Author:
Jones Blake,Scott Frank I.,Espinoza Jeannine,Laborde Sydney,Chambers Micah,Wani Sachin,Edmundowicz Steven,Austin Gregory,Pell Jonathan,Patel Swati G.
Abstract
AbstractMeasuring the adenoma detection rate (ADR) is critical to providing quality care, however it is also challenging. We aimed to develop a tool using pre-existing electronic health record (EHR) functions to accurately and easily measure total ADR and to provide real-time feedback for endoscopists. We utilized the Epic EHR. With the help of an Epic analyst, using existing tools, we developed a method by which endoscopy staff could mark whether an adenoma was detected for a given colonoscopy. Using these responses and all colonoscopies performed by the endoscopist recorded in the EHR, ADR was calculated in a report and displayed to endoscopists within the EHR. One endoscopist piloted the tool, and results of the tool were validated against a manual chart review. Over the pilot period the endoscopist performed 145 colonoscopies, of which 78 had adenomas. The tool correctly identified 76/78 colonoscopies with an adenoma and 67/67 of colonoscopies with no adenomas (97.4% sensitivity, 100% specificity, 98% accuracy). There was no difference in ADR as determined by the tool compared to manual review (53.1% vs. 53.8%, p = 0.912). We successfully developed and pilot tested a tool to measure ADR using existing EHR functionality.
Funder
Anschutz Medical Campus, University of Colorado
Foundation for the National Institutes of Health
Publisher
Springer Science and Business Media LLC
Reference23 articles.
1. Richardson, L., Tai, E., Rim, S. H., Joseph, D. & Plescia, M. Vital signs: Colorectal cancer screening, incidence, and mortality–United States, 2002–2010. MMWR Morb. Mortal Wkly. Rep. 60(26), 884–889 (2011).
2. Pohl, H. & Robertson, D. J. Colorectal cancers detected after colonoscopy frequently result from missed lesions. Clin. Gastroenterol. Hepatol. 8(10), 858–864 (2010).
3. Kaminski, M. F. et al. Quality indicators for colonoscopy and the risk of interval cancer. N. Engl. J. Med. 362(19), 1795–1803 (2010).
4. Corley, D. A. et al. Adenoma detection rate and risk of colorectal cancer and death. N. Engl. J. Med. 370(14), 1298–1306 (2014).
5. Keswani, R. N. et al. Physician report cards and implementing standards of practice are both significantly associated with improved screening colonoscopy quality. Am. J. Gastroenterol. 110(8), 1134–1139 (2015).
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