap tracking table embedded in the EMR for each subject.We compared abnormal Pap test follow-up rates for the 24 months pre-intervention with rates 12 months following its implementation (post-intervention). The evaluation followed all subjects for 12 months from the date of their abnormal Pap test, looking for diagnostic resolution.Subjects were young women (mean age = 30.5) of primarily white (42%) and African American (37%) descent, who spoke English (88%). Forty-eight percent were insured through publicly subsidized insurance. Controlling for type of abnormality and practice location, the adjusted mean time to resolution decreased significantly from 108 days (confidence interval, CI 105-112 days) in the pre-intervention period to 86 days (CI 81-91 days).Our study cannot demonstrate that with follow up, we directly avoided cases of invasive cervical cancer. However, we show that in an at-risk urban population, an automated, EMR-based tracking system reduced the time to resolution, and increased the number of women who achieved diagnostic resolution. |
| Databáze: | OpenAIRE |
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