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Colorectal Cancer Screening with Programmatic Mass Mailed FIT

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Screening is proven to reduce mortality from colorectal cancer (CRC), the second leading cause of cancer death in the United States. Unfortunately, hundreds of thousands of Veterans are not up to date with screening. To expand access to life-saving screening, the VHA has launched an effort to mail Fecal Immunochemical Test (FIT) kits for CRC screening directly to Veterans so that they can complete screening from the comfort of their homes.

We believe our FIT-first approach, modeled after the successful Kaiser Permanente program, will increase CRC screening adherence, reduce overall costs, increase colonoscopy access for Veterans with the highest risk for CRC, and ultimately save lives.

This innovation is scaling widely with the support of national stakeholders. See more scaling innovations.

Origin:

February 2021, VISN-21

Adoptions:

36 successful, 19 in-progress

Awards and Recognition:

SCOPY Award Winner, American College of Gastroenterology, Diffusion of Excellence Promising Practice, VHA Shark Tank Winner

Partners:

Gastroenterology and Hepatology, Office of Primary Care, Oncology, Pathology and Laboratory Medicine Service

Contact Team

Overview

Problem

Colorectal cancer (CRC) is the second leading cause of cancer death in the United States, but screening is proven to reduce incidence and mortality. Unfortunately, hundreds of thousands of Veterans remain unscreened.

Links

Solution

In partnership with the National Gastroenterology Program Office, staff from the Sierra Pacific Network (VISN 21) piloted a mailed fecal immunochemical test (FIT) program at the Fresno and Las Vegas Health Care Systems, subsequently expanded to all facilities in the VISN, and is now the model for VHA-wide expansion efforts.
The program is designed to suppo
... See more

Links

Results

During the Fresno pilot, 44.7% of Veterans returned their FIT kit.
In Las Vegas, 43.1% of Veterans returned their FIT kit, of whom.
Since VISN-wide implementation, VISN 21 has seen an increase in their overall Colorectal Cancer Screening rates (as measured by eQM).
Nationally, return rates have varied but average 34%.

Diffusion tracker

Does not include Clinical Resource Hubs (CRH)

Statuses

AL: Tuscaloosa VA Medical Center (Tuscaloosa) AR: John L. McClellan Memorial Veterans' Hospital (Little Rock, Arkansas) AZ: Carl T. Hayden Veterans' Administration Medical Center (Phoenix, Arizona) CA: Fresno VA Medical Center (Fresno)
  • Started adoption on 02/2021.
CA: Palo Alto VA Medical Center (Palo Alto, California) CA: Sacramento VA Medical Center (Sacramento) CA: San Francisco VA Medical Center (San Francisco) CA: Tibor Rubin VA Medical Center (Long Beach) CT: West Haven VA Medical Center (West Haven) HI: Spark M. Matsunaga Department of Veterans Affairs Medical Center (Honolulu) IA: Iowa City VA Medical Center (Iowa City, Iowa) IL: Edward Hines Junior Hospital (Hines) IL: Marion VA Medical Center (Marion, Illinois) IN: Richard L. Roudebush Veterans' Administration Medical Center (Indianapolis, Indiana) KS: Colmery-O'Neil Veterans' Administration Medical Center (Topeka) KS: Robert J. Dole Department of Veterans Affairs Medical and Regional Office Center (Wichita) MI: Battle Creek VA Medical Center (Battle Creek) MI: Oscar G. Johnson Department of Veterans Affairs Medical Facility (Iron Mountain) MN: Minneapolis VA Medical Center (Minneapolis, Minnesota) MO: Harry S. Truman Memorial Veterans' Hospital (Columbia, Missouri) MO: John J. Pershing Veterans' Administration Medical Center (Poplar Bluff) MO: Kansas City VA Medical Center (Kansas City, Missouri) MO: St. Louis VA Medical Center-Jefferson Barracks (St. Louis Jefferson Barracks) MS: G.V. (Sonny) Montgomery Department of Veterans Affairs Medical Center (Jackson, Mississippi) NV: Ioannis A. Lougaris Veterans' Administration Medical Center (Reno) NV: North Las Vegas VA Medical Center (North Las Vegas) NY: Northport VA Medical Center (Northport) NY: Syracuse VA Medical Center (Syracuse) OH: Chalmers P. Wylie Veterans Outpatient Clinic (Columbus, Ohio) OH: Chillicothe VA Medical Center (Chillicothe) OR: Portland VA Medical Center (Portland, Oregon) PA: Corporal Michael J. Crescenz Department of Veterans Affairs Medical Center (Philadelphia, Pennsylvania) PA: Erie VA Medical Center (Erie) RI: Providence VA Medical Center (Providence) TX: Thomas E. Creek Department of Veterans Affairs Medical Center (Amarillo) VA: Richmond VA Medical Center (Richmond, Virginia)

There are no unsuccessful adoptions for this innovation.

Implementation

Departments

  • Gastroenterology
  • Logistics
  • Laboratory and pathology
  • Primary care

Core Resources

Resource type Resource description
PEOPLE
  • VISN-level champions

Contact

Comment

Comments and replies are disabled for retired innovations and non-VA users.

VA User (Licensed Practical Nurse, BECVAMC) posted

i would also like more information in adopting this innovation

VA User (Chief Nurse Ambulatory Care) posted

I would to hear an update on this and how to adopt this innovation

VA User (PROGRAM MANAGER) Innovation adopter posted

I want to adopt this innovation

1
VA User (VISN 4 CRH Director) posted

We would be interested to hear an update on how other facilities are doing ni adopting this innovation.

VA User (Associate Chief Consultant for Preventive Medicine) posted

The National Center for Health Promotion is excited about this innovation which provides a highly scalable, evidence-based strategy for enhancing Colorectal Cancer (CFC) Screening, reducing the backlog of Veterans who are due for CRC screening, and ultimately reducing morbidity and mortality due to CRC. This innovation builds upon existing VHA resources and offers a highly cost-efficient approach that also reduces burden on front-line clinicians who are struggling to address care needs of Veterans during the pandemic. The developers of this intervention have created incredibly useful tools for educating Veterans and making it easy for them to participate in screening. This innovation should be adopted enterprise wide - ideally coordinated at the VISN level!

3

About

Original team

Chris Moore, MPH

National Program Manager

Jason Dominitz, MD, MHS

Executive Director, National Gastroenterology and Hepatology Program