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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:

101 successful, 25 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

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.

Videos

'Stay Ahead' CRC Screening Public Service Announcement

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

Since implementation, sites and networks with active programmatic mailed FIT have seen an increase in overall CRC screening rates,
Nationally, mailed FIT return rates have varied but average 34%.

Diffusion tracker

Does not include Clinical Resource Hubs (CRH)

Statuses

AL: Birmingham VA Medical Center (Birmingham, Alabama) AL: Central Alabama VA Medical Center-Montgomery (Montgomery) 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) AZ: Tucson VA Medical Center (Tucson) CA: Fresno VA Medical Center (Fresno)
  • Started adoption on 02/2021.
CA: Jennifer Moreno Department of Veterans Affairs Medical Center (San Diego, California) CA: Jerry L. Pettis Memorial Veterans' Hospital (Loma Linda, California) 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) CA: West Los Angeles VA Medical Center (West Los Angeles) CT: West Haven VA Medical Center (West Haven) DE: Wilmington VA Medical Center (Wilmington, Delaware) FL: Bruce W. Carter Department of Veterans Affairs Medical Center (Miami) FL: James A. Haley Veterans' Hospital (Tampa, Florida) FL: Malcom Randall Department of Veterans Affairs Medical Center (Gainesville) FL: Orlando VA Medical Center (Orlando) GA: Augusta VA Medical Center-Uptown (Augusta Uptown) GA: Carl Vinson Veterans' Administration Medical Center (Dublin) GA: Charlie Norwood Department of Veterans Affairs Medical Center (Augusta Downtown) HI: Spark M. Matsunaga Department of Veterans Affairs Medical Center (Honolulu) IA: Des Moines VA Medical Center (Des Moines, Iowa) IA: Iowa City VA Medical Center (Iowa City, Iowa) IL: Edward Hines Junior Hospital (Hines) IL: Marion VA Medical Center (Marion, Illinois) IN: Fort Wayne VA Medical Center (Fort Wayne) IN: Marion VA Medical Center (Marion, Indiana) IN: Richard L. Roudebush Veterans' Administration Medical Center (Indianapolis, Indiana) KS: Colmery-O'Neil Veterans' Administration Medical Center (Topeka) KS: Dwight D. Eisenhower Department of Veterans Affairs Medical Center (Leavenworth) KS: Robert J. Dole Department of Veterans Affairs Medical and Regional Office Center (Wichita) KY: Cincinnati VA Medical Center-Fort Thomas (Cincinnati Fort Thomas) KY: Robley Rex Department of Veterans Affairs Medical Center (Louisville) LA: New Orleans VA Medical Center (New Orleans) MA: Edith Nourse Rogers Memorial Veterans' Hospital (Bedford) MA: Edward P. Boland Department of Veterans Affairs Medical Center (Central Western Massachusetts) MA: West Roxbury VA Medical Center (West Roxbury) MI: Aleda E. Lutz Department of Veterans Affairs Medical Center (Saginaw, Michigan) MI: Battle Creek VA Medical Center (Battle Creek) MI: Detroit VA Medical Center-Valor Center (Detroit Valor Center) MI: John D. Dingell Department of Veterans Affairs Medical Center (Detroit) MI: Lieutenant Colonel Charles S. Kettles VA Medical Center (Ann Arbor) MI: Oscar G. Johnson Department of Veterans Affairs Medical Facility (Iron Mountain) MN: Minneapolis VA Medical Center (Minneapolis, Minnesota) MN: St. Cloud VA Medical Center (St. Cloud) 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: Biloxi VA Medical Center (Biloxi) MS: G.V. (Sonny) Montgomery Department of Veterans Affairs Medical Center (Jackson, Mississippi) NC: Durham VA Medical Center (Durham) ND: Fargo VA Medical Center (Fargo) NE: Omaha VA Medical Center (Omaha, Nebraska) NH: Manchester VA Medical Center (Manchester) NJ: East Orange VA Medical Center (East Orange) NM: Raymond G. Murphy Department of Veterans Affairs Medical Center (Albuquerque) NV: Ioannis A. Lougaris Veterans' Administration Medical Center (Reno) NV: North Las Vegas VA Medical Center (North Las Vegas) NY: Batavia VA Medical Center (Batavia) NY: Bath VA Medical Center (Bath) NY: Brooklyn VA Medical Center (Brooklyn) NY: Buffalo VA Medical Center (Buffalo, New York) NY: Canandaigua VA Medical Center (Canandaigua) NY: Castle Point VA Medical Center (Castle Point) NY: James J. Peters Department of Veterans Affairs Medical Center (Bronx) NY: Northport VA Medical Center (Northport) NY: Samuel S. Stratton Department of Veterans Affairs Medical Center (Albany, New York) NY: Syracuse VA Medical Center (Syracuse) OH: Chalmers P. Wylie Veterans Outpatient Clinic (Columbus, Ohio) OH: Chillicothe VA Medical Center (Chillicothe) OH: Dayton VA Medical Center (Dayton) OH: Louis Stokes Cleveland Department of Veterans Affairs Medical Center (Cleveland, Ohio) OR: Portland VA Medical Center (Portland, Oregon) PA: Butler VA Medical Center (Butler New Castle Road) PA: Corporal Michael J. Crescenz Department of Veterans Affairs Medical Center (Philadelphia, Pennsylvania) PA: Erie VA Medical Center (Erie) PA: James E. Van Zandt Veterans' Administration Medical Center (Altoona) PA: Lebanon VA Medical Center (Lebanon) PA: Pittsburgh VA Medical Center-University Drive (Pittsburgh) RI: Providence VA Medical Center (Providence) SC: Ralph H. Johnson Department of Veterans Affairs Medical Center (Charleston, South Carolina) SC: Wm. Jennings Bryan Dorn Department of Veterans Affairs Medical Center (Columbia, South Carolina) SD: Fort Meade VA Medical Center (Fort Meade, South Dakota) SD: Hot Springs VA Medical Center (Hot Springs, South Dakota) SD: Royal C. Johnson Veterans' Memorial Hospital (Sioux Falls) TN: Alvin C. York Veterans' Administration Medical Center (Murfreesboro) TN: James H. Quillen Department of Veterans Affairs Medical Center (Mountain Home, Tennessee) TN: Nashville VA Medical Center (Nashville) TX: Audie L. Murphy Memorial Veterans' Hospital (San Antonio, Texas) TX: Dallas VA Medical Center (Dallas) TX: Harlingen VA Clinic (Harlingen) TX: Thomas E. Creek Department of Veterans Affairs Medical Center (Amarillo) UT: George E. Wahlen Department of Veterans Affairs Medical Center (Salt Lake City) VA: Hampton VA Medical Center (Hampton) VA: Richmond VA Medical Center (Richmond, Virginia) VA: Salem VA Medical Center (Salem, Virginia) WA: Seattle VA Medical Center (Seattle)

