Utilization of Patient-Centered Digital Tools to Improve Adherence Rates for Outpatient Screening Colonoscopies in a Metropolitan Hospital

ABSTRACT

Introduction: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. Screening through stool testing or colonoscopy is the standard of care for all ages 50 to 75 years, but national rates of procedures remain sub-optimal. Digital applications i.e., frequent automated text-based reminders and assess through personal healthcare apps on smartphones, can be effective tools to overcome barriers to screening colonoscopy adherence thus improving the outcomes. Method(s) We performed a retrospective study on a prospectively maintained database on CRC screening adherence rates from July 2019 to March 2022 in outpatient settings of a metropolitan hospital. Only screening colonoscopies (SC) scheduled during the study time period were included. Demographics and health-care resources utilization were reviewed. Primary comparison was between SC performance rates, prior to and after implementation of a digital navigation program (DNP) developed by a private company that consisted of generating automated messages containing bowel-prep instructions, appointment reminders, driving instructions, short informative procedure videos;and EPIC EMR generated personal health app called MyChart. All participants were offered access to DNP through a digital platform and MyChart app set up on their smartphones. Result(s) Total of 3584 SC were scheduled during the study period. Overall age was 6069.6 years and majority were males at 55%;Hispanics were 49% with Not Hispanics at 24%. Pre-intervention period (n51057), 48% of SC performed and 52% cancelled;and in post-intervention period (n52527), 85% SC performed with 15% cancelled (p< .001) with a percent change of 74% increase in procedures. In postintervention group< DNP enrolled 930 patients of which 87% presented for procedure. Patients who did not present, received additional reminders. Bowel prep between groups showed no significant difference in quality (Table). Conclusion(s) Our study highlights a significant increase in performance rates of scheduled screening colonoscopies with a 74% increase after implementation of a DNP and MyChart app utilization. Usefulness of digital applications in improving screening colonoscopy adherence and reducing no show rates, has been well studied in literature with promising results, but implementation on a larger scale is lacking. Especially after COVID-19 pandemic, use of technology to increase adherence to CRC screening and surveillance seems more warranted.