June 29, 2016

FQHC and Hospital Partnership Aims to Increased Colorectal Screening Utilizing Cross Training and Team Approach


Karen Kim, M.D., discusses CRC Screening during the CRC walkthrough training session attended by Heartland Health Centers Integrated Care Specialists at the University of Chicago Hospitals.

Colorectal Cancer (CRC) is now the second leading cause of death and the third most common cancer. In Illinois, it appears that between 61 and 68 % of the age eligible population has had CRC screening. Heartland Health Centers is one of three Federally Qualified Health Centers (FQHC’s) that has partnered with the University of Chicago Medicine’s Center for Asian Health Equity(CAHE) to form the Cook County Cancer Alliance to Reignite and Enhance Screening (CARES) program. “The goal is   to systematically increase colorectal screening rates among Asian, African American and Hispanic minorities living in metro Chicago and Illinois through the implementation of evidence based interventions(EBI), says Dr. Karen Kim, Gastroenterologist and Director of both the CAHE and the CARES initiative.

Heathland Health Centers through the implementation process within the CARES partnership has opted to provide cross training of all medical staff involved in patient centered programs. “Our Integrated Care Specialists, work closely with the CARES Program Director on implementation of the EBI’s, “says Dr. Dave Freedman, Medical Director. “The CARES team works with Heartland medical professionals at all levels to provide technical support as needed with all aspects of this program including: health system assessment; establishing baseline data; assessment / documentation of clinic work-flow and patient-flow processes; implementation of evidence based interventions; provider and staff training; and ongoing evaluation / assessment.”

“The Integrated Care Specialists provide leadership for the program within the clinic site” says Arely Gasca, Lead Integrated Care Specialist. “Through the CARES program, we have received planning and implementation support along with financial resources to implement three (3) evidence based interventions which have been successful in raising CRC screening rates.” These interventions include: 1) Provider Reminder / pop-ups / clinician decision support: alert provider for possible screening need and raise awareness and knowledge of colorectal cancer prevention; 2) Patient Reminders – alert patients for possible screening need and raise awareness / knowledge of colorectal cancer prevention; 3) Provider Assessment and Feedback: use health information data to provide assessment reports and provider education/feedback including best practices / national guidelines on CRC screening.

The U.S. Preventive Services Task Force recommends colorectal cancer screening for men and women aged 50–75 using high-sensitivity fecal occult blood testing (FOBT), sigmoidoscopy, or colonoscopy. Early detection of colorectal cancer doesn’t have to be expensive and the tests are simple and in most cases affordable.

The CARES program plans to offer care coordinator training and individual health system CRC screening analysis for other FQHC sites across the state of Illinois this summer.

By Arely Gasca, Integrated Care Specialist and David Freedman, MD, Medical Director, Heartland Health Centers
Matt Johnson, MPH, CARES Director, and Fornessa Randal, MCRP, CARES Program Manager