AR: Fayetteville VA Medical Center (Fayetteville, Arkansas) AZ: Bob Stump Department of Veterans Affairs Medical Center (Prescott) CO: Grand Junction VA Medical Center (Grand Junction, Colorado) DC: Washington VA Medical Center (Washington, District of Columbia) FL: C.W. Bill Young Department of Veterans Affairs Medical Center (Bay Pines) FL: West Palm Beach VA Medical Center (West Palm Beach) GA: Joseph Maxwell Cleland Atlanta VA Medical Center (Atlanta, Georgia) IL: Danville VA Medical Center (Danville, Illinois) IL: Jesse Brown Department of Veterans Affairs Medical Center (Chicago, Illinois) KY: Franklin R. Sousley Campus (Lexington Leestown) KY: Troy Bowling Campus (Lexington Cooper) LA: Alexandria VA Medical Center (Alexandria, Louisiana) LA: Overton Brooks Veterans' Administration Medical Center (Shreveport) MD: Baltimore VA Medical Center (Baltimore) NC: Charles George Department of Veterans Affairs Medical Center (Asheville) NC: Fayetteville VA Medical Center (Fayetteville, North Carolina) NC: W.G. (Bill) Hefner Salisbury Department of Veterans Affairs Medical Center (Salisbury) PA: Coatesville VA Medical Center (Coatesville) PA: Wilkes-Barre VA Medical Center (Wilkes-Barre) PR: San Juan VA Medical Center (San Juan) TN: Lt. Col. Luke Weathers, Jr. VA Medical Center (Memphis) TX: George H. O'Brien, Jr., Department of Veterans Affairs Medical Center (Big Spring) TX: Michael E. DeBakey Department of Veterans Affairs Medical Center (Houston) TX: Olin E. Teague Veterans' Center (Temple) WI: Clement J. Zablocki Veterans' Administration Medical Center (Milwaukee, Wisconsin)

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

Links

  • Use this PowerBI Dashboard to identify populations of Veterans at average risk for CRC and overdue for screening Cohort Identification Tool
  • Use this dashboard to monitor and evaluate FIT-based screening in your VISN/Facility, including diagnostic colonoscopies completed after an abnormal FIT FIT Process of Care Dashboard

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

Associate Director for Operations, National Colorectal Cancer Screening Program

Jason Dominitz, MD, MHS

Executive Director, National Gastroenterology and Hepatology Program

Douglas Robertson, MD, MPH

Deputy Director, National Colorectal Cancer Screening Program

Anita Patil, MD

Deputy Director, National Colorectal Cancer Screening Program